三黄苓术汤治疗肥胖T2DM湿热困脾证的疗效观察及对血清RBP4的影响

发布时间：2018-03-13 11:40

本文选题：肥胖2型糖尿病　切入点：湿热困脾证　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察三黄苓术汤治疗肥胖2型糖尿病(T2DM)湿热困脾证的临床疗效,及对血清视黄醇结合蛋白4(RBP4)水平的影响,探讨其可能的作用机制。方法:采用随机对照分组法,将60例符合纳入标准的肥胖T2DM患者分为治疗组和对照组,各30例。对照组采用基础治疗和常规西药治疗,治疗组在对照组基础上,加用三黄苓术汤。治疗12周后观察两组患者的中医证候、体重、腰围、BMI、FBG、2hPG、HbA1c、FHNS、HOMA-IR、血脂、视黄醇结合蛋白4(RBP4)的变化;同时完善血尿便常规,肝肾功等安全性指标检查。全部数据采用SPSS22.0版本进行统计学分析。结果:1.中医证候疗效:治疗组总有效率93.1%,对照组27.6%,两者比较,P0.01,差异有统计学意义。2.中医证候积分:治疗后两组总积分均减少,组间及组内比较,P0.01,差异有统计学意义。治疗后两组单项症状积分比较,P0.01,治疗组效果优于对照组。3.FBG、2hPG、HbA1c 水平:治疗后两组 FBG、2hPG、HbA1c 均降低,2hPG、HbA1c组间比较,P0.01,FBG组间比较,P0.05;与治疗前比较,P0.01,差异有统计学意义。治疗组降低FBG、2hPG、HbA1c效果优于对照组。4.肥胖相关指标:治疗后两组体重、腰围、BMI均降低,BMI组间比较,P0.01,体重及腰围组间比较,P0.05;与治疗前比较,P0.01,差异有统计学意义。治疗组降低体重、腰围、BMI效果优于对照组。5.FINS、HOMA-IR:治疗后两组FINS、HOMA-IR均降低,组间比较,P0.05;与治疗前比较,P0.01,差异有统计学意义。治疗组降低FINS、HOMA-IR效果优于对照组。6.血脂水平:治疗后两组TG、TC、LDL-C均下降,HDL-C均升高,组间比较,P0.05;与治疗前比较,P0.01,差异有统计学意义。治疗组降低TG、TC、LDL-C,升高HDL-C效果优于对照组。7.RBP4水平:治疗后两组RBP4均有所下降,组间比较,P0.05;与治疗前比较,治疗组P0.01,对照组P0.05,差异有统计学意义。治疗组降低RBP4效果优于对照组。8.安全性:两组治疗前后血尿便常规,肝肾功未见明显异常。结论:1.三黄苓术汤能改善肥胖T2DM湿热困脾证患者的中医证候。2.三黄苓术汤能降低肥胖T2DM湿热困脾证患者的FBG、2hPG和HbA1c水平。3.三黄苓术汤能改善肥胖T2DM湿热困脾证患者的腰围、体重和BMI。4.三黄苓术汤能降低肥胖T2DM湿热困脾证患者的FINS水平,减轻胰岛素抵抗。5.三黄苓术汤能改善肥胖T2DM湿热困脾证患者的血脂,下调TG、TC、LDL-C水平,上调HDL-C水平。6.三黄苓术汤可降低肥胖T2DM湿热困脾证患者的血清RBP4水平,这可能是其改善胰岛素抵抗的作用机制之一。
[Abstract]:Objective: to observe the clinical effect of Sanhuanglingzhu decoction in treating the syndrome of dampness and heat trapped spleen of obesity type 2 diabetes mellitus (T2DM) and its effect on the level of serum retinol binding protein 4 (RBP4), and to explore its possible mechanism. Sixty obese T2DM patients who met the inclusion criteria were divided into treatment group (n = 30) and control group (n = 30). The control group was treated with basic treatment and conventional western medicine, and the treatment group was based on the control group. After 12 weeks of treatment, the changes of TCM syndromes, body weight, waist circumference of BMI-FBGG 2hPGN HbA1cFHNS-FHNS-HOMA-IRM, serum lipids, retinol binding protein 4 (RBP4) were observed, and the routine routine of hematuria was improved. All data were statistically analyzed by SPSS22.0 version. Results: 1. Effect of TCM syndrome: the total effective rate of the treatment group was 93.1g, the control group 27.6g, the difference between the two groups was statistically significant. 2. Score: after treatment, the total score of both groups decreased, The results of treatment group were better than that of control group. 3. The level of HbA1c in the treatment group was better than that in the control group: after treatment, the levels of 2hPGN HbA1c in the two groups were lower than those in the control group (P0.01hPGHbA1c), and the difference between the two groups before treatment was significant (P < 0.05). Compared with P0.01, the difference was statistically significant. The effect of reducing FBGG 2hPGN HbA1c in the treatment group was better than that in the control group .4.Obesity related index: after treatment, the weight of the two groups was higher than that of the control group. The body weight and waist circumference of the treatment group were significantly lower than those of the control group (P 0.01, P 0.01), the effect of waist circumference BMI in the treatment group was better than that in the control group (P 0.05), and the effect of FINSHOMA-IR in the treatment group was higher than that in the control group (P < 0.05), and the effect of FINSHOMA-IR in the treatment group was higher than that in the control group (P < 0.05). The effect of decreasing FINSHOMA-IR in the treatment group was better than that in the control group. 6. The level of blood lipid: after treatment, the LDL-C of TGG and TCU in both groups decreased and HDL-C increased, and compared with that before treatment, the effect of FINSHOMA-IR in the treatment group was better than that in the control group. There was significant difference between the two groups (P 0.05, P 0.01, P 0.01). The treatment group decreased TGG TCU LDL-Cand increased the level of HDL-C than the control group. 7. RBP4 level: after treatment, the RBP4 of both groups were decreased, the comparison between the two groups was P0.05, and compared with that before treatment, there was a significant difference between the two groups, and compared with before treatment, the effect of RBP4 in the treatment group was higher than that in the control group. The effect of RBP4 reduction in the treatment group was better than that in the control group. Conclusion: W1. 3 Huang ling zhu decoction can improve the TCM syndromes of obese T2DM patients with dampness and heat stagnation spleen syndrome. 2. Sanhuangling zhu decoction can reduce the levels of FBGG 2hPG and HbA1c in obese T2DM patients with dampness and heat entrapment spleen syndrome .3. Sanhuangling decoction can improve obesity T2DM patients with damp-heat stagnation spleen syndrome. Waist circumference of obese T2DM patients with damp-heat syndrome, Body weight and BMI.4.Sanhuanglingzhu decoction can reduce the FINS level of obese T2DM patients with damp-heat syndrome, reduce insulin resistance. 5. Sanhuang Lingzhu decoction can improve the blood lipid of obese T2DM patients with dampness and heat trap spleen syndrome, and down-regulate the level of TGG-TCC+ LDL-C. Upregulation of HDL-C level. 6. Sanhuanglingzhu decoction can reduce the serum RBP4 level of obese T2DM patients with dampness and heat, which may be one of the mechanisms of improving insulin resistance.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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