经方葛根芩连汤对湿热型糖尿病的口腔微生物学的研究  

Effect of Gegen Qinlian Decoction on Tongue Microbiota of Type 2Diabetes Patients with Dampness-heat Syndrome

作　　者：郭亚芳 陆红 曾艺鹏 马俐 顾勇刚 顾文忠 

机构地区：[1]上海市浦东医院复旦大学附属浦东医院中医科,上海220120

出　　处：《四川中医》2017年第11期105-108,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市普东新区名中医继承培养项目(编号:PD2YXK-6-2014027);上海市基层名老中医专家传承研究工作室建设项目(编号:JCZYGZS-001)

摘　　要：目的:观察葛根芩连汤加味对湿热型糖尿病的口腔微生物的影响。方法:选取我院中医科和内分泌科2015年10月~2017年3月收治的120例的2型糖尿病患者作为研究对象,根据辨证将120例患者分为2组,试验组(湿热组)和对照组(非湿热组),每组60例。对照组给予常规降糖西药治疗,试验组在常规降糖方案的基础上联合葛根芩连汤中药治疗,经过4周的治疗,观察两组治疗前后中医症候评分变化,西医生化指标变化以及两组治疗前后,两组之间舌苔菌群的区别。探讨葛根芩连汤加味对湿热型糖尿病的口腔微生物的影响。结果:试验组中医症候评分(91.67%>76.67%)和西医总体疗效均高于对照组(86.87%>63.33%),差异有统计学意义(P<0.05)。两组患者在舌苔菌群结构(种类)上比较无明显差异,治疗后两组患者的Fusobacteria(梭杆菌属)以及Streptococcus(链球菌属)含量均较治疗前降低,试验组含有Streptococcus阳性率(13.21±1.01)低于对照组(33.21±1.31),差异有统计学意义(P<0.05)。试验组含有Fusobacteria阳性率(32.21±2.01)高于对照组(12.21±1.01),差异有统计学意义(P<0.05)。试验组Streptococcus)水平与湿热评分减分率呈负相关(r=-0.430,P=0.002);试验组Fusobacterium含量与湿热评分减分率成正相关(r=0.421,P=0.003);对照组Streptococcus含量与湿热评分减分率成正相关(r=0.236,P=0.042);对照组Fusobacterium含量与湿热评分减分率成正相关(r=0.136,P=0.023)。试验组Streptococcus)水平与血糖降低值呈负相关(r=-0.612,P=0.021);试验组Fusobacterium含量与血糖降低值成正相关(r=0.513,P=0.004);而对照组Streptococcus含量与血糖降低值成正相关(r=0.369,P=0.031);对照组Fusobacterium含量与血糖降低值成正相关(r=0.305,P=0.016)。结论:中药葛根芩连汤联合西药二甲双胍治疗湿热证2型糖尿病,疗效显著,Fusobacterium和Streptococcus水平变化可作为湿热证2型糖尿病患者疗效评估的微生物指标。Objective： To study the effect of Gegen Qinlian Decoction on tongue microbiota of type 2diabetes patients with dampness-heat syndrome. Methods： 120cases type 2diabetes patients with dampness- heat syndrome in our hospital from 2015October to 2017March were chose, and were divided into experiment group （60cases） and controlled group （60cases）. The experiment group was treated with Gegen Qinlian Decoction combined with routine hypoglycemic agents. The controlled group was treated with routine hypoglycemic agents. The effect of Gegen Qinlian Decoction on tongue microbiota was tested in the two groups. Results： The total TCM symptom grade effective rate in the experiment group was obviously higher than that in the con- trolledgroup （91.67% 〉76. 67 % ） （P〈0. 05）. The total biochemical indicator of west medicine in the experiment group was ob- viously than the controlled group （86. 87% 〉63.33% ） （P〈0. 05）. The positive rate of Streptococcus in the experiment group （13.21±1.01） was obviously lower than the controlled group （33.21±1.31） （P〈0. 05）. The positive rate of Fusobacterium in the experiment group （ 32. 21 ±2. 01 ） was obviously higher than the controlled group （ 12. 21 ± 1.01 ） （ P〈0. 05 ）. Spearman re- sults showed that, in the experiment group, there were positive correlations between Fusobacterium and the reduction rate of dampness-heat syndrome （r=0. 421, P=O. 003 ）. However, there were negative correlations between Streptococcus and the re- duction rate of dampness-heat syndrome （r=-0. 430, P= 0. 002）. The same there were positive correlations between Fusobac- terium and the reduction level of blood sngar （ r = 0. 513, P = 0. 004）. However, there were negative correlations between Strep- tococcus and the reduction level of blood sugar （r =-0. 612, P= 0. 021 ）. Conclusion： Using Gegen Qinlian Decoction combined with Metformin in the treatment of type 2diabetes patients with dampness-heat syndrome has good curative effect.

关 键 词：葛根芩连汤 湿热证 糖尿病 口腔微生物学 

分 类 号：R287.1[医药卫生—中药学]