大黄黄连泻心汤结合西医常规疗法治疗2型糖尿病临床研究  

Study of Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine in patients with type 2 diabetes

作　　者：李静[1] 朱海慧 庞雅玲[3] 杨瑞 王东亮 王育园 乔峰 Li Jing;Zhu Haihui;Pang Yaling;Yang Rui;Wang Dongliang;Wang Yuyuan;Qiao Feng(Department of Traditional Chinese Medicine,Shaanxi People's Hospital,Xi'an 710068,China;Department of Endocrine,Shaanxi Traditional Chinese Medicine Hospital,Xi'an 710003,China;Department of Endocrinology,Shaanxi People's Hospital,Xi'an 710068,China;Chinese Medicine Internal Medicine,Yulin Traditional Chinese Medicine Hospital,Yulin 719000,China)

机构地区：[1]陕西省人民医院中医科,西安710068 [2]陕西省中医医院内分泌科,西安710003 [3]陕西省人民医院内分泌科,西安710068 [4]陕西省榆林市中医医院中医内科,719000

出　　处：《国际中医中药杂志》2019年第12期1301-1305,共5页International Journal of Traditional Chinese Medicine

基　　金：陕西省科技计划项目(2014K14-03-08)。

摘　　要：目的评价大黄黄连泻心汤结合西医常规疗法治疗T2DM的疗效,并观察对脂代谢紊乱及肠道菌群变化的影响。方法将符合入选标准的120例患者按就诊顺序分为2组,每组60例。2组均给予常规降糖治疗,对照组在此基础上口服双歧杆菌乳杆菌三联活菌片,治疗组在对照组基础上服用大黄黄连泻心汤加减。2组均14 d为1个疗程,共治疗4个疗程。分别于治疗前后进行中医症状评分;于油镜下观察记录每500个细菌中的革兰阳性球菌(gram-positive coccus,G+c)、革兰阴性球菌(gram-negative coccus,G-c)、革兰阳性杆菌(grampositive bacillus,G+b)、革兰阴性杆菌(gram-negative bacillus,G-b)数量,计算球菌/杆菌比值;采用氧化酶法检测血清TC、TG,采用全自动生化分析仪检测血清HDL、LDL、FPG、2 hPG、HbA1c。结果治疗后,治疗组脘腹胀满、痞塞不适、大便秘结评分均低于对照组(t值分别为3.685、3.551、3.708,P值均<0.05);血清TG、TC、LDL-C水平均低于对照组(t值分别为3.602、3.581、3.421,P值均<0.05),HDL-C水平高于对照组(t=3.358,P=0.046);血清FPG、2 hPG、HbA1c水平均低于对照组(t值分别为3.502、3.271、3.708,P值均<0.05)。治疗后,治疗组G-c[(271.47±22.63)/500比(266.81±22.36)/500,t=3.792]、G+b[(81.26±6.52)/500比(73.19±6.94)/500,t=3.511]、G-b[(183.76±16.19)/500比(164.37±15.83)/500,t=3.306]数量均高于对照组(P<0.05);球菌/杆菌[(0.65±0.13)比(0.87±0.21),t=3.325]比值低于对照组(P<0.05)。结论大黄黄连泻心汤结合西医常规疗法可明显改善T2DM患者临床症状,降低血糖、血脂水平,可通过调整肠道菌群结构、增加益生菌、降低致病菌等来抑制BMI增加、改善胰岛素抵抗。Objective To evaluate the effects of the classical prescriptions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine on the lipid metabolism disorder and changes of intestinal microflora in patients with type 2 diabetes mellitus(T2DM).Methods A total of 120 patients who met the inclusion criteria were divided into the two group according to the treatment order,with 60 patients in each group.Both groups were given conventional hypoglycemic therapy,the control group was given bifidobacteria lactobacillus triple viable tablets,and the treatment group was given Dahuang-Huanglian-Xiexin decoction on the basis of the control group.Both groups were treated with 14 days for one course and 4 courses in total.The number of gram-positive coccus(G+c),gram-negative coccus(G-c),gram-positive bacillus(G+b)and gram-negative bacillus(G-b)in each 500 bacteria were observed under oil microscope,and the cocci/bacillus ratio were calculated.The TC and TG were detected by oxidase method,and HDL and LDL were detected by automatic biochemical analyzer.The FPG,2 hPG and HbA1c were detected by automatic biochemical analyzer.TCM symptom scores were calculated.Results After treatment,the abdominal distension,congestion discomfort,and constipation score were significantly lower than the control group(t values were 3.685,3.551 and 3.708,respectively,all Ps<0.05);Serum TG,TC and LDL-c levels were significantly lower than the control group(t values were 3.602,3.581 and 3.421,respectively,all Ps<0.05);HDL-c level was significantly higher than that of the control group(t=3.358,P=0.046);Serum FPG,2 hPG and HbA1c levels were significantly lower than the control group(t values were 3.502,3.271 and 3.708,respectively,all Ps<0.05).After treatment,the G-c(271.47/500±22.63/500 vs.266.81/500±22.36/500,t=3.792),G+b(81.26/500±6.52/500 vs.73.19/500±6.94/500,t=3.511),G-b(183.76/500±16.19/500 vs.164.37/500±15.83/500,t=3.306)levels in the treatment group significantly higher than those in the control group(P<0.05).After treatme

关 键 词：糖尿病 2型 脂类代谢紊乱 肠道菌群 大黄黄连泻心汤 治疗 临床研究性 

分 类 号：R58[医药卫生—内分泌]