疏肝健脾方对2型糖尿病合并抑郁症肝郁脾虚证患者神经内分泌指标、血清簇集蛋白、AQP4、NLRP3炎性小体和esRAGE水平的影响  

Effect of Shugan Jianpi Prescription(疏肝健脾方)on Neuroendocrine Indexes,Serum Cluster Protein,AQP4,NLRP3 Inflammasome and esRAGE Levels in Patients with Type 2 Diabetes Complicated with Depression of Liver Depression and Spleen Deficiency Syndrome

作　　者：毕菲菲[1] 张冬冬 荀艳平 刘伟[2] BI Fei-fei;ZHANG Dong-dong;XUN Yan-ping;LIU Wei(Tangshan Hospital of Traditional Chinese Medicine,Tangshan Hebei 063000,China;The Second People’s Hospital of Fengrun District,Tangshan Hebei 063000,China)

机构地区：[1]唐山市中医医院,河北唐山063000 [2]唐山市丰润区第二人民医院,河北唐山063000

出　　处：《中医药导报》2021年第3期86-90,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河北省中医药管理局科研计划项目(2019235)。

摘　　要：目的:分析疏肝健脾方对2型糖尿病合并抑郁症肝郁脾虚证患者神经内分泌指标、血清簇集蛋白、水通道蛋白-4(AQP4)、NOD样受体热蛋白结构域相关蛋白-3(NLRP3)炎性小体、内源性分泌型糖基化终产物受体(esRAGE)水平的影响。方法:纳入84例2型糖尿病合并抑郁症肝郁脾虚证患者,随机分为对照组与治疗组各42例。对照组患者采用二甲双胍联合帕罗西汀治疗,治疗组患者在此基础上联用疏肝健脾方治疗。连续治疗3个月后,对两组患者治疗前后各项生化指标进行对比分析。结果:治疗后,治疗组患者空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbAlc)、HAMD评分、促肾上腺皮质激素(ACTH)、皮质醇(COR)水平均明显低于对照组(P<0.05);两组患者促甲状腺激素(TSH)、游离型甲状腺素(FT4)、游离型三碘甲状腺原氨酸(FT3)水平比较,差异均无统计学意义(P>0.05);治疗组患者簇集蛋白、AQP4、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、单个核细胞(PBMCs)中NLRP3mRNA、ASC mRNA、Caspase-1 mRNA表达水平均明显低于对照组(P<0.05),esRAGE水平明显高于对照组(P<0.05)。结论:疏肝健脾方可以调节2型糖尿病合并抑郁症肝郁脾虚证患者神经内分泌功能,提高机体血糖控制水平,改善患者抑郁情绪状态,其机制可能与下调NLRP3炎性小体mRNA表达、上调esRAGE水平有关。Objective:To analyze the effects of Shugan Jianpi Prescription on the levels of neuroendocrine indexes,serum cluster protein,hydro-channel protein-4(AQP4),Nod-like receptor thermal protein-3(NLRP3)inflammasome,and endogenous secretion glycyrylation end product receptor(esRAGE)in patients with type 2 diabetes complicated with depression of liver depression and spleen deficiency syndrome.Methods:A total of 84 patients with type 2 diabetes complicated with depression of liver depression and spleen deficiency syndrome were selected as study subjects.The patients were divided into control and treatment groups,with 42 patients in each group.The control group was treated with metformin and paxil,and the treatment group was treated with Shugan Jianpi Prescription on this basis.The biochemical indexes were compared between the two groups in three months.Results:After treatment,the treatment group showed lower fasting blood glucose(FBG),2 h postpranational blood glucose(2 h PBG),Hb Alc,HAMD,ACTH and COR than control group(P<0.05).There was no significant difference in the levels of TSH,FT4 and FT3 between the two groups(P>0.05).The treatment group showed lower cluster protein,AQP4,interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-18(IL-18)and expression levels of NLRP3 m RNA,ASC m RNA and Caspase-1 m RNA in mononuclear cells(PBMCs)than control group(P<0.05),while higher level of es RAGE than control group(P<0.05).Conclusion:Shugan Jianpi Prescription can regulate the neuroendocrine function of patients with type 2 diabetes complicated with depression of liver depression and spleen deficiency syndrome,improve the body’s blood glucose control level,and relieve patients’depressed mood state.The mechanism may be related to the down-regulation of NLRP3 inflamsmome m RNA expression and up-regulation of esRAGE level.

关 键 词：2型糖尿病 抑郁症 肝郁脾虚证 疏肝健脾方 NOD样受体热蛋白结构域相关蛋白-3炎性小体 内源性分泌型糖基化终产物受体 

分 类 号：R255.4[医药卫生—中医内科学]