降糖解郁汤治疗2型糖尿病共病抑郁患者临床疗效及机制分析  

Analysis of efficacy and mechanism of Jiangtang Jieyu Decoction for type 2 diabetes complicated by depression in patients

作　　者：王京贤 张春平 墨亚芳 赵静[2] 杜秀芳 WANG Jingxian;ZHANG Chunping;MO Yafang;ZHAO Jing;DU Xiufang(Department of Mental Hygiene,Shijiazhuang Maternity&Child Healthcare Hospital,Hebei,Shijiazhuang 050051;不详)

机构地区：[1]河北省石家庄市妇幼保健院精神卫生科,河北石家庄050051 [2]河北省石家庄市第八医院精神卫生科,河北石家庄050051 [3]河北省石家庄市妇幼保健院产一科,河北石家庄050051

出　　处：《河北中医》2021年第3期399-403,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2018年度中医药类科研计划项目(编号:2018243)。

摘　　要：目的观察降糖解郁汤治疗2型糖尿病共病抑郁的临床疗效。方法将120例2型糖尿病共病抑郁患者按照随机数字表法分为2组。对照组60例予盐酸帕罗西汀片口服治疗,治疗组60例在对照组治疗基础上联合降糖解郁汤治疗。2组均治疗12周。比较2组治疗前后汉密尔顿抑郁量表(HAMD)评分,血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6),促肾上腺皮质激素(ACTH)、皮质醇(COR),空腹血糖(FPG)、餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)水平,额上回、海马旁回、半卵圆中心区各向异性分数(FA)。结果治疗后2组HAMD评分均较本组治疗前降低(P<0.05),且治疗后治疗组低于对照组(P<0.05)。治疗后2组血清TNF-α、IL-6水平均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组血清ACTH、COR水平均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组FPG、2 hPG、FINS、HOMA-IR、LDL-C水平均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组额上回、海马旁回、半卵圆中心区FA均较本组治疗前升高(P<0.05),且治疗后治疗组均高于对照组(P<0.05)。结论降糖解郁汤可以促进2型糖尿病共病抑郁患者糖脂代谢水平,下调机体炎性反应,调节体内神经内分泌功能,防治脑组织神经重构,显著提高临床疗效。Objective To observe the clinical efficacy of Jiangtang Jieyu Decoction for type 2 diabetes complicated by depression.Methods Totally 120 patients with type 2 diabetes complicated by depression were randomly divided into the two groups,60 cases in the control group were treated with paroxetine hydrochloride tablets orally,and 60 cases in the treatment group was additionally treated with Jiangtang Jieyu Decoction on the basis of the control group.Both groups were treated for 12 weeks.Hamilton Depression Scale(HAMD)scores,serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),adrenocorticotropic hormone(ACTH),cortisol(COR),fasting plasma glucose(FPG),and 2 h postprandial blood glucose(2 hPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),low density lipoprotein cholesterol(LDL-C)levels,superior frontal gyrus,parahippocampal gyrus,fractional anisotropy(FA)in central semiovale were compared between two groups before and after treatment.Results Compared with before treatment,HAMD score in the both groups was decreased after treatment(P<0.05),which in the treatment group was lower than the control group(P<0.05);serum TNF-αand IL-6 after treatment in the both groups were decreased after treatment(P<0.05),which in the treatment group were lower than the control group(P<0.05);serum ACTH and COR in the both groups were decreased after treatment(P<0.05),which in the treatment group were lower than the control group(P<0.05);levels of FPG,2 hPG,FINS,HOMA-IR and LDL-C after treatment in the both groups were decreased(P<0.05),which in the treatment group were lower than the control group(P<0.05);superior frontal gyrus,parahippocampal gyrus,FA in central semiovale in the both groups were increased after treatment(P<0.05),which in the treatment group were higher than the control group(P<0.05).Conclusion For patients with type 2 diabetic complicated by depression,Jiangtang Jieyu Decoction can promote level of glucose and lipid metabolism,reduce the body's inflammatory response,regulate neuroendocrine function of the

关 键 词：糖尿病 2型 抑郁 解郁 中药疗法 

分 类 号：R587.1[医药卫生—内分泌] R749.42[医药卫生—内科学]