甘草泻心汤对糖调节受损湿热蕴脾证患者血清炎症因子、脂联素、胰岛素抵抗的影响  

Effects of Gancao Xiexin Decoction on Serum Inflammatory Factors,Adiponectin and Insulin Resistance in Patients with Impaired Glucose Regulation with Damp-Heat Accumulation in Spleen Syndrome

作　　者：王炳恒[1] 陈新旺[1] 吴明阳[2] WANG Bingheng;CHEN Xinwang;WU Mingyang(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Provincial Hospital of Chinese Medicine,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2022年第7期1530-1534,共5页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项资助项目(2017ZY2113)。

摘　　要：目的:观察甘草泻心汤对糖调节受损患者血清炎症因子、脂联素和胰岛素抵抗的影响。方法:选择120例糖调节受损(湿热蕴脾证)患者,随机分为对照组(生活方式干预)和治疗组(口服甘草泻心汤)。治疗3个月后,比较两组临床证候疗效、糖代谢指标、炎症因子水平及胰岛素抵抗指数(homa insulin-resistance,HOMA-IR)。结果:对照组有效率为78.33%,治疗组有效率为96.66%,两组有效率比较,差异有统计学意义(P<0.05)。治疗后,两组患者空腹血糖(fasting blood-glucose,FPG)、餐后2小时血糖(2-hour post-meal blood glucose,2hPG)、空腹胰岛素(fasting insulin,FINS)水平,HOMA-IR均显著低于治疗前,治疗组以上指标均显著低于同期对照组,差异均有统计学意义(P<0.01)。治疗后,两组患者白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平显著低于治疗前,脂褐素水平显著高于治疗前(P<0.05);治疗组IL-6、TNF-α、hs-CRP水平显著低于同期对照组,脂褐素水平显著高于同期对照组,差异均有统计学意义(P<0.01)。IL-6、TNF-α、hs-CRP与HOMA-IR呈显著正相关(P<0.05),脂褐素与HOMA-IR呈显著负相关(P<0.05)。结论:甘草泻心汤可有效缓解糖调节受损患者临床症状,降低炎症反应,减少胰岛素抵抗;糖调节受损患者胰岛素抵抗与炎症因子呈正相关,与脂褐素呈负相关。Objective:To observe the effect of Gancao Xiexin Decoction on serum inflammatory factors,adiponectin and insulin resistance in patients with impaired glucose regulation.Methods:A total of 120 patients with impaired glucose regulation(damp-heat accommodating spleen syndrome)were selected and randomly divided into control group(lifestyle intervention)and treatment group(oral Gancao Xiexin Decoction).After treatment,the two groups were evaluated and compared on clinical syndrome curative effect,glucose metabolism indexes,inflammatory factors,various inflammatory factors and HOMA-IR.Results:The effective rate of the control group was 78.33%,and the effective rate of the treatment group was 96.66%.There was a statistically significant difference in the effective rate between the two groups(P<0.05).After treatment,FPG,2hPG,FINS,and HOMA-IR in the two groups were significantly lower than those before treatment,and the above indexes in the treatment group were significantly lower than those in the control group at the same period,with statistical significance(P<0.01).After treatment,the levels of IL-6,TNF-αand hs-CRP in the two groups were significantly lower than those before treatment,and the levels of lipofuscin were significantly higher than those before treatment;the levels of IL-6,TNF-αand hs-CRP in the treatment group were significantly lower In the control group in the same period,the level of lipofuscin was significantly higher than that in the control group in the same period,and the difference was statistically significant(P<0.01).IL-6,TNF-α,hs-CRP were significantly positively correlated with HOMA-IR(P<0.05),and lipofuscin was significantly negatively correlated with HOMA-IR(P<0.05).Conclusion:Gancao Xiexin Decoction can effectively relieve the clinical syndromes of patients with impaired glucose regulation,reduce inflammatory response,and reduce insulin resistance;insulin resistance in patients with impaired glucose regulation is positively correlated with inflammatory factors and negatively correlated wi

关 键 词：甘草泻心汤 糖调节受损 湿热蕴脾证 炎症因子 脂联素 胰岛素抵抗 

分 类 号：R259.87[医药卫生—中西医结合]