加味玉女煎内服联合电针治疗胃热炽盛型2型糖尿病临床观察  

Clinical efficacy of oral modified Jade Maid Decoction combined with electroacupuncture for type 2 diabetes mellitus of stomach-heat type

作　　者：修颖 付于 方芳 于淑静 XIU Ying;FU Yu;FANG Fang;YU Shujing(Department of Rehabilitation,Binhai New Area Hospital of TCM.Tianjin,Tianjin 300270;Department of Acupuncture and Moxibustion,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300112)

机构地区：[1]天津市滨海新区大港中医医院康复科,天津300270 [2]天津中医药大学第一附属医院针灸科,天津300112

出　　处：《河北中医》2022年第6期943-948,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的探讨加味玉女煎内服联合电针治疗胃热炽盛型2型糖尿病(T2DM)的临床疗效及可能作用机制。方法选择天津市滨海新区大港中医医院康复科胃热炽盛型T2DM患者186例,按照随机数字表法分为治疗组和对照组,各93例。2组均给予常规综合治疗,对照组同时给予二甲双胍联合阿卡波糖口服治疗,治疗组在对照组基础上给予加味玉女煎内服联合电针治疗。连续治疗8周,比较2组中医证候积分、糖脂代谢、血清炎症指标、胰岛素抵抗及胰岛β细胞功能、临床疗效及不良反应。结果试验过程中,治疗组脱落3例,对照组脱落、剔除5例,最终共完成178例,治疗组90例,对照组88例。治疗组治疗后中医证候多食易饥、口渴、尿多、大便干燥积分及总分均低于对照组(P<0.05)。治疗组治疗后空腹血糖(FPG)、2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1c))、总胆固醇(TC)、甘油三酯(TG)均低于对照组(P<0.05)。治疗组治疗后血清超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)均低于对照组(P<0.05)。治疗组治疗后空腹胰岛素(FINS)、瘦素(LP)、胰岛素抵抗指数(HOMA-IR)均低于对照组,胰岛β细胞功能指数(HOMA-β)高于对照组(P<0.05)。治疗组总有效率91.11%(82/90),对照组76.14%(67/88),治疗组疗效优于对照组(χ^(2)=7.361,P<0.05)。治疗组治疗后不良反应发生率6.67%(6/90),对照组17.04%(15/88),治疗组低于对照组(χ^(2)=4.606,P<0.05)。结论加味玉女煎内服联合电针治疗有助于调节胃热炽盛型T2DM患者糖脂代谢水平,提高临床疗效,减少不良反应的发生,可能与抑制炎性反应、缓解胰岛素抵抗、改善胰岛β细胞功能等因素有关。Objective To explore the clinical efficacy of oral modified Jade Maid Decoction combined with electroacupuncture for type 2 diabetes mellitus(T2DM)of stomach-heat type and its possible mechanism.Methods Totally 186 patients with T2DM(stomach-heat type)were randomly divided into the treatment group(n=93)and the control group(n=93);in addition to routine complex treatment,control group received oral metformin combined with acarbose,and treatment group received oral modified Jade Maid Decoction combined with electroacupuncture based on control group.Treated for 8 weeks,aiming to compare traditional Chinese medicine(TCM)syndrome score,glucose and lipid metabolism,serum inflammatory markers,insulin resistance(IR)and islet beta-cell function;the curative effect and adverse reaction were assessed.Results A total of 178 cases completed the treatment,including 90 cases(3 cases of shedding)and 88 cases(5 cases of shedding)in the treatment group and the control group,respectively.TCM syndrome(overeating and hunger,thirst,excessive urine,dry stool)scores in the treatment group were decreased in comparison with the control group(P<0.05).Fasting plasma glucose(FPG),two hour plasma glucose(2 hPG),glycosylated hemoglobin(HbA_(1c)),total cholesterol(TC),triglycerides(TG)were decreased in the treatment group compared with the control group(P<0.05).Serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)were decreased(P<0.05)in the treatment group relevant to the control group.Lower fasting insulin(FINS),leptin(LP),Insulin resistance index(HOMA-IR),and higher islet beta-cell function were detected in the treatment group than those in the control group(P<0.05).The overall effective rate in the treatment group was higher than that in the control group(91.11%vs 76.14%,[χ^(2)=7.361,P<0.05],respectively).The incidence of adverse reactions was 6.67%in the treatment group,lower than that of 17.04%in the control group(χ^(2)=4.606,P<0.05).Conclusion For patients with T2DM(stomach-heat type),or

关 键 词：糖尿病 2型 玉女煎 胃热 电针 中药疗法 针刺疗法 

分 类 号：R587.105[医药卫生—内分泌]