加味三黄枳术汤对糖尿病肾病气阴两虚兼湿瘀互结证胃肠功能紊乱患者胃肠激素水平的影响  

Effect of Modified Sanhuang Zhizhu Decoction(加味三黄枳术汤)on Gastrointestinal Hormones in Patients with Diabetic Nephropathy and Gastrointestinal Dysfunction of Deficiency of Qi and Yin Accompanied with Intermingled Dampness and Stasis Syndrome

作　　者：修方睿 米杰[1] 王世军 苏珊珊[1,2] 王冬燕 刘慧[1] 周晓宇[2] 高祖 XIU Fangrui;MI Jie;WANG Shijun;SU Shanshan;WANG Dongyan;LIU Hui;ZHOU Xiaoyu;GAO Zu(Department of Nephrology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院肾病科,山东济南250011 [2]山东中医药大学中医学院,山东济南250355

出　　处：《山东中医杂志》2022年第10期1081-1086,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省医药卫生科技发展计划项目(编号:2017WS707);山东省中医药科技发展计划项目(编号:2019-0181)。

摘　　要：目的:观察加味三黄枳术汤对糖尿病肾病3~4期气阴两虚兼湿瘀互结证胃肠功能紊乱患者相关指标的影响。方法:将63例确诊患者按随机数字表法分为观察组32例与对照组31例,均采用糖尿病肾病基础治疗,对照组予枸橼酸莫沙必利口服,观察组在对照组基础上予加味三黄枳术汤口服,8周后对比治疗前后中医证候积分、血糖、血清白蛋白(ALB)、胃动素(MTL)、胃泌素(GAS)、胰高血糖素(GLC)及生长抑素(SS)的变化,并比较两组总体临床疗效和终点事件发生率。结果:治疗后,观察组中医证候积分的改善明显优于对照组(P<0.05);经秩和检验,观察组总体疗效优于对照组(P<0.05);观察组ALB升高优于对照组(P<0.05);观察组血清中MTL、SS水平高于对照组(P<0.05),GAS、GLC水平低于对照组(P<0.05);两组患者血糖、终点事件比较差异无统计学意义(P>0.05)。结论:加味三黄枳术汤治疗糖尿病肾病3~4期胃肠功能紊乱气阴两虚兼湿瘀互结证,可缓解消化功能紊乱症状,改善营养状况,其机制可能与调节胃肠激素有关。Objective:To observe the effect of Modified Sanhuang Zhizhu Decoction(加味三黄枳术汤,MSZD)on some related laboratory indicators in patients with diabetic nephropathy(DN)at 3~4 stages and gastrointestinal dysfunction of deficiency of qi and yin accompanied with intermingled dampness and stasis syndrome.Methods:Sixty three patients were divided into observation group(32 cases)and control group(31 cases)using random number table methods.Both groups were given routine treatment for DN. The control group was treated with oral administration of mosapride citrate,and the observation group was treated with oral administration of mosapride citrate and MSZD. After treated for 8 weeks,traditional Chinese medicine(TCM) syndrome score,levels of blood glucose,serum albumin(ALB),motilin(MTL),gastrin(GAS),glucagon(GLC),and somatostatin(SS) were detected and compared before and after treatment,and the total efficacy and endpoints incidence were also compared. Results:After treatment,the improvement of TCM syndromes score in the observation group were better than that in the control group(P<0.05). According to the rank-sum test,the total efficacy in the observation group was better than that in the control group(P<0.05). The increase of ALB level in the observation group was higher than that in the control group(P<0.05). Levels of MTL and SS in the observation group were higher than those in the control group(P<0.05),while levels of GAS and GLC were lower than those in the control group(P<0.05). There was no statistically significant difference in blood glucose and endpoints incidence in both groups(P>0.05). Conclusions:In treating patients with DN at 3~4 stages and gastrointestinal dysfunction of deficiency of qi and yin accompanied with intermingled dampness and stasis syndrome,MSZD could relieve manifestations of digestive disorders and improve nutritional status. The mechanism might be related to the regulation of gastrointestinal hormones.

关 键 词：加味三黄枳术汤 糖尿病肾病 气阴两虚 湿瘀互结 胃肠功能紊乱 胃肠激素 

分 类 号：R259.872[医药卫生—中西医结合]