参苓白术散合藿香正气散在糖尿病合并寒湿泄泻型胃肠功能紊乱中的应用  

Application of Shenling Baizhu powder and Huoxiang Zhengqi powder in the treatment of diabetes complicated with cold dampness diarrhea gastrointestinal dysfunction

作　　者：张玉花 王立君 朱晓琳 白玉婷 宁静 董大文 ZHANG Yuhua;WANG Lijun;ZHU Xiaolin;BAI Yuting;NING Jing;DONG Dawen(Department of Endocrinology,Wuwei Hosipital of Traditional Chinese Medicine,Wuwei,Gansu,China,733000)

机构地区：[1]武威市中医院内分泌科,甘肃武威733000

出　　处：《分子诊断与治疗杂志》2022年第10期1696-1700,共5页Journal of Molecular Diagnostics and Therapy

基　　金：甘肃省中医药科研课题(GZKP-2020-42)。

摘　　要：目的 探讨参苓白术散合藿香正气散对糖尿病合并寒湿泄泻型胃肠功能紊乱患者神经肽S受体-1(NPSR1)、胃泌素(GAS)、降钙素基因相关肽(CGRP)的影响。方法 选2019年4月至2020年5月在武威市中医院接受治疗的糖尿病合并寒湿泄泻型胃肠功能紊乱患者86例,随机分为观察组(43例)、对照组(43例)。两组均予降糖药物等常规治疗,观察组添加参苓白术散合藿香正气散治疗。比较两组血清NPSR1、GAS及CGRP水平,中医症状积分,肠道菌群变化情况,胃动力参数及临床疗效。结果 治疗前,两组NPSR1、GAS及CGRP水平比较,差异无统计学意义(P均>0.05);治疗后,观察组与血清CGRP水平显著低于对照组,而血清NPSR1、GAS水平显著高于对照组,差异有统计学意义(t=4.423、4.152、-5.564,P<0.05)。治疗前两组中医症状积分比较,差异无统计学意义(P均>0.05);治疗后两组评分均降低,且观察组各评分显著低于对照组,差异有统计学意义(t=-14.688、-4.631、-16.399、-11.447、-11.037、-22.381,P<0.05)。治疗前两组菌群比较,差异无统计学意义(P均>0.05);治疗后两组菌群均升高,且观察组各菌群显著高于对照组,差异有统计学意义(t=7.334、7.601、6.917、8.330、11.078,P<0.05)。治疗前两组胃动力参数比较,差异无统计学意义(P均>0.05);治疗后观察组餐后LEP、餐前LEP、MTL、排空速率显著高于对照组,CRH、2h留存率显著低于对照组,差异有统计学意义(P均<0.05)。观察组总有效率(95.35%)显著高于对照组(72.09%),差异有统计学意义(χ~2=8.532,P<0.05)。结论 参苓白术散合藿香正气散治疗糖尿病合并寒湿泄泻型胃肠功能紊乱可通过调节NPRSI、GAS及CGRP等胃肠激素水平、肠道菌群及胃肠动力,显著改善患者临床症状,具有较好疗效。Objective To investigate the effects of Shen Ling Baizhu powder and Herba Xiang Xiang Zheng Qi San on neuropeptide S receptor-1(NPSR1),gastrin(GAS)and calcitonin gene-related peptide(CGRP)in patients with diabetes mellitus complicated with cold and damp diarrhea. Methods 86 patients with diabetes combined with cold and damp diarrhea type gastrointestinal dysfunction who received treatment from April 2019 to May 2020 were selected and randomly divided into the observation group and the control group,43 cases each. Both groups were given routine treatment,and the observation group was added with Shenling Baizhu Powder and Huoxiang Zhengqi Powder. Serum NPSR1,GAS and CGRP levels,TCM symptom scores,intestinal flora changes,gastric motility parameters and clinical efficacy were compared between the two groups. Results Before treatment,there was no significant difference in the levels of NPSR1,GAS and CGRP between the two groups(P>0.05). After treatment,the level of CGRP in the observation group was lower than that in the control group,while the levels of NPSR1 and GAS were higher than those in the control group(t=4.423,4.152,-5.564,P<0.05). Before treatment,there was no significant difference in TCM symptom scores between the two groups(P>0.05). After treatment,the scores of both groups were decreased,and the scores of the observation group were significantly lower than those of the control group(t=-14.688,-4.631,-16.399,-11.447,-11.037,-22.381,P<0.05). There was no significant difference in the flora between the two groups before treatment(P>0.05). After treatment,the flora of both groups increased,and the flora of the observation group was significantly higher than that of the control group(t=7.334,7.601,6.917,8.330,11.078,P<0.05). There was no significant difference in gastric motility parameters between the two groups before treatment(P>0.05). After treatment,the postprandial LEP,pre prandial LEP,MTL and emptying rate in the observation group were higher than those in the control group,while the CRH and 2h retenti

关 键 词：参苓白术散 藿香正气散 寒湿泄泻胃肠功能紊乱 糖尿病 

分 类 号：R259[医药卫生—中西医结合]