耳穴埋豆联合柴术汤治疗2型糖尿病伴抑郁患者的疗效观察及对神经内分泌指标的影响  

Effect of Ear Point′s Seed Pressing Therapy Combined with Chaizhu Decoction on T2DM with Depression and on Neuroendocrine Indexes

作　　者：侯敏[1] 崔志梅[1] 朱欧鸰[1] 齐丽丽[1] HOU Min;CUI Zhi-mei;ZHU Ou-ling;Qi Li-li(Second Endocrine Department,TCM Hospital of Shijiazhuang City,Shijiazhuang Hebei050000)

机构地区：[1]石家庄市中医院内分泌二科,河北石家庄050000

出　　处：《世界中西医结合杂志》2022年第10期2087-2091,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020339)。

摘　　要：目的观察耳穴埋豆联合柴术汤治疗2型糖尿病(Type 2 diabetes mellitus,T2DM)伴抑郁患者的临床疗效及对神经内分泌指标的影响。方法选取2019年9月—2020年5月期间石家庄市中医院收治的90例T2DM伴抑郁患者,按简单随机化法分为治疗组、对照1组和对照2组,各30例。治疗组采取氟哌噻吨美利曲辛片联合柴术汤、耳穴埋豆,对照1组采取氟哌噻吨美利曲辛片联合柴术汤,对照2组采取氟哌噻吨美利曲辛片。治疗3个月后,比较3组患者治疗效果、中医证候积分(心情抑郁、胸肋胀满、心烦易怒)、汉密尔顿抑郁量表24项(Hamilton depresssion scale-24,HAMD-24)、血糖指标[糖化血红蛋白(Gglycosylated hemoglobin,HbA1c)、空腹血糖(Fasting plasma glucose,FPG)、餐后2 h血糖(2 h blood glucose after meal,2 h PG)]、神经内分泌指标[5-羟色氨酸(5-hydroxytryptamine,5-HT)、多巴胺(Dopamine,DA)、促肾上腺皮质激素(Adrenocorticotrophic hormone,ACTH)]及不良反应情况。结果治疗3个月后,治疗组总有效率93.10%(27/29)高于对照2组55.17%(16/29)、对照1组65.52%(19/29),差异有统计学意义(P<0.05);对照2组和对照1组治疗总有效率比较,差异无统计学意义(P>0.05)。治疗3个月后3组患者中医证候积分及HAMD-24评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组HAMD-24及心情抑郁、心烦易怒、胸肋胀满评分均低于对照2组、对照1组,对照1组低于对照2组,差异有统计学意义(P<0.05)。治疗3个月后3组患者FPG、2 h PG、HbA1c水平均低于治疗前,差异有统计学意义(P<0.05);且治疗组FPG、2 h PG、HbA1c水平均低于对照2组、对照1组,对照1组低于对照2组,差异有统计学意义(P<0.05)。治疗3个月后3组患者5-HT、DA水平均高于治疗前,ACTH水平均低于治疗前,差异有统计学意义(P<0.05);且治疗组5-HT、DA水平均高于对照2组、对照1组,ACTH水平均低于对照2组、对照1组,对照1组5-HT、DA水平均高于对照2组,ACTHObjective To investigate the effect of ear point′s seed pressing therapy(EPSPT)combined with Chaizhu Decoction on type 2 diabetes mellitus(T2DM)with depression and on neuroendocrine indicators.Methods A total of 90 T2DM patients with depression who were treated in TCM Hospital of Shijiazhuang City from September 2019 to May 2020 were randomized into the treatment group,control group 1,and control group 2,30 patients in each group.The treatment group was treated with Flupentixol and Melitracen Tablets,Chaizhu Decoction,and EPSPT.The control group 1 received Flupentixol and Melitracen Tablets and Chaizhu Decoction,and the control group 2 was only given Flupentixol and Melitracen Tablets.After 3 months of treatment,the efficacy,score of traditional Chinese medicine(TCM)syndrome(depression,distension and stuffiness in the chest,irritability),Hamilton Depression Rating Scale-24(HAMD-24)score,blood glucose indexes[hemoglobin A1 c(HbA1 c),fasting plasma glucose(FPG),2-hour postprandial glucose(2 h PG)],neuroendocrine indexes[5-hydroxytryptophan(5-HT),dopamine(DA),adrenocorticotropic hormone(ACTH)],and adverse reactions were compared among the groups.Results After 3 months of treatment,the total effective rate in the treatment group was 93.10%(27/29),in comparison with the 55.17%(16/29)in control group 2 and the65.52%(19/29)in control group 1(P<0.05).Thetotal effective rate showed no significant difference between control group 2 and control group 1(P>0.05).After 3 months of treatment,HAMD-24 score and TCM syndrome score were lower than those before treatment in the three groups(P<0.05).In addition,HAMD-24 score and scores of depression,distension and stuffiness in the chest,and irritability were lower in the treatment group than in control group 1 and control group 2 and lower in control group 1 than in control group 2(P<0.05).Levels of FPG,2 h PG,and HbA1 c were lower than those before treatment in the three groups(P<0.05).Moreover,the levels of the above three indexes in the treatment group were lower than those in

关 键 词：2型糖尿病 抑郁 耳穴埋豆 柴术汤 氟哌噻吨美利曲辛片 

分 类 号：R781.64[医药卫生—口腔医学] R749[医药卫生—临床医学]