清热利湿健脾降糖方联合穴位埋线治疗肥胖型2型糖尿病湿热困脾证患者的疗效观察  

Clinical Observation of Qingre Lishi Jianpi Jiangtang Recipe Combined with Acupoint Catgut Embedding in the Treatment of Obese Type 2 Diabetes with Dampness-Heat Disturbing Spleen

作　　者：张娟 杨丽平 潘静 ZHANG Juan;YANG Li-ping;PAN Jing(Department of Comprehensive Diagnosis and Treatment of the First Affiliated Hospital of Air Force Military Medical University,Xi'an Shaanxi 710032)

机构地区：[1]空军军医大学第一附属医院综合诊疗科,陕西西安710032

出　　处：《世界中西医结合杂志》2023年第1期98-103,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：陕西省社会发展科技项目(2017SF157)。

摘　　要：目的探讨清热利湿健脾降糖方联合穴位埋线治疗肥胖型2型糖尿病(Type 2 diabetes,T2DM)湿热困脾证的临床价值。方法选取2020年1月—2021年10月期间空军军医大学第一附属医院收治的肥胖型T2DM湿热困脾证患者88例,采用随机数字表法分为对照组与试验组,每组各44例。两组患者均开展T2DM基础治疗,在此基础上,对照组给予盐酸二甲双胍治疗,试验组给予盐酸二甲双胍+中医特色疗法(清热利湿健脾降糖方、穴位埋线)。治疗12周后,观察比较两组患者治疗前后中医证候积分、血糖指标[空腹血糖(Fasting plasma glucose,FPG)、餐后2 h血糖(Blood glucose 2 h after meal,2 h PG)、糖化血红蛋白(Glycosylated hemoglobin,HbAlc)]、血脂指标[高密度脂蛋白(High density lipoprotein,HDL)、低密度脂蛋白(Low density lipoprotein,LDL)、甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)]、肥胖指数[体质量指数(Body mass index,BMI)、腰臀比(Waist hip ratio,WHR)]、生活质量评分(Adjusted diabetes-specific quality of life scale,A-DQOL)变化及中医证候疗效、治疗安全性。结果(1)中医证候积分:治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且试验组中医证候积分均低于对照组,差异有统计学意义(P<0.05);(2)中医证候疗效:治疗后试验组中医证候总有效率92.86%(39/42)高于对照组64.29%(27/42),差异有统计学意义(P<0.05);(3)血糖水平:治疗后两组患者血糖FPG、2 h PG、HbAlc水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组血糖FPG、2 h PG、HbAlc水平均低于对照组,差异有统计学意义(P<0.05);(4)血脂水平:治疗后两组患者血脂HDL-C、LDL-C、TG、TC水平均较治疗前改善,差异有统计学意义(P<0.05);且试验组血脂HDL-C、LDL-C、TG、TC水平改善均优于对照组,差异有统计学意义(P<0.05);(5)肥胖指数:治疗后两组患者肥胖指数BMI、WHR均较治疗前降低,差异有统�Objective To investigate the clinical value of Qingre Lishi Jianpi Jiangtang Recipe combined with acupoint catgut embedding in the treatment of obese type 2 diabetes with dampness-heat disturbing spleen.Methods A total of 88 patients with obese type 2 diabetes(dampness-heat disturbing spleen)treated in the First Affiliated Hospital of Air Force Military Medical University from January 2020 to October 2021 were selected and divided into a control group and an experimental group by random number table,with 44 in each group.Both groups were given basic treatmentfortype 2 diabetes.On this basis,the control group received metformin hydrochloride,while the experimental group received metformin hydrochloride+traditional Chinese medicine(TCM)therapy(Qingre Lishi Jianpi Jiangtang Recipe combined with acupoint catgut embedding).After 12 weeks of treatment,the changes in theTCM syndrome score,blood glucose indexes[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycated hemoglobin(HbAlc)],blood lipid indexes[high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)],obesity indexes[body mass index(BMI),waist-to-hip ratio(WHR)],[adjusted diabetes-specific quality of life scale(A-DQOLS)]score in the two groups before and after treatment as well as the TCM syndrome efficacy and treatment safety were observed and compared.Results After treatment,the TCM syndrome scores,blood glucose levels(FPG,2h PG and HbAlc),obesity indexes(BMI and WHR),and A-DQOLS scorein both groups were decreased compared with those before treatment(all P<0.05),and the experimental group had more decrease than the control group(P<0.05).The total effective rate of TCM syndromes in the experimental group was 92.86%(39/42)higher than 64.29%(27/42)in the control group(P<0.05).The blood lipid levels(HDL-C,LDL-C,TG,TC)in the two groups after treatment were improved compared with those before treatment(P<0.05),and the experimental group had more improvement than the control group(P<0

关 键 词：肥胖型2型糖尿病 湿热困脾证 清热利湿健脾降糖方 穴位埋线 血糖控制 肥胖指数 生活质量 

分 类 号：R781.64[医药卫生—口腔医学] R245.91[医药卫生—临床医学]