莲实健脾食疗方干预糖耐量受损脾虚不运证患者36例临床观察  

Clinical Observation on Lianshi Jianpi Dietary Formula(莲实健脾食疗方)on Impaired Glucose Tolerance with Failure of Transportation due to Spleen Deficiency Pattern in 36 Cases

作　　者：叶彬华[1] 江铭倩 邱晨[1] 郑凯林[1] 林莉[1] 郭芳[1] 梁艳彬 许容坤 YE Binhua;JIANG Mingqian;QIU Chen;ZHENG Kailin;LIN Li;GUO Fang;LIANG Yanbin;XU Rongkun(Affiliated People's Hospital,Fujian University of Traditional Chinese Medicine,Fuzhou,350004)

机构地区：[1]福建中医药大学附属人民医院,福建省福州市350004

出　　处：《中医杂志》2023年第2期153-158,共6页Journal of Traditional Chinese Medicine

基　　金：国家中医临床研究基地专项科研课题(JDZX201933);全国名老中医药专家传承工作室建设项目(闽卫中医药[2019]21号)。

摘　　要：目的观察莲实健脾食疗方干预糖耐量受损脾虚不运证患者的临床疗效及可能作用机制。方法将78例糖耐量受损脾虚不运证患者随机分为治疗组与对照组各39例。两组均予相同的营养及生活方式指导,治疗组每日早餐为莲实健脾食疗方+鸡蛋,对照组每日早餐为馒头+鸡蛋,干预周期均为90天。治疗前后检测糖代谢相关指标[包括空腹血糖(FPG)、葡萄糖负荷后2 h血糖(OGTT2hPG)、糖化血红蛋白(HbA1c)],人体测量学指标包括[体重、体重指数(BMI)、腰围、体脂率、肌肉量],胰岛功能指标[包括空腹胰岛素(FINS)、葡萄糖负荷后2h胰岛素(OGTT 2h INS)、胰岛素抵抗指数(HOMA-IR)、胰岛素β细胞功能指数(HOMA-β)],糖脂代谢相关因子[包括成纤维细胞生长因子21(FGF21)、游离脂肪酸(FFA)、胰高糖素样肽1(GLP-1)]水平,干预后判定临床疗效。结果干预期间共脱落6例患者,最终纳入分析两组各36例。治疗组患者临床缓解率为61.1%(22/36),明显高于对照组的27.8%(10/36,P<0.05)。与治疗前比较,治疗组OGTT 2hPG、体重、BMI、腰围、体脂率、HOMA-IR、FGF21、FFA降低,肌肉量、GLP-1升高(P<0.05);对照组FGF21、BMI、腰围降低,GLP-1升高(P<0.05)。治疗后组间比较,治疗组OGTT 2hPG、HOMA-IR、体重、BMI、腰围、体脂率、FGF21、肌肉量、GLP-1水平改善均优于对照组(P<0.05)。结论莲实健脾食疗方可改善糖耐量受损脾虚不运证患者糖代谢及胰岛素抵抗,其机制可能与下调FGF21、上调GLP-1水平有关。Objective To evaluate the clinical efficacy and the possible mechanism of Lianshi Jianpi Dietary Formula(莲实健脾食疗,LJDF)on impaired glucose tolerance(IGT)with failure of transportation due to spleen defi⁃ciency pattern.Methods Seventy-eight patients with IGT and failure of transportation due to spleen deficiency pat⁃tern were randomly divided into test group and control group,with 39 cases in each group.Both groups were given the same nutrition and lifestyle guidance.The breakfast of the test group was LJDF plus an egg,and that of the control group was steamed bread plus an egg,both for 90 days.The glucose metabolism-related levels including fasting blood glucose(FPG),2 h plasma glucose after an oral glucose tolerance test(OGTT 2hPG),glycosylated hemoglobin(HbA1c),anthropometric indicators including weight,body mass index(BMI),waist circumference,body fat percentage,muscle mass,islet function indicators including fasting insulin(FINS),2 h insulin after an oral glucose tolerance test(OGTT 2 h INS),homeostatic model assessment for insulin resistance(HOMA-IR),homeostasis model assessment ofβ-cell function(HOMA-β),glucolipid metabolism-related factors including fibroblast growth factor 21(FGF21,FFA),free fatty acid(FFA),and glucagon-like peptide 1(GLP-1)were observed before and after treat⁃ment in the two groups.The clinical efficacy was judged after the treatment.Results Six patients dropped out,and 36 cases in each group were included in the final analysis.The clinical remission rate of patients in the test group was 61.1%(22/36),which was significantly better than 27.8%(10/36)in the control group(P<0.05).After treat⁃ment,OGTT 2hPG,body weight,BMI,waist circumference,body fat percentage,HOMA-IR,FGF21,and FFA in the test group decreased,while muscle mass and GLP-1 increased(P<0.05);FGF21,BMI,waist circumference in the control group decreased,while GLP-1 increased(P<0.05).When compared between groups,much more im⁃provements were seen in the test group than the control group regarding OGTT 2hPG,HO

关 键 词：糖耐量受损 脾虚 莲实健脾食疗方 糖代谢 胰岛素抵抗 

分 类 号：R259[医药卫生—中西医结合]