连术消渴方对肥胖2型糖尿病患者糖脂代谢及炎症因子的影响  

Effect of Lianzhu Xiaoke Recipe on Glucose and Lipid Metabolism and Inflammatory Factors of Type 2 Diabetes Patients

作　　者：金凯 李鹏辉 张芳 魏光辉 吉兰洁 徐伶俐 卢昭 王银姗 李慧敏 朱珊珊 闫镛 JIN Kai;LI Penghui;ZHANG Fang;WEI Guanghui;JI Lanjie;XU Lingli;LU Zhao;WANG Yinshan;LI Huimin;ZHU Shanshan;YAN Yong(Kaifeng Traditional Chinese Medicine Hospital,Kaifeng Henan China 475000;The Eighth People′s Hospital of Zhengzhou,Zhengzhou Henan China 450000;Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]开封市中医院,河南开封475000 [2]郑州市第八人民医院,河南郑州450000 [3]河南中医药大学,河南郑州450046

出　　处：《中医学报》2023年第5期1095-1101,共7页Acta Chinese Medicine

基　　金：第七批老中医药专家学术经验继承项目{国中医药人教函[2022]76号};开封市科技发展计划项目(2103003,1906012)。

摘　　要：目的:观察连术消渴方对肥胖2型糖尿病湿热互结兼瘀证患者的临床疗效及白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)及瘦素(leptin,LEP)、可溶性瘦素受体(soluble leptin receptor,sLR)、神经肽Y(neuropeptide Y,NPY)、细胞因子信号传导抑制蛋白3(cytokine signaling inhibition protein 3,SOCS3)水平的影响。方法:将66例肥胖2型糖尿病湿热互结兼瘀证患者随机分为治疗组和对照组各33例,治疗组给予连术消渴方,对照组给予盐酸二甲双胍片,疗程8周。比较两组患者治疗后中医临床疗效、中医证候积分及血糖、血脂、IL-6、CRP、LEP、sLR、NPY、SOCS3水平。结果:治疗组与对照组有效率分别为93.94%、69.70%;与治疗前比较:两组患者的中医证候积分、体质量指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)、空腹血糖(fasting blood glucose,FPG)、餐后2小时血糖(blood sugar 2 hours after meal,2hPG)、果糖胺(fructosamine,FMN)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、IL-6、CRP、LEP、SOCS3水平降低,sLR水平升高,差异有统计学意义(P<0.05);与对照组比较,治疗组治疗后患者FPG、TC、TG、IL-6、LEP、SOCS3水平降低,差异具有统计学意义(P<0.05),CRP、NPY、sLR未见明显变化,差异无统计学意义(P>0.05)。结论:连术消渴方治疗肥胖2型糖尿病湿热互结兼瘀证临床疗效显著,可降低患者中医证候积分、血糖、血脂、IL-6、CRP、LEP、SOCS3水平,升高血清sLR水平。其作用机制可能与改善瘦素抵抗、炎症反应相关。Objective:to observe the clinical effect of Lianzhu Xiaoke Recipe on obese patients with Damp-Heat syndrome and blood stasis syndrome and the effects of interleukin-6(IL-6),C-reactive protein(CRP),leptin(LEP),soluble leptin receptor(sLR),neuropeptide Y(NPY)and cytokine signal transduction inhibitory protein 3(Cytokinesignalinginhibitionprotein3,SOCS3).Methods:66 patients with Damp-Heat syndrome and blood stasis syndrome of obese type 2 diabetes were randomly divided into treatment group(n=33)and control group(n=33).The treatment group was treated with Lianzhu Xiaoke Recipe and the control group was treated with metformin hydrochloride tablets for 8 weeks.The clinical efficacy of TCM,TCM syndrome score and the levels of blood glucose,blood lipid,IL-6,CRP,LEP,sLR,NPY and SOCS3 were compared between the two groups after treatment.Results:The total effective rate of the treatment group and the control group was 93.94%and 69.70%respectively.Compared with those before treatment,the TCM syndrome score,body mass index(BMI),waist-to-hip ratio(WHR),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),fructosamine(FMN),total cholesterol(TC),triglyceride(triglyceride,TG),IL-6,CRP,LEP,SOCS3 decreased and sLR increased in the two groups(P<0.05).Compared with that of the control group,the levels of FPG,TC,TG,IL-6,LEP and SOCS3 in the treatment group decreased significantly after treatment(P<0.05),but there was no significant difference in CRP,NPY and sLR(P>0.05).Conclusion:Lianzhu Xiaoke Recipe is effective in the treatment of damp-heat syndrome and blood stasis syndrome of obese type 2 diabetes.It can reduce TCM syndrome score,blood glucose,blood lipid,IL-6,CRP,LEP,SOCS3 and increase the level of serum sLR.Its mechanism may be related to the improvement of leptin resistance and inflammation.

关 键 词：2型糖尿病 肥胖 连术消渴方 湿热互结 瘀证 瘦素抵抗 糖脂代谢 炎症 

分 类 号：R259.871[医药卫生—中西医结合]