加味苓桂术甘汤治疗肥胖型2型糖尿病  

Clinical effect of modified Linggui Zhugan decoction in the treatment of obese type 2 diabetes mellitus

作　　者：李勤[1] 吴瑞[1] 郭丰年[1] 安然[1] 石白[1] LI Qin;WU Rui;GUO Fengnian;AN Ran;SHI Bai(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102618,China)

机构地区：[1]中国中医科学院广安门医院南区,北京102618

出　　处：《吉林中医药》2023年第7期784-788,共5页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金青年基金项目(82004345);中国中医科学院广安门医院南区院级课题(Y2019-02);中国中医科学院广安门医院南区本部专家学术经验传承(Y2018SC-03)。

摘　　要：目的探讨加味苓桂术甘汤对脾虚痰湿型肥胖型2型糖尿病(T2DM)的临床效果。方法选择脾虚痰湿型肥胖型2型糖尿病患者80例,随机分为治疗组与对照组,各40例。2组均予生活方式指导,对照组予盐酸二甲双胍片治疗,治疗组在对照组基础上予加味苓桂术甘汤颗粒治疗,观察治疗12周后,对2组中医证候变化、体质量(Wt)、体质量指数(BMI)、腰臀比(WHR)、血糖(FPG、2h PG、Hb A1c)、血脂(TC、LDL、HDL、TG)、胰岛素抵抗指数(HOMA-IR)及安全性指标进行统计分析。结果治疗组中医证候疗效总有效率(84.6%,33/39)明显优于对照组(53.8%,21/39)(P<0.05),治疗组中医证候中形体肥胖、头身困重、脘腹痞满、倦怠乏力、气短懒言、口淡无味、头面眩晕评分低于治疗前(P<0.05),治疗组除头晕目眩外,其余各项评分及总评分均优于对照组(P<0.05)。2组Wt、BMI、WHR、FPG、2h PG、Hb A1c、FINS、HOMA-IR均较治疗前降低(P<0.05),治疗组TC、TG、LDL-C降低明显(P<0.05),治疗组除WHR及HDL指标外,其余观察指标均优于对照组(P<0.05)。结论加味苓桂术甘汤治疗脾虚痰湿型肥胖型T2DM患者效果显著,可以降低患者体质量,调节糖脂代谢紊乱,改善胰岛素抵抗,改善临床症状,且安全性良好。Objective To explore the clinical effect of the modified Linggui Zhugan decoction in the treatment of obese type 2 diabetes mellitus(T2DM)with the syndrome of phlegm-dampness due to spleen deficiency.Methods eighty patients were randomly divided into a treatment group and a control group,with 40 cases in each group.Both groups were given a lifestyle guidance.Besides,the control group was given the metformin hydrochloride tablets(1.0g/time,2 times/day),while the treatment group was given the modified Linggui Zhugan decoction on the basis of that.After 12 weeks of treatment,the changes of TCM syndromes,body weight(Wt),body mass index(BMI),waist-hip ratio(WHR),blood glucose(FPG,2hPG,HbA1c),blood lipids(TC,LDL,HDL,TG)insulin resistance index(HOMA-IR)and safety indexes of the two groups were statistically analyzed.Results The total effective rate of TCM syndromes in the treatment group(84.6%,33/39)was significantly better than that in the control group(53.8%,21/39)(P<0.05).The TCM syndrome scores of body obesity,heavy head and body,abdominal fullness,fatigue,shortness of breath and lazy speech,tasteless mouth,head and face dizziness in the treatment group were lower than before treatment(P<0.05),and all the other scores and the total score in the treatment group were better than those in the control group except dizziness(P<0.05).The levels of Wt,BMI,WHR,FPG,2hPG,HbA1c,FINS,HOMAIR of the two groups were decreased compared to before treatment(P<0.05),and the levels of TC,TG and LDL-C were decreased significantly in the treatment group(P<0.05),and the other observation indexes in the treatment group were better than those in control group except WHR and HDL(P<0.05).Conclusion The modified Linggui Zhugan decoction is effective in the treatment of obese T2DM patients with the syndrome of phlegm dampness due to spleen deficiency,which can reduce their body weight,regulate the glucose and lipid metabolism disorders,improve their insulin resistance and improve their TCM symptoms,having a good safety.

关 键 词：肥胖型2型糖尿病 苓桂术甘汤 脾虚痰湿证 

分 类 号：R259[医药卫生—中西医结合]