健脾清化方对气阴两虚型初发2型糖尿病患者TIR及四肢骨骼肌的影响  

Effect of Jianpi Qinghua Formula on TIR and skeletal muscle of extremities in patients of initial type 2 diabetes with type of qi and yin deficiency

作　　者：陆立群 金燊懿 闫子惠 陈清光[1] 韩煦 徐隽斐[1] 陆灏[1] LU Liqun;JIN Shenyi;YAN Zihui;CHEN Qingguang;HAN Xu;XU Junfei;LU Hao(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《上海中医药大学学报》2023年第3期19-24,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82074381,81874434)。

摘　　要：目的:探讨健脾清化方对初发气阴两虚型2型糖尿病(T2DM)患者的血糖波动、骨骼肌含量及功能的影响。方法:纳入70例初发气阴两虚型T2DM患者,随机分为治疗组和对照组,每组各35例。两组患者均给予生活方式干预,在此基础上,治疗组患者予健脾清化方口服,对照组患者予安慰剂口服,疗程均为12周。治疗后,评价并比较两组患者的临床疗效;治疗前后,比较两组患者的中医证候总积分,检测患者的血糖在目标范围内时间(TIR)、四肢骨骼肌质量、优势手握力及糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)水平。结果:研究过程中,治疗组2例患者、对照组1例患者脱落或剔除,最终纳入统计分析者治疗组33例、对照组34例。①治疗后,治疗组的临床总有效率为75.8%,对照组为38.2%,治疗组的疗效优于对照组(P<0.01)。②治疗后,治疗组患者的中医证候总积分较治疗前降低(P<0.05),且治疗组患者的中医证候总积分改善情况优于对照组(P<0.05)。③治疗后,治疗组患者的TIR有上升趋势,但治疗前后差异无统计学意义(P>0.05),对照组患者的TIR显著下降(P<0.05),且治疗组患者的TIR改善情况优于对照组(P<0.05)。④治疗后,治疗组患者的四肢骨骼肌质量及优势手握力均升高(P<0.05),而对照组患者的四肢骨骼肌质量及优势手握力均降低(P<0.05),且治疗组患者的四肢骨骼肌质量及优势手握力改善情况优于对照组(P<0.05)。⑤治疗后,治疗组患者的HbA1c水平降低(P<0.05),且治疗组患者的HbA1c水平改善情况优于对照组(P<0.05)。结论:健脾清化方可改善初发气阴两虚型T2DM患者的血糖波动,提升优势手握力及四肢骨骼肌含量,改善糖代谢及临床症状,其改善血糖波动的机制可能与改善骨骼肌质量和功能有关。Objective:To investigate the effects of Jianpi Qinghua Formula on the blood glucose fluctuation and the skeletal muscle content and function in patients of initial type 2 diabetes mellitus(T2DM)with type of qi and yin deficiency.Methods:Seventy patients of initial T2DM with type of qi and yin deficiency were included and randomly divided into the treatment group and control group,35 cases in each group.The patients in the two groups were given lifestyle intervention.Based on above,the patients in the treatment group were orally treated with Jianpi Qinghua Formula,and the patients in the control group were orally treated with placebo,with a course of 12 weeks.After treatment,the clinical efficacy of the two groups were evaluated and compared.Before and after treatment,the total scores of traditional Chinese medicine(TCM)syndrome were compared between the two groups,and the levels of the time in the target range of blood glucose(TIR),the skeletal muscle mass of extremities,the dominant hand grip strength,and glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG)were detected.Results:In the course of research,2 patients in the treatment group and 1 patient in the control group were shed off or removed,finally 33 cases in the treatment group and 34 cases in the control group were included in the statistical analysis.①After treatment,the total clinical effective rate was 75.8%in the treatment group and 38.2%in the control group,and the therapeutic effect of the treatment group was better than that of the control group(P<0.01).②After treatment,the total score of TCM syndrome in the treatment group was decreased compared with that before treatment(P<0.05),and the improvement of the total score of TCM syndrome in the treatment group was better than that in the control group(P<0.05).③After treatment,the TIR of the treatment group showed an upward trend,but there was no statistically significant difference between before and after treatment(P>0.05),the TIR of the control

关 键 词：2型糖尿病 气阴两虚型 健脾清化方 血糖波动 骨骼肌 中医药疗法 

分 类 号：R259[医药卫生—中西医结合]