六君子汤加味穴位贴敷治疗脾虚痰湿型糖尿病前期肥胖患者的疗效及对患者炎症因子和肠道菌群的影响  

Effect of modified Liujunzi decoction acupoint sticking on serum inflammatory factors and intestinal flora in obese patients of pre-diabetes with spleen deficiency and phlegm-dampness syndrome

作　　者：赵加 王倩[1] 苑浩彬 唐迎超 ZHAO Jia;WANG Qian;YUAN Haobin;TANG Yingchao(Department of Endocrinology,Baoding No.1 Hospital of TCM,Baoding,Hebei 071000)

机构地区：[1]河北省保定市第一中医院内分泌科,河北保定071000

出　　处：《河北中医》2023年第7期1150-1155,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：保定市科技计划项目(编号:2141ZF102)。

摘　　要：目的观察六君子汤加味穴位贴敷治疗脾虚痰湿型糖尿病前期肥胖患者的临床疗效,以及对患者炎症因子及肠道菌群的影响。方法将90例脾虚痰湿型糖尿病前期肥胖患者按照随机数字表法分为2组,对照组45例(实际完成41例)予西医常规治疗,治疗组45例(实际完成42例)在对照组基础上加用六君子汤加味穴位贴敷治疗。2组均治疗3个月后统计疗效,比较2组治疗前后中医症状评分(包括形体肥胖、腹部增大、脘腹胀满、纳呆便溏及口淡无味或黏腻)、糖脂代谢指标[包括空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1)C)、甘油三酯(TG)及总胆固醇(TC)]、炎症因子[包括超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、IL-10及肿瘤坏死因子α(TNF-α)]及肠道菌群(包括大肠杆菌、双歧杆菌及乳酸杆菌)变化情况。结果治疗组总有效率为90.48%(38/42),对照组总有效率73.17%(30/41),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状形体肥胖、腹部增大、脘腹胀满、纳呆便溏、口淡无味或黏腻评分及总分均降低(P<0.05),且治疗组治疗后中医症状形体肥胖、腹部增大、脘腹胀满、纳呆便溏、口淡无味或黏腻评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后FPG、2 hPG、HbA_(1)C、TC及TG水平均降低(P<0.05),且治疗组治疗后FPG、2 hPG、HbA_(1)C、TC及TG水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后hs-CRP、IL-6及TNF-α水平均降低(P<0.05),IL-10水平均升高(P<0.05),且治疗组治疗后hs-CRP、IL-6及TNF-α水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。与本组治疗前比较,2组治疗后乳酸杆菌及双歧杆菌数量均增多(P<0.05),大肠杆菌数量均减少(P<0.05),且治疗组治疗后乳酸杆菌及双歧杆菌数量多于对照组(P<0.05),大肠杆菌数量少于对照组(P<0.05)。结论六君子汤加味穴位贴敷治�Objective To observe the effect of modified Liujunzi decoction acupoint sticking on serum inflammatory factors and intestinal flora in obese patients of pre-diabetes with spleen deficiency and phlegm-dampness syndrome.Methods A totally 90 obese patients with pre-diabetes(spleen deficiency and phlegm-dampness syndrome)were randomized 1:1 to two groups.The patients in the control group(41 cases completed)were treated with conventional Western medicine,and those in the treatment group(42 cases completed)were additionally treated with modified Liujunzi Decoction acupoint sticking on the basis of the control group.The efficacy was statistically analyzed after 3 months.The traditional Chinese medicine(TCM)syndrome score(body obesity,abdominal enlargement,abdominal distension,anorexia,loose stools and tasteless or sticky mouth),glucose and lipid metabolism indexes(fasting blood glucose[FBG],2 h postprandial blood glucose[2 hPG],glycosylated hemoglobin[HbA_(1)C],triglyceride[TG]and total cholesterol[TC]),inflammatory factors(high-sensitivity C-reactive protein[hs-CRP],interleukin-6[IL-6],IL-10 and tumor necrosis factor-α[TNF-α])and intestinal flora(Escherichia coli,Bifidobacterium and Lactobacillus)were included as comparisons between groups before and after treatment.Results After treatment,the total effective rate in the treatment group was higher than that in the control group(90.48%[38/42]vs 73.17%[30/41],P<0.05).TCM symptoms scores and total scores in the two groups were significantly decreased(P<0.05),and which were significantly lower in the treatment group than in the control group(P<0.05).FBG,2hPG,HbA1C,TC and TG in the two groups were significantly decreased(P<0.05),and the decrease in the treatment group were more pronounced(P<0.05).Decreased hs-CRP,IL-6 and TNF-α,and increased IL-10 were detected in the two groups(all P<0.05),which were significant differences between the treatment group and the control group(all P<0.05).After treatment,the abundance of Lactobacillus and Bifidobacterium in the two groups i

关 键 词：糖尿病前期 脾虚痰湿 六君子汤 贴敷疗法 炎症因子 肠道菌群 

分 类 号：R259.8[医药卫生—中西医结合]