小陷胸汤合防己茯苓汤联合二甲双胍治疗肥胖2型糖尿病痰热互结证的临床研究  

Clinical Study on Xiaoxianxiong Decoction(小陷胸汤)and Fangji Fuling Decoction(防己茯苓汤)Combined with Metformin in the Treatment of Obese Type 2 Diabetes with Phlegm-Heat Accumulation Syndrome

作　　者：庞健丽[1] 钟润芬[1] 周卓宁[1] 岑晴[1] PANG Jianli;ZHONG Runfen;ZHOU Zhuoning;CEN Qin(Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning Guangxi 530011,China)

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《中医药导报》2023年第7期96-100,121,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(81560731);全国中医药创新骨干人才培养项目(国中医药人教函〔2019〕128号);广西中医药优秀人才研修项目(桂中医药发〔2022〕7号)。

摘　　要：目的:探讨小陷胸汤合防己茯苓汤联合二甲双胍治疗肥胖2型糖尿病痰热互结证的临床疗效。方法:将70例初诊肥胖2型糖尿病痰热互结证患者按照随机数字表分为治疗组与对照组各35例。两组患者均遵循常规糖尿病饮食方案、合理运动。对照组患者应用二甲双胍片治疗,治疗组患者在此基础上应用小陷胸汤合防己茯苓汤治疗。疗程为3个月。比较两组患者中医证候积分、肥胖指标、糖代谢指标、胰岛功能、微炎症指标及不良反应发生情况。结果:对照组总有效率为72.73%(24/33),治疗组总有效率为94.12%(32/34),治疗组总有效率高于对照组(P<0.05)。两组患者治疗后中医证候积分、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、体质量、体质量指数(BMI)、腰围、腰臀比(WHR)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、血清超敏C反应蛋白(hs-CRP)、血清肿瘤坏死因子-α(TNF-α)水平均较治疗前降低(P<0.01),且治疗后治疗组患者中医证候积分、FBG、2 h PBG、HbA1c、体质量、BMI、腰围、FINS、HOMA-IR、血清hs-CRP、血清TNF-α水平均低于对照组(P<0.01或P<0.05);两组患者治疗后胰岛素敏感指数(In ISI)及胰岛β细胞功能指数(HOMA-β)水平均较治疗前升高(P<0.01),且治疗后治疗组患者In ISI及HOMA-β均高于对照组(P<0.01)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:小陷胸汤合防己茯苓汤联合二甲双胍能够有效改善肥胖2型糖尿病痰热互结证患者临床症状,降低患者血糖,减轻体质量,改善胰岛素抵抗和炎症指标。Objective:To explore the clinical effect of Xiaoxianxiong Decoction and Fangji Fuling Decoction combined with metformin in the treatment of obese type 2 diabetes with phlegm-heat accumulation syndrome.Methods:A total of 70 patients with newly diagnosed obese type 2 diabetes with phlegm-heat accumulation syndrome were randomly divided into treatment group and control group according to the random number table method,with 35 cases in each group.Both groups were treated with routine diet and reasonable exercise.The control group was treated with metformin,and the treatment group was treated with Xiaoxianxiong Decoction and Fangji Fuling Decoction on the basis of the control group.The course of treatment was three months.The changes of traditional Chinese medicine(TCM)syndrome score,obesity indicators,glucose metabolism indicators,pancreatic function,microinflammation indexes and adverse reactions were compared between the two groups.Results:The total effective rate was 72.73%(24/33)in control group and 94.12%(32/34)in treatment group.Treatment group showed higher total effective rate than control group(P<0.05).After treatment,the levels of TCM symptom score,fasting blood glucose(FBG),postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1c),body weight,body mass index(BMI),waist,waist to hip ratio(WHR),fasting insulin(FINS),HOMA-IR,hs-CRP and TNF-αdecreased in two groups(P<0.01),and the treatment group showed lower levels of TCM syndrome score,FBG,2 hPBG,HbA1c,body weight,BMI,waist,FINS,HOMA-IR,hs-CRP and TNF-αthan control group(P<0.01 or P<0.05).The levels of InISI and HOMA-βincreased in two groups after treatment(P<0.01),and the treatment group showed higher levels of InISI and HOMA-βthan control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Xiaoxianxiong Decoction and Fangji Fuling Decoction combined with metformin can effectively improve the clinical symptoms,reduce blood glucose,decrease body weight,and improve insul

关 键 词：2型糖尿病 肥胖 痰热互结证 小陷胸汤合防己茯苓汤 二甲双胍 胰岛素抵抗 临床研究 

分 类 号：R255.4[医药卫生—中医内科学]