萆苓祛痛方对2型糖尿病合并痛风性关节炎患者P2X7R、NLRP3、FN及肝脂肪变性的影响  

Effect of Biling Qutong Prescription on NLRP3,P2X7R,FN,and Hepatic Steatosis in Type 2 Diabetes Mellitus Complicated with Gouty Arthritis

作　　者：石红宾 李中南[2] 陈明月 彭甜甜 陈理 SHI Hongbin;LI Zhongnan;CHEN Mingyue;PENG Tiantian;CHEN Li(The First Clinical Medical School of Anhui University of Chinese Medicine,Hefei 230031,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,合肥230031 [2]安徽中医药大学第一附属医院,合肥230031

出　　处：《中国实验方剂学杂志》2023年第21期132-139,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医临床研究基地业务建设科研专项立项课题(JDZX2012004);安徽省红十字会中医药传承创新发展研究项目(2022ZYZD01);安徽省名中医及基层名中医工作室建设项目(中发展[2020]10号)。

摘　　要：目的:探讨萆苓祛痛方对2型糖尿病(T2DM)合并痛风性关节炎(GA)患者血清NLRP3、P2X7R、FN及肝脂肪变性的影响。方法:选取2019年1月至2022年12月在安徽中医药大学第一附属医院就诊的T2DM合并GA患者64例,随机分为萆苓祛痛方组(中药组,32例)和布洛芬组(西药组,32例),同期健康体检30例作为对照组。两组维持基础治疗,西药组加布洛芬,中药组加萆苓祛痛方治疗。连续治疗8周后评估患者治疗前后中医证候评分,比较治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白A1c(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、血尿酸(SUA)、血肌酐(SCr)、总胆固醇(TC)、甘油三酯(TG)、高密低脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆度醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、受控衰减参数(CAP)、肝脏硬度(LSM)、NOD样受体热蛋白结构域相关蛋白3(NLRP3)、嘌呤能离子通道型受体7(P2X7R)、血清纤维连接蛋白(FN)的差异,记录用药期间出现的药物不良反应。结果:与本组治疗前比较,中药组西药组患者关节红肿疼痛、关节灼热、尿色黄、舌红苔黄腻及中医证候总积分均明显降低(P<0.05,P<0.01),中药组患者口干口渴、多饮多尿、脉滑数积分显著降低(P<0.01);与西药组治疗后比较,中药组各证候积分及总积分下降更显著(P<0.05,P<0.01)。与本组治疗前比较,中药组西药组治疗后FPG、2 h PG、HbA1c、SCr、SUA、TG、TC、LDL-C水平下降(P<0.05,P<0.01),中药组患者HOMA-IR、ALT、AST、HDL-C水平下降(P<0.05,P<0.01);与西药组治疗后比较,中药组患者除HDL-C外各实验室检查指标均明显降低(P<0.05,P<0.01)。治疗前,中药组西药组NLRP3、P2X7R、FN水平均高于对照组(P<0.01);与本组治疗前比较,两组患者治疗后NLRP3、P2X7R水平均显著降低(P<0.01);中药组FN水平明显下降(P<0.01);与西药组治疗后比较,中药组NLRP3、P2X7R、FN水平明显降Objective:To investigate the effects of Biling Qutong prescription(BLQT)on serum levels of NOD-like receptor thermal protein domain associated protein 3(NLRP3),purinergic ligand-gated ion channel 7 receptor(P2X7R),fibronectin(FN),and hepatic steatosis in patients with type 2 diabetes mellitus(T2DM)complicated with gouty arthritis(GA).Method:Sixty-four patients diagnosed with T2DM comorbid with GA and treated at the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to December 2022 were enrolled and randomly divided into a BLQT group(Chinese medicine group,32 cases)and the ibuprofen group(western medicine group,32 cases).Thirty healthy individuals who underwent routine health examinations during the same period were assigned to the control group.The BLQT group and the western medicine group received basic treatment along with BLQT and ibuprofen,respectively.After 8 weeks of continuous treatment,the traditional Chinese medicine syndrome score(TCMSS)of the patients was evaluated before and after treatment.The differences in fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 h PG),glycated hemoglobin(HbA1c),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),serum uric acid(SUA),serum creatinine(SCr),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),controlled attenuation parameter(CAP),liver stiffness measurement(LSM),NLRP3,P2X7R,and FN levels before and after treatment were compared.Adverse drug reactions that occurred during treatment were recorded.Result:The TCMSS for joint redness,swelling,pain,joint burning,yellow urine,and red tongue with yellow and greasy coating,as well as total score were significantly reduced in both the BLQT group and the western medicine group as compared with those before treatment(P<0.05,P<0.01).The BLQT group also showed a significant reduction in symptom scores such as dr

关 键 词：2型糖尿病合并痛风 NOD样受体热蛋白结构域相关蛋白3 嘌呤能离子通道型受体7 纤维连接蛋白 萆苓祛痛方 肝脂肪变性 

分 类 号：R2-0[医药卫生—中医学] R22R242R2-031R259R587.1R781.64R971