补肾健脾方联合短期胰岛素强化治疗对胰岛β细胞去分化的影响  

Effect of Bushen Jianpi Prescription Combined with Short-Term Intensive Insulin Therapy on the Dedifferentiation of Pancreatic β-Cells

作　　者：陈天荣 张杰文 林靖 莫嘉明 季兵 CHEN Tian-Rong;ZHANG Jie-Wen;LIN Jing;MO Jia-Ming;JI Bing(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Clifford Hospital,Guangzhou 511495 Guangdong,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东祈福医院,广东广州511495 [3]广州中医药大学第三附属医院,广东广州510378

出　　处：《广州中医药大学学报》2024年第7期1738-1743,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20212190);广州市中医药和中西医结合科技项目(编号:20232A010023);广州市番禺区科技计划重点医疗卫生项目(编号:2022-Z04-109);广东祈福医院院内项目(编号:QF20222210)。

摘　　要：【目的】观察补肾健脾方联合短期胰岛素强化治疗对脾肾两虚型2型糖尿病患者胰岛β细胞去分化的影响。【方法】将70例脾肾两虚型2型糖尿病患者随机分为对照组和观察组,每组各35例。对照组给予胰岛素强化治疗,观察组在对照组的基础上给予补肾健脾方治疗,疗程为2周。观察2组患者治疗前后中医证候积分、血糖水平、血清高迁移率族蛋白B1(HMGB1)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)、胰岛素原/胰岛素比值(PI/I)的变化情况。【结果】(1)脱落情况方面:治疗过程中,对照组脱落1例,观察组脱落2例,最终对照组34例、观察组33例患者纳入疗效统计。(2)中医证候积分方面:治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且观察组的降低幅度明显优于对照组(P<0.05)。(3)血糖水平方面:治疗后,2组患者的空腹血糖(FPG)、餐后2 h血糖(2hPG)水平均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(4)HMGB1水平方面:治疗后,2组患者的HMGB1水平均较治疗前明显降低(P<0.05),且观察组的降低幅度明显优于对照组(P<0.05)。(5)炎症因子水平方面:治疗后,2组患者血清IL-1β、TNF-α水平均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(6)PI/I值方面:治疗后,2组患者的PI/I值均较治疗前明显降低(P<0.05),且观察组的降低幅度明显优于对照组(P<0.05)。【结论】补肾健脾方联合短期胰岛素强化治疗可有效改善脾肾两虚型2型糖尿病患者的胰岛功能,其机制可能与解除高糖毒性、降低炎症因子水平,从而抑制胰岛β细胞去分化有关。Objective To observe the effect of Bushen Jianpi Prescription,a prescription with the actions of tonifying the kidney and strengthening the spleen,combined with short-term intensive insulin therapy on dedifferentiation of pancreatic beta-cells in patients with type 2 diabetes mellitus(T2DM)of spleen and kidney deficiency type.Methods Seventy patients with T2DM of spleen and kidney deficiency type were randomly divided into control group and observation group,with 35 cases in each group.The control group was treated with intensive insulin therapy,and the observation group was treated with Bushen Jianpi Prescription on the basis of treatment for the control group.The course of treatment lasted for 2 weeks.The changes of TCM syndrome score,and levels of blood glucose,serum high mobility group protein B1(HMGB1),interleukin 1β(IL-1β),tumor necrosis factorα(TNF-α)and the ratio of proinsulin to insulin(PI/I)in the two groups were observed before and after treatment.Results(1)During the treatment,one case in the control group and 2 cases in the observation group fell off.Eventually,34 cases in the control group and 33 cases in the observation group were included in the efficacy statistics.(2)After treatment,the scores of TCM syndromes in the two groups were significantly lower than those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the levels of fasting plasma glucose(FPG)and 2-hour postprandial plasma glucose(2hPG)in the two groups were significantly lower than those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(4)After treatment,the level of HMGB1 in the two groups was significantly lower than that before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(5)After treatment,the serum levels of inflammatory factors of IL-1βand TNF-αin the two groups were

关 键 词：2型糖尿病 脾肾两虚型 胰岛素强化治疗 补肾 健脾 胰岛β细胞去分化 

分 类 号：R259.871[医药卫生—中西医结合]