苍柴调中方辅助改善肝郁脾虚型肥胖2型糖尿病的疗效及对胰岛素抵抗、FFA、LDL-C水平的影响  

Efficacy of Cangchai Tiaozhong Formula in Adjuvant Treatment of Obese Type 2 Diabetes Mellitus with Liver Depression and Spleen Deficiency Syndrome and Its Effects on Insulin Resistance,FFA and LDL-C Levels

作　　者：陆聆韵[1] 张惟郁[1] 刘兴静 LU Lingyun;ZHANG Weiyu;LIU Xingjing(Dept.of Traditional Chinese Medicine,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院中医科,上海200025

出　　处：《中国医院用药评价与分析》2024年第9期1090-1092,1096,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：上海市嘉定区卫生健康委员会中医药科研项目(No.2019-KY-ZYY-17)。

摘　　要：目的:探讨苍柴调中方辅助改善肝郁脾虚型肥胖2型糖尿病(T2DM)的疗效,并分析其对胰岛素抵抗、游离脂肪酸(FFA)、低密度脂蛋白胆固醇(LDL-C)水平的影响。方法:选取2020年4月至2023年4月该院收治的肝郁脾虚型肥胖T2DM患者100例,根据随机数字表法分为两组,各50例。对照组患者使用二甲双胍治疗,观察组患者在对照组基础上联合苍柴调中方辅助治疗。观察两组患者的治疗效果,比较两组患者治疗前后中医症状积分、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血清FFA、LDL-C、肿瘤坏死因子α(TNF-α)水平的差异,并对不良反应发生率进行统计。结果:观察组患者的治疗总有效率高于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者倦怠乏力、精神抑郁、脘腹闷胀及大便黏滞等中医症状积分均低于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,两组患者治疗后的FBG、HOMA-IR、FINS水平均明显降低,其中观察组患者治疗后的FINS、FBG及HOMA-IR水平低于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗后的血清LDL-C、FFA、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。结论:苍柴调中方辅助治疗可明显提高肝郁脾虚型肥胖T2DM患者的治疗效果,改善胰岛素抵抗,下调血清FFA、LDL-C水平。OBJECTIVE:To probe into the efficacy of Cangchai Tiaozhong formula in adjuvant treatment of obese type 2 diabetes mellitus(T2DM)with liver depression and spleen deficiency syndrome,and to analyze the effects on insulin resistance,free fatty acids(FFA),and low density lipoprotein cholesterol(LDL-C)levels.METHODS:Totally 100 patients with T2DM admitted into the hospital from Apr.2020 to Apr.2023 were extracted to be divided into two groups through the random number table method,with 50 cases in each group.The control group was treated with metformin,while the observation group received Cangchai Tiaozhong formula on the basis of the control group.Curative effect of two groups was observed.Differences of traditional Chinese medicine symptom score,glucose metabolism index[fasting blood glucose(FBG),fasting insulin(FINS),homeostatic model assessment of insulin resistance(HOMA-IR)],serum FFA,LDL-C and tumor necrosis factor α(TNF-α)before and after treatment were compared between two groups.The incidence of adverse drug reactions was statistically analyzed.RESULTS:The total effective rate of treatment in the observation group was higher than that in the control group,and the incidence of adverse reactions was lower than that in the control group,with statistically significant difference(P<0.05).After treatment,the scores of traditional Chinese medicine symptoms in the observation group were lower than those in the control group,such as fatigue,mental depression,abdominal distension,and sticky stool,with statistically significant differences(P<0.05).Compared with before treatment,the levels of FBG,HOMA-IR and FINS in the two groups decreased significantly after treatment,and the levels of FINS,FBG and HOMA-IR in the observation group were lower than those in the control group after treatment,with statistically significant differences(P<0.05).The levels of serum LDL-C,FFA and TNF-αin the observation group were lower than those in the control group after treatment,and the differences were statistically significant(P<0.05

关 键 词：苍柴调中方 肥胖 2型糖尿病 胰岛素抵抗 游离脂肪酸 低密度脂蛋白胆固醇 

分 类 号：R932[医药卫生—生药学]