疏肝健脾化浊汤治疗肝郁脾虚证糖尿病前期患者的临床疗效及对TyG指数的影响  

Clinical Efficacy of Shugan Jianpi Huazhuo Decoction in Treating Patients with Liver-depression and Spleen-deficiency Syndrome Prediabetes Mellitus and Its Impact on TyG Index

作　　者：李硕 张贺芳 臧钰荣 何瑞雪 LI Shuo;ZHANG Hefang;ZANG Yurong;HE Ruixue(The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]河北中医药大学第一附属医院,河北石家庄050011

出　　处：《河北中医药学报》2025年第1期14-18,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省中医药管理局课题(2023169)。

摘　　要：目的:观察疏肝健脾化浊汤对肝郁脾虚证糖尿病前期(prediabetes mellitus, PDM)患者的临床疗效及对甘油三酯葡萄糖乘积(TyG)指数的影响。方法:选取2022年10月至2023年3月就诊于河北中医药大学第一附属医院内分泌科的60例PDM肝郁脾虚证患者,随机分为对照组(30例)与治疗组(30例)。对照组予饮食、运动干预,治疗组在饮食及运动基础上加用疏肝健脾化浊汤治疗,疗程为12周。分别于治疗前后比较2组中医证候积分、血糖、血脂、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛素分泌指数(HOMA-β)和TyG指数的差异,判断2组临床疗效,比较治疗结束6个月后2组的糖尿病转化率。结果:治疗组中医证候积分、血糖、血脂、胰岛功能、TyG指数均得到改善,对照组除低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、HOMA-β外其余指标均得到改善(P<0.05);治疗组上述各指标改善优于对照组(P<0.05);治疗组总有效率高于对照组(P<0.05);治疗结束6个月后,治疗组糖尿病转化率低于对照组(P<0.05)。结论:疏肝健脾化浊汤能够有效改善肝郁脾虚型PDM患者TyG指数,调节糖脂代谢,改善胰岛功能,降低糖尿病转化率,具有较好的安全性。Objective:To observe the clinical efficacy of Shugan Jianpi Huazhuo Decoction in patients with liver-depression and spleen-deficiency type prediabetes mellitus(PDM)and its impact on the triglyceride-glucose(TyG)index.Methods:A total of 60 patients with PDM and liver-depression and spleen-deficiency syndrome who visited the endocrinology department of our hospital from October 2022 to March 2023 were selected and randomly divided into a control group(30 cases)and a treatment group(30 cases).The control group received dietary and exercise interventions,while the treatment group was treated with Shugan Jianpi Huazhuo Decoction in addition to diet and exercise,with a treatment course of 12 weeks.The differences in TCM syndrome scores,blood glucose,blood lipids,insulin resistance index(HOMA-IR),insulin sensitivity index(ISI),insulin secretion index(HOMA-β),and TyG index between the two groups were compared before and after treatment respectively;The clinical efficacy of the two groups was evaluated;The diabetes conversion rate of the two groups was compared six months after the end of treatment.Results:The TCM syndrome scores,blood glucose,blood lipids,pancreatic function,and TyG index in the treatment group were all improved.In the control group,except low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and HOMA-β,all indicators were improved(P<0.05);the improvement of the above indicators in the treatment group was better than that in the control group(P<0.05);the total effective rate in the treatment group was higher than that in the control group(P<0.05);six months after the end of treatment,the diabetes conversion rate in the treatment group was lower than that in the control group(P<0.05).Conclusion:Shugan Jianpi Huazhuo Decoction can effectively improve the TyG index in PDM patients with liver-depression and spleen-deficiency type,regulate sugar and lipid metabolism,improve pancreatic function,reduce the conversion rate of diabetes,and has good safety.

关 键 词：糖尿病前期 肝郁脾虚证 疏肝健脾化浊汤 TyG指数 

分 类 号：R259[医药卫生—中西医结合]