本文選題：糖尿病前期 + 脾虛痰濕證��； 參考：《長春中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:本研究從邪伏散膏病機(jī)假說論治糖尿病前期脾虛痰濕證,旨在驗(yàn)證益氣健脾,化痰祛濕通絡(luò),清熱透邪法治療糖尿病前期脾虛痰濕證的有效性和安全性,為糖尿病早期干預(yù),提早預(yù)防提供新思路,為控制糖尿病的發(fā)展提供新方法。方法:選取長春中醫(yī)藥大學(xué)附屬醫(yī)院本部、二部門診及糖尿病療區(qū)住院符合辨證分組要求的糖尿病前期患者共60例,采用隨機(jī)對(duì)照法分組,治療組、對(duì)照組各30例。治療組給予基礎(chǔ)治療即嚴(yán)格的飲食、運(yùn)動(dòng)療法加上加味六君子湯口服,對(duì)照組給予基礎(chǔ)治療加阿卡波糖片口服,觀察治療前后中醫(yī)癥狀、空腹及餐后2小時(shí)血糖、糖化血紅蛋白、腰臀比、體重指數(shù)、空腹血清胰島素、胰島素抵抗指數(shù)、胰島素敏感指數(shù)、β細(xì)胞功能指數(shù)的變化,4周為1個(gè)療程,連續(xù)觀察3個(gè)療程。結(jié)果:從邪伏散膏論治糖尿病前期脾虛痰濕證60例,治療組總有效率90.00%,對(duì)照組總有效率73.33%;兩組在降低空腹及餐后2小時(shí)血糖、糖化血紅蛋白方面均療效顯著(P0.01);降低腰臀比、體重指數(shù)方面治療組明顯優(yōu)于對(duì)照組,有顯著差異(P0.01);中醫(yī)癥狀方面:治療組臨床癥狀肥胖、神疲乏力、少氣懶言、便溏、納呆、面色不華、腰膝酸軟、頭脹肢沉、小便多、舌、脈象改善優(yōu)于對(duì)照組,有顯著差異(P0.01),畏寒肢冷、頭暈耳鳴改善優(yōu)于對(duì)照組,有明顯差異(P0.05);改善胰島素抵抗指數(shù)、胰島素敏感指數(shù)方面治療組明顯優(yōu)于對(duì)照組,有顯著差異(P0.01)。結(jié)論:加味六君子湯治療糖尿病前期脾虛痰濕證降糖效果與阿卡波糖無明顯差異;且在改善臨床癥狀、胰島素抵抗等多項(xiàng)觀察指標(biāo)方面優(yōu)于阿卡波糖;初步研究得出其降糖機(jī)制可能與改善胰島素抵抗有關(guān),體現(xiàn)了“治未病”理論的指導(dǎo)性意義,降低了糖尿病的發(fā)病率,療效顯著,且隨訪復(fù)發(fā)率低。
[Abstract]:Objective: to treat the syndrome of spleen deficiency and phlegm dampness in early stage of diabetes mellitus from the hypothesis of pathogenic Fu San ointment, in order to verify the efficacy and safety of invigorating qi and invigorating spleen, eliminating phlegm and removing dampness and clearing away heat and clearing away pathogenic factors in treating the syndrome of spleen deficiency and phlegm dampness in early stage of diabetes mellitus. To provide new ideas for early intervention and early prevention of diabetes mellitus and to control the development of diabetes mellitus. Methods: a total of 60 pre-diabetic patients were selected from the hospital of Changchun University of traditional Chinese Medicine, two outpatients and the diabetes treatment area. The patients were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was given basic treatment, namely strict diet, exercise therapy plus Jiawei Liujunzi decoction, while the control group was given basic treatment plus acarbose tablets orally. The symptoms of traditional Chinese medicine, fasting and 2 hours postprandial blood glucose were observed before and after treatment. The changes of glycosylated hemoglobin, waist-hip ratio, body mass index, fasting serum insulin, insulin resistance index, insulin sensitivity index and 尾 cell function index were observed for 3 consecutive courses. Results: 60 cases of spleen deficiency and phlegm dampness syndrome were treated with Xiefu San plaster, the total effective rate of treatment group was 90.00m, the total effective rate of control group was 73.33.The effect of both groups in reducing fasting and postprandial blood glucose and glycosylated hemoglobin was significant (P 0.01); The treatment group was obviously superior to the control group in body mass index (BMI), there was significant difference (P0.01) in TCM symptoms: in the treatment group, the clinical symptoms were obesity, fatigue, indolence, loose stools, indolence, pale complexion, sore waist and knee, head swelling and limb sinking, more urination, tongue, The improvement of pulse was better than that of control group (P 0.01), cold of cold limbs, dizziness and tinnitus were better than that of control group (P 0.05), the improvement of insulin resistance index in treatment group was better than that in control group, and there was significant difference between treatment group and control group (P 0.01). Conclusion: the effect of Jiawei Liujunzi decoction on reducing blood sugar of spleen deficiency and phlegm dampness syndrome before diabetes is not significantly different from that of acarbose, and it is superior to acarbose in improving clinical symptoms and insulin resistance. The preliminary study shows that the mechanism of hypoglycemic effect may be related to improving insulin resistance, which reflects the guiding significance of the theory of "cure without disease", reduces the incidence of diabetes mellitus, and has a significant curative effect, and the recurrence rate of follow-up is low.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R587.1

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