發(fā)布時(shí)間：2018-06-28 22:42

  本文選題：促炎因子 + 2型糖尿病　； 參考：《湖北中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的胰島素抵抗(IR)作為2型糖尿病(T2DM)的核心發(fā)病機(jī)制,其形成的原因目前尚未研究清楚。本實(shí)驗(yàn)旨在通過在T2DM患者常規(guī)降糖方案的基礎(chǔ)上聯(lián)合應(yīng)用清血解毒合劑以觀察白細(xì)胞介素6(IL-6)、白細(xì)胞介素8(IL-8)、腫瘤壞死因子(TNF-α)、超敏C反應(yīng)蛋白(hs-CRP)、空腹血清胰島素(Fins)等指標(biāo)的變化,用以分析清血解毒合劑對(duì)促炎因子的影響及與2型糖尿病胰島素抵抗的關(guān)系。方法隨機(jī)選取2013年7月至2015年2月武漢市中西醫(yī)結(jié)合醫(yī)院(武漢市一醫(yī)院)內(nèi)分泌科住院部2型糖尿病患者60例,證型均為陰虛火旺兼夾血瘀證。按照隨機(jī)原則分為常規(guī)治療組及聯(lián)合治療組,每組各30例,兩組2型糖尿病患者在年齡、性別及病程上均無明顯差異(PO.O5)。常規(guī)治療組給予常規(guī)降糖方案治療八周,聯(lián)合治療組在常規(guī)降糖方案的基礎(chǔ)上聯(lián)合應(yīng)用清血解毒合劑治療八周,清血解毒合劑為武漢市一醫(yī)院藥劑科制備,規(guī)格為200 ml/瓶,服用方法:每次30ml,每日3次。治療前后分別檢測(cè)兩組患者的IL-6、IL-8、TNF-α、hs-CRP、Fins及中醫(yī)證候評(píng)分、臨床證候療效。結(jié)果1.常規(guī)治療組及聯(lián)合治療組治療前后Fins及IRI均較前下降,但聯(lián)合治療組差異性較常規(guī)治療組更大(P0.01)。2.兩組患者治療前后IL-6、IL-8、TNF-α、hs-CRP等炎癥因子在體內(nèi)的濃度均較前下降,有統(tǒng)計(jì)學(xué)意義(P0.05),治療八周后聯(lián)合治療組在IL-6、IL-8、TNF-α、hs-CRP等促炎因子的組內(nèi)差異(P0.01)優(yōu)于常規(guī)治療組(P0.05)。3.常規(guī)治療組及聯(lián)合治療組治療前后Hb A1C、FPG及2 h PG均較前下降(P0.01),但兩組間未見明顯差異(P0.05)。4.常規(guī)治療組在治療過程中出現(xiàn)低血糖患者2例,聯(lián)合治療組治療過程中出現(xiàn)低血糖患者1例,兩組間未見明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05)。5.經(jīng)過八周治療后,聯(lián)合治療組在中醫(yī)證候評(píng)分及臨床證候療效方面較常規(guī)治療組差異性更大(P0.05),差異具有統(tǒng)計(jì)學(xué)意義。6.安全性觀察:研究過程中兩組患者均未見肝、腎功能,血、尿常規(guī)均未見明顯變化。結(jié)論1.清血解毒合劑在直接有效降低2型糖尿病患者體內(nèi)炎癥因子表達(dá)濃度的同時(shí),可明顯改善其胰島素抵抗程度2.清血解毒合劑可明顯改善消渴患者口燥咽干、渴喜冷飲等臨床癥狀。3.清血解毒合劑不會(huì)對(duì)2型糖尿病血糖波動(dòng)性產(chǎn)生影響,不會(huì)引起低血糖。4.清血解毒合劑合劑安全有效,無毒副作用。
[Abstract]:Objective insulin resistance (IR) is the core pathogenesis of type 2 diabetes (T2DM). The cause of its formation is not yet clear. The purpose of this experiment is to observe interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF- a), hypersensitivity C by the combination of clearing blood and detoxifying mixture on the basis of routine hypoglycemic scheme in T2DM patients. The changes of reactive protein (hs-CRP) and fasting serum insulin (Fins) were used to analyze the effect of clearing blood and detoxification mixture on proinflammatory factors and the relationship with insulin resistance of type 2 diabetes. Methods 6 patients with type 2 diabetes in the Department of endocrinology of the Department of Endocrinology, Wuhan city (a hospital) from July 2013 to February 2015, were randomly selected. In 0 cases, the syndrome types were both yin deficiency and fire stagnation and blood stasis syndrome. According to the random principle, the routine treatment group and the combined treatment group were divided into 30 cases in each group, and there was no significant difference in age, sex and course of disease between the two groups of type 2 diabetic patients (PO.O5). The routine treatment group was given the routine hypoglycemic regimen for eight weeks, and the combined treatment group was based on the routine hypoglycemic plan. Combined use of Qing Xue Jiedu mixture for eight weeks, the Qing Xue Jiedu mixture was prepared in the pharmacy department of a hospital in Wuhan, with a specification of 200 ml/ bottles and 3 times a day, 30ml, IL-8, TNF- a, hs-CRP, Fins and TCM syndrome scores and clinical symptoms before and after treatment. The results were 1. routine treatment group and combined treatment. Fins and IRI were lower before and after treatment, but the difference in the combined treatment group was greater than that in the conventional treatment group (P0.01). The concentrations of IL-6, IL-8, TNF- a, hs-CRP and other inflammatory factors in the.2. two group were all decreased in the body before and after the treatment, and were statistically significant (P0.05). After eight weeks of treatment, the combined treatment group was in IL-6, IL-8, TNF- alpha, and other inflammatory factors. Intra group difference (P0.01) was superior to conventional treatment group (P0.05), Hb A1C, FPG and 2 h PG before and after treatment in.3. routine treatment group and combined treatment group were lower than before (P0.01), but there was no significant difference between the two groups (P0.05).4. conventional treatment group in the treatment process of 2 cases of hypoglycemia, 1 cases of hypoglycemia in the combined treatment group and two groups. No significant difference was found, no statistically significant (P0.05).5. after eight weeks of treatment, the combined treatment group in TCM syndrome score and clinical syndrome effect is more different than the conventional treatment group (P0.05), the difference has statistical significance.6. safety observation: the study process of no liver, renal function, blood, urine routine is not clear Conclusion 1. clear blood and detoxification mixture can effectively reduce the concentration of inflammatory factors in type 2 diabetic patients, and can obviously improve the degree of insulin resistance, 2. clear blood and detoxification mixture can obviously improve the dry pharynx of the patients with thirst, and the clinical symptoms such as thirst and cold drink and other clinical symptoms.3. clearing blood and detoxifying mixture will not affect the blood glucose fluctuation in type 2 diabetes mellitus The effect of sex will not cause hypoglycemia..4. blood clearing and detoxicating mixture mixture is safe and effective, with no toxic side effects.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 黃雯暉;衡先培;;中醫(yī)對(duì)糖尿病炎癥狀態(tài)的理論與實(shí)踐研究[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2008年02期

2 林以寧;高茹;張萌;高緣;;金銀花-連翹配伍比例對(duì)有效成分溶出和大鼠體內(nèi)藥動(dòng)學(xué)的影響[J];中國實(shí)驗(yàn)方劑學(xué)雜志;2013年17期

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本文編號(hào)：2079656