本文選題：肥胖2型糖尿病　切入點(diǎn)：濕熱困脾證　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:觀察三黃苓術(shù)湯治療肥胖2型糖尿病(T2DM)濕熱困脾證的臨床療效,及對(duì)血清視黃醇結(jié)合蛋白4(RBP4)水平的影響,探討其可能的作用機(jī)制。方法:采用隨機(jī)對(duì)照分組法,將60例符合納入標(biāo)準(zhǔn)的肥胖T2DM患者分為治療組和對(duì)照組,各30例。對(duì)照組采用基礎(chǔ)治療和常規(guī)西藥治療,治療組在對(duì)照組基礎(chǔ)上,加用三黃苓術(shù)湯。治療12周后觀察兩組患者的中醫(yī)證候、體重、腰圍、BMI、FBG、2hPG、HbA1c、FHNS、HOMA-IR、血脂、視黃醇結(jié)合蛋白4(RBP4)的變化;同時(shí)完善血尿便常規(guī),肝腎功等安全性指標(biāo)檢查。全部數(shù)據(jù)采用SPSS22.0版本進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.中醫(yī)證候療效:治療組總有效率93.1%,對(duì)照組27.6%,兩者比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。2.中醫(yī)證候積分:治療后兩組總積分均減少,組間及組內(nèi)比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。治療后兩組單項(xiàng)癥狀積分比較,P0.01,治療組效果優(yōu)于對(duì)照組。3.FBG、2hPG、HbA1c 水平:治療后兩組 FBG、2hPG、HbA1c 均降低,2hPG、HbA1c組間比較,P0.01,FBG組間比較,P0.05;與治療前比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。治療組降低FBG、2hPG、HbA1c效果優(yōu)于對(duì)照組。4.肥胖相關(guān)指標(biāo):治療后兩組體重、腰圍、BMI均降低,BMI組間比較,P0.01,體重及腰圍組間比較,P0.05;與治療前比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。治療組降低體重、腰圍、BMI效果優(yōu)于對(duì)照組。5.FINS、HOMA-IR:治療后兩組FINS、HOMA-IR均降低,組間比較,P0.05;與治療前比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。治療組降低FINS、HOMA-IR效果優(yōu)于對(duì)照組。6.血脂水平:治療后兩組TG、TC、LDL-C均下降,HDL-C均升高,組間比較,P0.05;與治療前比較,P0.01,差異有統(tǒng)計(jì)學(xué)意義。治療組降低TG、TC、LDL-C,升高HDL-C效果優(yōu)于對(duì)照組。7.RBP4水平:治療后兩組RBP4均有所下降,組間比較,P0.05;與治療前比較,治療組P0.01,對(duì)照組P0.05,差異有統(tǒng)計(jì)學(xué)意義。治療組降低RBP4效果優(yōu)于對(duì)照組。8.安全性:兩組治療前后血尿便常規(guī),肝腎功未見(jiàn)明顯異常。結(jié)論:1.三黃苓術(shù)湯能改善肥胖T2DM濕熱困脾證患者的中醫(yī)證候。2.三黃苓術(shù)湯能降低肥胖T2DM濕熱困脾證患者的FBG、2hPG和HbA1c水平。3.三黃苓術(shù)湯能改善肥胖T2DM濕熱困脾證患者的腰圍、體重和BMI。4.三黃苓術(shù)湯能降低肥胖T2DM濕熱困脾證患者的FINS水平,減輕胰島素抵抗。5.三黃苓術(shù)湯能改善肥胖T2DM濕熱困脾證患者的血脂,下調(diào)TG、TC、LDL-C水平,上調(diào)HDL-C水平。6.三黃苓術(shù)湯可降低肥胖T2DM濕熱困脾證患者的血清RBP4水平,這可能是其改善胰島素抵抗的作用機(jī)制之一。
[Abstract]:Objective: to observe the clinical effect of Sanhuanglingzhu decoction in treating the syndrome of dampness and heat trapped spleen of obesity type 2 diabetes mellitus (T2DM) and its effect on the level of serum retinol binding protein 4 (RBP4), and to explore its possible mechanism. Sixty obese T2DM patients who met the inclusion criteria were divided into treatment group (n = 30) and control group (n = 30). The control group was treated with basic treatment and conventional western medicine, and the treatment group was based on the control group. After 12 weeks of treatment, the changes of TCM syndromes, body weight, waist circumference of BMI-FBGG 2hPGN HbA1cFHNS-FHNS-HOMA-IRM, serum lipids, retinol binding protein 4 (RBP4) were observed, and the routine routine of hematuria was improved. All data were statistically analyzed by SPSS22.0 version. Results: 1. Effect of TCM syndrome: the total effective rate of the treatment group was 93.1g, the control group 27.6g, the difference between the two groups was statistically significant. 2. Score: after treatment, the total score of both groups decreased, The results of treatment group were better than that of control group. 3. The level of HbA1c in the treatment group was better than that in the control group: after treatment, the levels of 2hPGN HbA1c in the two groups were lower than those in the control group (P0.01hPGHbA1c), and the difference between the two groups before treatment was significant (P < 0.05). Compared with P0.01, the difference was statistically significant. The effect of reducing FBGG 2hPGN HbA1c in the treatment group was better than that in the control group .4.Obesity related index: after treatment, the weight of the two groups was higher than that of the control group. The body weight and waist circumference of the treatment group were significantly lower than those of the control group (P 0.01, P 0.01), the effect of waist circumference BMI in the treatment group was better than that in the control group (P 0.05), and the effect of FINSHOMA-IR in the treatment group was higher than that in the control group (P < 0.05), and the effect of FINSHOMA-IR in the treatment group was higher than that in the control group (P < 0.05). The effect of decreasing FINSHOMA-IR in the treatment group was better than that in the control group. 6. The level of blood lipid: after treatment, the LDL-C of TGG and TCU in both groups decreased and HDL-C increased, and compared with that before treatment, the effect of FINSHOMA-IR in the treatment group was better than that in the control group. There was significant difference between the two groups (P 0.05, P 0.01, P 0.01). The treatment group decreased TGG TCU LDL-Cand increased the level of HDL-C than the control group. 7. RBP4 level: after treatment, the RBP4 of both groups were decreased, the comparison between the two groups was P0.05, and compared with that before treatment, there was a significant difference between the two groups, and compared with before treatment, the effect of RBP4 in the treatment group was higher than that in the control group. The effect of RBP4 reduction in the treatment group was better than that in the control group. Conclusion: W1. 3 Huang ling zhu decoction can improve the TCM syndromes of obese T2DM patients with dampness and heat stagnation spleen syndrome. 2. Sanhuangling zhu decoction can reduce the levels of FBGG 2hPG and HbA1c in obese T2DM patients with dampness and heat entrapment spleen syndrome .3. Sanhuangling decoction can improve obesity T2DM patients with damp-heat stagnation spleen syndrome. Waist circumference of obese T2DM patients with damp-heat syndrome, Body weight and BMI.4.Sanhuanglingzhu decoction can reduce the FINS level of obese T2DM patients with damp-heat syndrome, reduce insulin resistance. 5. Sanhuang Lingzhu decoction can improve the blood lipid of obese T2DM patients with dampness and heat trap spleen syndrome, and down-regulate the level of TGG-TCC+ LDL-C. Upregulation of HDL-C level. 6. Sanhuanglingzhu decoction can reduce the serum RBP4 level of obese T2DM patients with dampness and heat, which may be one of the mechanisms of improving insulin resistance.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

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