本文選題：糖尿病前期 + 血糖調(diào)節(jié)異常�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:1.研究白茯苓丸的降糖作用,用白茯苓丸中藥煎劑對糖尿病前期患者進(jìn)行臨床干預(yù),分析干預(yù)前后的血糖變化水平;2.實(shí)驗(yàn)組和對照組降血糖效果的對比研究,觀察干預(yù)后的兩組患者血糖下降水平和效果評價(jià);3.白茯苓丸對血脂的干預(yù)效果研究;4.觀察白茯苓丸對中醫(yī)證候的改善情況。方法:以符合糖尿病前期的診斷標(biāo)準(zhǔn)、相關(guān)中醫(yī)證候符合氣陰兩虛(如不耐勞力、食后脘腹脹滿,偶有心煩、手足心熱、腿軟難以久立,大便粘滯)的患者及排除標(biāo)準(zhǔn)作為篩選的工具,選取山西醫(yī)科大學(xué)第一附屬醫(yī)院在2016年5月到2016年12月于中醫(yī)科門診就診的患者,符合上述標(biāo)準(zhǔn)的46例患者。對入選患者進(jìn)行隨機(jī)分為試驗(yàn)組和對照組,試驗(yàn)組給予白茯苓丸中藥煎劑,每日1劑,早晚分服200ml;對照組用天麥消渴片進(jìn)行干預(yù),一次2片,一天兩次,療程都設(shè)置為6周。采集兩組受試者試驗(yàn)前的血液樣本、試驗(yàn)中每7天采集兩組受試者的血液樣本,并記錄兩組受試者的中醫(yī)證候變化。所采集的血液樣本即刻送我院化驗(yàn)科化驗(yàn),記錄受試者空腹血糖、75g無水葡萄糖攝入后2小時(shí)血糖、糖化血紅蛋白、血清甘油三酯、血清膽固醇,高密度脂蛋白、低密度脂蛋白的變化。療效評價(jià)參考《中藥新藥臨床研究指導(dǎo)原則》對得到的指標(biāo)進(jìn)行評價(jià),分為顯效、有效、無效。實(shí)驗(yàn)過程中得到的計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,分析采用獨(dú)立樣本t檢驗(yàn),P0.05,認(rèn)為差異有統(tǒng)計(jì)學(xué)意義;得到的計(jì)數(shù)資料用卡方(χ2)檢驗(yàn),P0.05,認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.一般資料分析干預(yù)前評價(jià)兩組的性別無差異,年齡、BMI指數(shù)、空腹血糖(FPG)、餐后2小時(shí)血糖(P2BG)、糖化血紅蛋白(Hb A1c)、血清甘油三酯(TG)、血清膽固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)經(jīng)檢驗(yàn),P0.05,差異無統(tǒng)計(jì)學(xué)意義。2.血糖相關(guān)指標(biāo)分析2.1分別對比試驗(yàn)組干預(yù)前后FBG、P2BG、Hb A1c,P0.05,差異有統(tǒng)計(jì)學(xué)意義。對照組干預(yù)前后的血糖相關(guān)指標(biāo)FBG、P2BG、Hb A1c,P0.05,差異有統(tǒng)計(jì)學(xué)意義;2.2兩組受試者干預(yù)后血糖相關(guān)指標(biāo)FBG、P2BG、Hb A1c對比,P0.05,差異無統(tǒng)計(jì)學(xué)差異;對比白茯苓丸干預(yù)后血糖指標(biāo)FBG、P2BG、Hb A1c的均數(shù)均小于天麥消渴片干預(yù)后的血糖指標(biāo)的均數(shù),說明白茯苓丸復(fù)方湯藥制劑的降糖效果要優(yōu)于對照組天麥消渴片的降糖效果。3.血脂相關(guān)指標(biāo)分析3.1試驗(yàn)組干預(yù)前后,對比其LDL-C、TC均數(shù)±標(biāo)準(zhǔn)差,P0.05,差異有統(tǒng)計(jì)學(xué)意義,TG、HDL-C的對比分析,P0.05,差異沒有統(tǒng)計(jì)學(xué)意義;對照組干預(yù)前后血脂相關(guān)指標(biāo)分析,P0.05,差異無統(tǒng)計(jì)學(xué)意義。3.2兩組的調(diào)脂效果對比,在調(diào)節(jié)LDL-C方面,P0.05,差異有統(tǒng)計(jì)學(xué)意義;白茯苓丸干預(yù)后的低密度脂蛋白的均數(shù)小于對照組,說明白茯苓丸復(fù)方湯藥制劑在降低低密度脂蛋白的效果上優(yōu)于天麥消渴片。4.有效率對比分析試驗(yàn)組顯效者20例,有效者0例,無效者3例;對照組顯效16例,0例有效,7例無效,整個(gè)試驗(yàn)過程中無不良反應(yīng)發(fā)生。對比兩組顯效率,P0.05,差異無統(tǒng)計(jì)學(xué)意義。5.中醫(yī)證候改善率對比分析對改善中醫(yī)證候的效果進(jìn)行對比研究,試驗(yàn)組的改善率高于對照組,P0.05,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.白茯苓丸湯有降糖的效果,且降糖力度和天麥消渴片相當(dāng);2.白茯苓丸湯和天麥消渴片兩種藥物均可以降低血糖水平,但在顯效率方面二者未顯示出統(tǒng)計(jì)學(xué)差異;3.白茯苓丸中藥煎劑可以降低LDL-C、TC的濃度,且降低LDL-C的力度優(yōu)于天麥消渴片;4.白茯苓丸湯對中醫(yī)證候的改善效果優(yōu)于天麥消渴片。
[Abstract]:Objective: To study the hypoglycemic effect of 1. white Poria pill, clinical intervention on patients with pre diabetes with white Poria pill of Chinese medicine decoction, the change of blood glucose level before and after the intervention analysis; comparative study of the 2. experimental group and control group hypoglycemic effect, evaluation of two groups of patients to observe the blood glucose level and decreased after the intervention effect of intervention; 3. white Poria the effect of pill on blood lipid; improvement of 4. white Poria Pill on the observation of TCM syndrome. Methods: according to diagnostic criteria of pre diabetes, TCM syndromes associated with Yin deficiency (such as resistance to labor, after eating flatulence, occasionally upset, hot feeling, difficult to long leg soft, sticky stool) the patients and exclusion criteria as a screening tool, the First Affiliated Hospital of Shanxi Medical University from May 2016 to December 2016 in the outpatient department of traditional Chinese medicine patients, 46 patients were in conformity with the standards of the patients. Were randomly divided into experimental group and control group, the experimental group was given the white Poria pill of Chinese medicine decoction, 1 dose daily, sooner or later the service 200ml; the control group with tianmaixiaoke tablet intervention, a 2 tablets, two times a day. The course is set to 6 weeks. Collecting two groups of subjects before the blood test sample test in every 7 days to collect two subjects blood samples, and record the changes of TCM syndrome of the two groups of subjects. Blood samples were collected immediately sent to the testing laboratory of our hospital, and records the subjects' fasting blood glucose, 75g glucose intake after 2 hours blood glucose, glycosylated hemoglobin, serum serum cholesterol, triglyceride, high density lipoprotein, low density lipoprotein changes. The curative effect evaluation of reference "Chinese medicine clinical research guiding principles > on of the evaluation indicators, divided into markedly effective, effective and ineffective. The measurement data in the experiment with the mean and standard deviation (x + s) said the analysis The independent sample t test, P0.05, that the difference was statistically significant; count data obtained by chi square test, P0.05 (x 2), considered statistically significant. Results: 1. general data before intervention evaluation of two groups of gender differences, age, BMI index, fasting blood glucose (FPG), after the meal 2 hours blood glucose (P2BG), glycosylated hemoglobin (Hb A1c), serum triglyceride (TG), serum cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) by P0.05 test, there was no significant difference in.2. blood glucose related index analysis before and after the 2.1 comparative experiments were FBG group intervention P2BG, Hb, A1c, P0.05, the difference was statistically significant. The control indexes of blood glucose before and after the intervention group FBG, P2BG, Hb, A1c, P0.05, FBG, the difference was statistically significant; the relevant indicators of blood glucose of 2.2 subjects in the two groups after the intervention of P2BG, Hb P0.05, A1c comparison, the difference was not statistically different compared to white Poria; dry pill The prognosis of the glycemic index of FBG, P2BG, Hb, A1c were less than the average number of days of wheat were dry Xiaoke tablets glycemic index prognosis, that the hypoglycemic effect of Fuling pill compound decoction preparation is superior to the control group of tianmaixiaoke tablet.3. hypoglycemic effect of serum lipids of 3.1 experimental groups before and after intervention, compared with the LDL-C. TC standard deviation, P0.05, a statistically significant difference of TG, HDL-C analysis, P0.05, the difference was not statistically significant; the control group before and after the intervention of lipid related indicators analysis, P0.05, no statistical significance differences in lipid regulating effects of.3.2 two groups of P0.05, in the regulation of LDL-C, and the difference was statistically significant dry white Poria pill; low density lipoprotein prognosis were less than the control group, said that Fuling pill compound decoction preparation superior in low density lipoprotein on the effect of tianmaixiaoke tablet.4. efficiency analysis of 20 cases of test group, have 0 cases with effect, 3 cases; 16 cases of the control group, 0 cases were effective, 7 cases ineffective, no adverse reactions occurred during the whole experiment. Comparing the two groups of significant efficiency, P0.05, there was no significant difference in.5. syndrome improvement rate comparison and Analysis on the comparative study of the improvement of TCM syndrome effect. The improvement of the experimental group was significantly higher than the control group, P0.05, the difference was statistically significant. Conclusion: 1. white Poria pill decoction has a hypoglycemic effect, and hypoglycemic strength and tianmaixiaoke tablets; 2. white Poria pill and tianmaixiaoke tablets of two kinds of drugs can reduce blood glucose levels, but not in significant efficiency two showed significant difference; 3. white Poria pill decoction can reduce LDL-C, TC concentration, and reduce the strength of the LDL-C is better than that of tianmaixiaoke tablets; 4. white Poria pill Decoction on syndrome of traditional Chinese medicine better than tianmaixiaoke tablets.

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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