茵陈五苓散联合穴位按摩治疗痰湿型肥胖2型糖尿病的临床疗效观察

Effect of Yinchen Wuling Powder(茵陈五苓散)Combined with Acupoint Massage in Treatment of Type 2 Diabetes Mellitus of Phlegm-Damp Syndrome Obese

目的探究茵陈五苓散联合穴位按摩对痰湿型肥胖2型糖尿病(T2DM)的治疗效果。方法选取2019年6月—2020年12月由医院内分泌科收治的痰湿型肥胖T2DM患者60例为研究对象,采用随机数字表法分为A、B、C 3组各20例,A组给予陈五苓散治疗,B组采用穴位按摩治疗,C组采用茵陈五苓散联合穴位按摩治疗,治疗3个月,比较3组治疗前后临床疗效、血糖指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2 h(2 hPG)、平均血糖波动(MAGE)]、胰岛素指标[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、血脂水平[胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]、肥胖指标[体质量、腰围、体质量指数(BMI)]、身体成分分析结果及不良反应发生情况。结果C组总有效率为(95.00%,19/20),与A组(75.00%,15/20)、B组(70.0%,14/20)比较差异有统计学意义(P<0.05),A、B两组总有效率组间比较差异无统计学意义(P>0.05);治疗后,3组HbA1c、FPG、2 hPG、TC、TG、LDL、HDL水平及FINS、HOMA-IR、体质量、BMI及腰围值显著下降,HOMA-β值显著增大,差异有统计学意义(P<0.05),C组血糖、血脂、胰岛素及肥胖指标水平与A、B两组比较差异有统计学意义(P<0.05);C组脂肪含量、上肢肌肉含量、内脏脂肪面积、体脂率、蛋白质含量及无机盐含量等与A、B两组比较差异有统计学意义(P<0.05);3组治疗过程未见严重不良反应。结论茵陈五苓散联合穴位按摩治疗痰湿型肥胖T2DM疗效确切,较单独使用茵陈五苓散或穴位按摩疗能有效调节血糖、血脂水平,改善胰岛素抵抗。

Objective To investigate the effect of Yinchen Wuling Powder(茵陈五苓散)combined with acupoint massage in the treatment of type 2 diabetes mellitus(T2DM)of phlegm-damp syndrome obese.Methods Sixty patients with obese T2DM of phlegm-damp syndrome in the hospital from June 2019 to December 2020 were enrolled and divided into three groups by random number table methods,each with 20 cases.Group A received Yinchen Wuling Powder,group B received acupoint massage,while group C received Yinchen Wuling Powder combined with acupoint massage.The treatment in all three groups lasted for 3 months.And then,various indexes were compared among three groups,including clinical efficacy,blood glucose indicators[fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),2-hour postprandial blood glucose(2 hPG),mean amplitude of glycemic excursions(MAGE)],insulin indicators[fasting insulin(FINS),HOMA-β,insulin resistance index(HOMA-IR)],blood lipid indicators[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)],obesity indicators[weight,waist circumference,BMI],body composition analysis results and adverse reaction rate.Results The clinical efficacy was 95.00%(19/20)in group C,which showed significant difference with 75.00%(15/20)in group A and 70.00%(14/20)in group B(P<0.05),while the clinical efficacy of group A and B had no significant difference(P>0.05).After treatment,there was a significant decrease in HbA1c,FPG,2 hPG,TC,TG,LDL,HDL,FINS,HOMA-IR,body weight,BMI and waist circumference and a significant increase in HOMA-βin all three groups(P<0.05).The blood glucose,blood lipid,insulin and obesity index levels had statistic difference among three groups(P<0.05).There were significant differences in fat content,upper limb muscle content,visceral fat area,body fat percentage,protein content and inorganic salt content between group C and group A and B(P<0.05).No adverse reaction was found in three groups(P>0.05).Conclusion Compared with single application,the combination of Yinchen Wuling Powder and acupoint massage in the treatment of T2DM of phlegm-damp syndrome obese has better effect,which can effectively regulate the blood glucose,blood lipid and insulin levels,and thus improving the insulin resistance.