温肾健脾、疏肝调气中药对肥胖2型糖尿病炎症标志物影响的研究

Effect of Therapy of Warming Kidney and Strengthening Spleen,Soothing Liver and Regulating Qi on Inflammatory Markers in Type 2 Diabetes Mellitus Patients with Obesity

目的:观察温肾健脾、疏肝调气中药对肥胖2型糖尿病(T2DM)相关炎症因子的影响。方法:将60例2型糖尿病患者随机分为治疗组、对照组各30例,2组均予糖尿病教育、合理饮食并常规应用西药降血糖,治疗组加用温肾健脾、疏肝调气中药治疗。测定2组治疗前后空腹血糖(FBG)、胰岛素(FINS)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)含量,计算胰岛素敏感指数(ISI)及2组治疗前后中医临床症状积分、体重指数(BMI)。结果:治疗后2组中医临床症状积分、BMI均有下降(P<0.05,P<0.01),其中治疗组较对照组下降明显,差异有显著性或非常显著性意义(P<0.05,P<0.01)。治疗组FINS、IL-6、TNF-α、CRP含量治疗后均显著下降、ISI明显升高,且优于对照组(P<0.05,P<0.01)。结论:温肾健脾、疏肝调气中药能有效改善胰岛素抵抗,减轻患者临床症状,其作用机理可能与调节炎症因子的产生、抑制炎症反应有相关。

Objective： To observe the effect of therapy of warming kidney and strengthening spleen, soothing liver and regulating qi on inflammatory markers in type 2 diabetes meliitus （T2DM） patients with obesity. Methods： Sixty T2DM patients were equally randomized into treatment group and control group. The two groups were given diabetic healthy training, proper diet and routine drugs for lowering blood glucose, and the treatment group was given oral use of Chinese medicine with the actions of warming kidney and strengthening spleen, soothing liver and regulating qi. Serum levels of fasting blood glucose （FBG）, fasting insulin（FINS）, interleukin 6（IL-6）, tumor necrosis factor alpha （TNF-α）, and C-reactive protein （CRP） were measured, insulin sensitivity index was calculated and the scores of traditional Chinese medical symptoms were observed. Results： After treatment, the scores of traditional Chinese medical symptoms and body mass index （BMI） were decreased （P 〈 0.05 or P 〈 0.01 compared with those before treatment）, and the decrease in the treatment group was superior to that in the control group（P 〈 0.05, P 〈 0.01）. In the treatment group, serum FINS, IL-6, TNF-α, and CRP levels as well as ISI were decreased obviously, and the effect was superior to that o fthe control group （P 〈 0.05, P 〈 0.01）. Conclusion： Therapy of warming kidney and etrengthening spleen, soothing liver and regulating qi is effective on improving insulin resistance and relieving clinical symptoms, and its mechanism is probably related with the regulation of inflammatory markers.