健脾补肾、养阴清热中药对2型糖尿病患者血清CRP、IL-6及TNF-α炎性因子的影响

Impacts on Serum CRP,IL-6 and TNF-α in the Patients with T2DM Treated with Herbal Medicine for Strengthening Spleen and Kidney,Nourishing Yin and Clearing Heat

目的探究健脾补肾、养阴清热中药对2型糖尿病(T2DM)相关炎症因子的影响及其治疗糖尿病的作用机理。方法选择我院2012年7月~2014年6月内分泌科室收治的83例T2DM患者为研究对象,采用随机数字法将其随机分为治疗组(43例)和对照组(40例);两组均予饮食控制、运动疗法及西药降血糖等常规治疗,治疗组在此基础上给予健脾补肾、养阴清热中药的降糖补肾方;比较两组患者治疗前后中医临床症状积分、空腹血糖(FBG)、胰岛素(FINs)、胰岛素敏感指数(ISI)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)。结果两组治疗后与治疗前比较,中医临床症状积分、FBG均明显下降,差异有统计学意义(P<0.05),治疗组FINS积分下降,ISI上升,差异有统计学意义(P<0.05);两组间比较,治疗前两组各项指标差异均无统计学意义(P>0.05),治疗后治疗组中医临床症状积分、FINS高于对照组,ISI低于对照组,差异有统计学意义(P<0.05);两组患者治疗前组间CRP、IL-6及TNF-α比较,差异均无统计学意义(P>0.05),治疗后治疗组CRP、IL-6及TNF-α均低于对照组,差异有统计学意义(P<0.05);治疗组治疗后CRP、IL-6及TNF-α均出现下降,差异有统计学意义(P<0.05),对照组治疗前后CRP、IL-6及TNF-α差异均无统计学意义(P>0.05)。结论健脾补肾、养阴清热中药能够改善T2DM的临床症状和机体的IR,降低机体的炎症因子,抑制炎症反应,在治疗T2DM及预防并发症的发生方面具有重要意义。

Objective To study the impacts on serum CRP,IL-6 and TNF-α in the patients with type 2 diabetes mellitus（T2DM）treated with herbal medicine for strengthening spleen and kidney,nourishing yin and clearing heat and the effect mechanisms on the treatment of T2DM.Methods Eighty-three T2DM patients were collected in the Department of Endocrinology,from July 2012 to June 2014 as the subjects.According to the random number method,they were randomized into a treatment group（43 cases）and a control group（40 cases）.The routine treatment was applied in the two groups for diet control,physical exercise therapy and regulating blood glucose with western medicine.In the treatment group,besides the routine treatment,jiangtang bushen formula was added for strengthening spleen and kidney,nourishing yin and clearing heat.The clinical TCM symptom score,FBG,FINs,ISI,IL-6,TNF-α and CRP were compared before and after treatment in the patients of the two groups.Results Compared with those before treatment,the clinical TCM symptom score and FBG were reduced apparently in the two groups,indicating the significant differences（P〈0.05）.In the treatment group,FINS was reduced and ISI increased,indicating the significant differences（P〈0.05）.In comparison of the two groups,the differences were not significant in the indexes before treatment（P〉0.05）.After treatment,the clinical TCM symptom score and FINS were higher than those in the control group and ISI was lower than the control group,indicating the significant differences（P〈0.05）.The differences were not significant in CRP,IL-6 and TNF-α before treatment between the two groups（P〉0.05）.After treatment,CRP,IL-6 and TNF-α in the treatment group were difference significantly as comparedwith the control group（P〈0.05）.After treatment,CRP,IL-6 and TNF-α were reduced in the treatment group,indicating the significant differences as compared with those before treatment（P〈0.05）.The differences in CRP,IL-6 and TNF-α were not significant before and after treatment in the control group（P〉0.05）.Conclusion The herbal medicine for strengthening spleen and kidney,nourishing yin and clearing heat relieves the clinical symptoms of T2DM,improves IR of the body,reduces inflammatory factors and inhibits inflammatory reaction.It plays the significant role in the treatment of T2DM and prevention of its complications.