清热利湿化痰方对痰湿瘀热型2型糖尿病患者中医症候积分、血糖代谢及血清MCP-1、IL-1β、HMGB1水平的影响

Effects of Qingre Lishi Huatan Recipe on TCM Syndrome Scores,Blood Glucose Metabolism and Serum Levels of MCP-1,IL-1βand HMGB1 in Patients with Type 2 Diabetes Mellitus with Phlegm-Damp-Stasis-Heat Type

目的:探讨清热利湿化痰方对痰湿瘀热型2型糖尿病患者中医症候积分、血糖代谢及血清单核细胞趋化蛋白-1(MCP-1)、高迁移率族蛋白B1(HMGB1)、白介素-1β(IL-1β)水平的影响。方法:收集恩施土家族苗族自治州州中心医院2018年05月~2021年05月期间接受治疗的104例2型糖尿病患者为研究对象,按抛硬币法随机分为观察组和对照组各52例。对照组以胰岛素强化治疗,观察组在对照组基础上增加清热利湿化痰方治疗。评估对比组间临床疗效、中医症候积分、血糖代谢、血清MCP-1、IL-1β、HMGB1指标及不良反应发生情况。结果:观察组总有效率为90.38%(47/52),高于对照组总有效率73.08%(38/52),差异有统计学意义(P<0.05)。治疗后两组患者中医症候积分均有降低,且观察组中医症候包括口苦咽干、神疲乏力、烦躁易怒、舌红苔黄等积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者各项血糖代谢指标水平均有降低,且观察组患者的血糖指标糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者各项炎症因子水平均有降低,且观察组MCP-1、IL-1β、HMGB1水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间观察组和对照组的不良反应发生率分别为15.38%(8/52)、9.62%(5/52),组间比较差异无统计学意义(P>0.05)。结论:清热利湿化痰方对痰湿瘀热型2型糖尿病有较好的治疗效果,能纠正患者的糖代谢紊乱状态,降低患者的不良中医症候程度,抑制MCP-1、IL-1β、HMGB1水平的表达,且不良反应发生率较低。

Objective:To Investigate the Effects of Qingre Lishi Huatan Recipe on TCM Syndrome Scores,Blood Glucose Metabolism and Serum Levels of monocyte chemoattractant protein-1(MCP-1),Interleukin-1β(IL-1β)and high mobility group protein B1(HMGB1)in patients with type 2 diabetes mellitus with phlegm-damp-stasis-heat type.Methods:A total of 104 patients with type 2 diabetes who received treatment from May 2018 to May 2021 in the Enshi Tujia and Miao Autonomous Prefecture Central Hospital were collected as the research objects,and according to the coin tossing method,they were randomly divided into observation group and control group,with 52 cases in each group.The control group was given intensive insulin treatment,while the observation group was given the addition of Qingre Lishi Huatan Recipe on the basis of the control group.The clinical efficacy,TCM symptom scores,blood glucose metabolism,serum MCP-1,IL-1β,HMGB1 indexes and the occurrence of adverse reactions between the comparison groups were evaluated.Results:The total effective rate of the observation group was 90.38%(47/52),which was higher than that 73.08%(38/52)of the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM symptom scores in both groups were decreased,and the TCM symptom scores in the observation group,including including bitter mouth and dry throat,mental fatigue,irritability,red tongue and yellow fur were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of various blood glucose metabolism indexes in the two groups were decreased,and the blood glucose indexes glycosylated hemoglobin(HbA1c),fasting insulin(FINS),and insulin resistance index(HOMA-IR)levels of the observation group were lower than those of the control group,and the differences were higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of various inflammatory factors in the two groups were decreased,and the levels of MCP-1,IL-1β,and HMGB1 in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).During the treatment period,the incidence of adverse reactions in the observation group and the control group were 15.38%(8/52)and 9.62%(5/52),respectively,and there was no significant difference between the groups(P>0.05).Conclusion:Qingre Lishi Huatan recipe has a good therapeutic effect on type 2 diabetes mellitus with phlegm-damp-stasis-heat type.It can correct the disorder of glucose metabolism,reduce the degree of adverse TCM symptoms,and inhibit the expression of MCP-1,IL-1β,HMGB1 and the incidence of adverse reactions were low.