甘麦百黄汤治疗气阴两虚型2型糖尿病伴失眠的疗效及对血清5-羟色胺、白细胞介素1β水平的影响

Curative effect of Ganmai Baihuang Decoction on serum 5-hydroxytryptamine and interleukin-1βin patients with type 2 diabetes and insomnia of deficiency of both Qi and Yin

目的 观察甘麦百黄汤治疗气阴两虚型2型糖尿病伴失眠的疗效及对血清5-羟色胺(5-HT)、白细胞介素1β(IL-1β)水平的影响。方法 将116例气阴两虚型2型糖尿病伴失眠患者按照随机数字表法分为2组,对照组58例予盐酸二甲双胍片治疗,治疗组58例在对照组治疗基础上加服甘麦百黄汤。2组均1周为1个疗程,治疗4个疗程。比较2组临床疗效;比较2组治疗前后血糖空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)和空腹胰岛素(FINS)水平变化;比较2组治疗前后睡眠指标实际睡眠总时间、睡眠潜伏期、快速动眼(REM)潜伏期、夜间觉醒次数和觉醒总时间变化;比较2组治疗前后5-HT、IL-1β水平变化;比较2组治疗前后中医证候评分变化。结果 治疗组总有效率91.38%(53/58),对照组总有效率77.59%(45/58),治疗组临床疗效优于对照组(P<0.05)。2组治疗后FPG、2 hPG、HbA1c和FINS水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后实际睡眠总时间、快速动眼(REM)潜伏期均较本组治疗前升高(P<0.05),睡眠潜伏期、夜间觉醒次数和觉醒总时间均较本组治疗前降低(P<0.05);治疗后治疗组实际睡眠总时间、REM潜伏期均高于对照组(P<0.05),且睡眠潜伏期、夜间觉醒次数和觉醒总时间均低于对照组(P<0.05)。2组治疗后5-HT水平均较本组治疗前升高(P<0.05),IL-1β水平均较本组治疗前降低(P<0.05);治疗后治疗组5-HT水平高于对照组(P<0.05),IL-1β水平低于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论 甘麦百黄汤治疗气阴两虚型2型糖尿病伴失眠效果肯定,可调节患者血清5-HT、IL-1β水平,降低血糖,改善临床症状。

Objective To observe the curative effect of Ganmai Baihuang Decoction on serum 5-hydroxytryptamine(5-HT)and interleukin-1β(IL-1β)in patients with type 2 diabetes and insomnia(deficiency of both Qi and Yin)and its influence on.Methods A total of 116 patients with type 2 diabetes and insomnia(deficiency of both Qi and Yin)were randomized 1∶1 to receive Metformin(the control group)or Ganmai Baihuang Decoction+Metformin(the treatment group).The treatment continued for 4 courses(1 course for 1 week),the aim was to compare clinical efficacy,fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA 1c),fasting insulin(FINS),sleep indexes(actual total sleep time,sleep latency,rapid eye movement[REM]latency,night awakening times and total awakening time),as well as 5-HT,IL-1β,traditional Chinese medicine(TCM)syndrome score before and after treatment between the two groups.Results After treatment,the total effective rate in the treatment group was higher than that in the control group(91.38%[53/58]vs 77.59%[45/58],P<0.05).FPG,2 hPG,HbA 1c and FINS in the two groups were decreased(P<0.05),the treatment group was more common(P<0.05).Elevated actual total sleep time and REM latency and reduced sleep latency,night awakening times and total awakening time were found in groups than those before treatment(all P<0.05),and the different was significant between groups for the above indexes(all P<0.05).Increased 5-HT level and decreased IL-1βwere detected in groups(all P<0.05),and the different was significant between groups(all P<0.05).TCM symptom scores in groups were decreased(P<0.05),which decreased in treatment group compared with control group(P<0.05).Conclusion For patients with type 2 diabetes and insomnia(deficiency of both Qi and Yin),Ganmai Baihuang Decoction has a positive effect.It can regulate the serum 5-HT and IL-1βlevels,lower blood sugar,and improve clinical symptoms.