参苓白术散辅助西医对肥胖2型糖尿病患者血糖控制、体质量指数及胰岛β细胞功能的影响

Shenling Baizhu Powder assists western medicine in controlling blood glucose,body mass index and islet of pancreas in obese type 2 diabetes patientsβeffect of cell function

目的观察参苓白术散辅助西医对肥胖2型糖尿病(T2DM)患者血糖控制、体质量指数(BMI)及胰岛β细胞功能的影响。方法以2021年1月~2022年3月收治的170例肥胖T2DM患者为研究对象,随机分为常规组(85例)和联合组(85例)。常规组采用二甲双胍,联合组基于常规组辅助参苓白术散。比较2组临床疗效、臀围比(WHR)、BMI、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、β细胞功能指数(HOMA-β)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、单核趋化蛋白-1(MCP-1)、胰高血糖素样肽-1(GLP-1)、微小RNA-146a(miR-146a)、miR-221及不良反应。结果联合组总有效率(88.24%)高于常规组(71.12%)(P<0.05);治疗后,联合组WHR、BMI、FPG、HbA1c变化幅度大于常规组(P<0.05);与常规组相比,治疗后联合组HOMA-β升高,FINS、HOMA-IR下降(P<0.05);联合组MCP-1下降,GLP-1、miR-146a、miR-221上升(P<0.05);联合组不良反应发生率(5.88%)与常规组(11.76%)比较,差异无统计学意义(P>0.05)。结论参苓白术散辅助西医治疗肥胖T2DM疗效确切,能缓解患者胰岛素耐受及高血糖,抑制炎症反应,减轻体重,调控miR-146a、miR-221表达。

Objective To explore the effect of Shenling Baizhu Powder(SLBSP)on blood glucose control,body mass index(BMI)and pancreatic islets in obese patients with type 2 diabetes(T2DM)βthe influence of cell function.Methods From January 2021 to March 2022,one hundred and seventy obese T2DM patients admitted to the hospital were selected as the research objects.They were randomly divided into the conventional group(85 cases)and the combined group(85 cases)by computer random number table.The conventional group was treated with metformin,and the combined group was based on the conventional group assisted with Shenling Baizhu Powder.Compare the clinical efficacy,obesity indicators:hip circumference ratio(WHR),BMI,blood glucose:HbA1c,FPG,and islets of Langerhans between the two groupsβCell function:βCell function index(HOMA-β),Fasting insulin(FINS),insulin resistance index(HOMA-IR),inflammatory factors:monocyte chemoattractant protein-1(MCP-1),glucagon like peptide-1(GLP-1),microRNA-146a(miR-146a),miR-221 and adverse reactions.Results The total effective rate in the combined group was higher than that in the conventional group(88.24%vs 71.12%,P<0.05);After treatment,the changes of WHR,BMI,FPG and HbA1c in the combined group were greater than those in the conventional group(P<0.05);Compared with the conventional group,HOMA in the combined group after treatment-βFINS and HOMA-IR decreased(P<0.05);After treatment,MCP-1 in the combined group decreased,GLP-1,miR-146a,miR-221 increased(P<0.05);The incidence of adverse reactions in the combination group was 5.88%compared with 11.76%in the conventional group,with no significant difference(P>0.05).Conclusion Shenling Baizhu Powder is effective in assisting western medicine in treating obesity T2DM,which can alleviate insulin tolerance and hyperglycemia,inhibit inflammatory reaction,reduce weight,and regulate the expression of miR-146a and miR-221.