大黄黄连泻心汤联合针刺治疗肥胖2型糖尿病患者的临床研究

Clinical study on Dahuang Huanglian Xiexin Decoction combined with acupuncture in treating obese patients with type 2 diabetes mellitu

目的 观察大黄黄连泻心汤联合“土郁夺之”针刺法治疗肥胖2型糖尿病患者的临床疗效。方法 选择2021年9月至2023年2月于广西壮族自治区江滨医院就诊的肥胖2型糖尿病患者112例,根据随机数字表法分为观察组与对照组,根据纳入排除标准,最终每组54例患者。2组均给予西药常规治疗,对照组给予“土郁夺之”针刺法治疗,观察组在对照组基础上给予大黄黄连泻心汤治疗。观察2组治疗前后临床疗效、中医证候评分、血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平、肥胖指标(体质量指数、内脏脂肪面积、腰臀比)、血脂(总胆固醇、甘油三酯、低密度脂蛋白胆固醇)水平、血清脂肪因子(血清脂联素、血清瘦素、神经肽Y)水平及不良反应发生情况。结果 治疗后观察组总有效率为92.59%,显著高于对照组的79.63%(P<0.05)。治疗后2组中医证候评分、血糖、血脂、肥胖指标、血清瘦素、神经肽Y水平均较治疗前降低,且观察组低于对照组,2组治疗后血清脂联素水平较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组治疗过程中均未出现低血糖等严重不良反应。结论 大黄黄连泻心汤联合“土郁夺之”针刺法治疗肥胖2型糖尿病患者临床疗效显著。

Objective To observe the clinical effect of Dahuang Huanglian Xiexin Decoction combined with"Tuyu duozhi"acupuncture in treating the obese patients with type 2 diabetes mellitus.Methods A total of 112 obese patients with type 2 diabetes mellitus in Jiangbin Hospital of Guangxi Zhuang Autonomous Region from September 2021 to February 2023 were selected and divided into the observation group and control group by the random number table method.There were 54 cases in each group according to the inclusion and exclusion criterion.Both groups were given the conventional Western medicine treatment,the control group was given"Tuyu duozhi"acupuncture treatment,and the observation group was given Dahuang Huanglian Xiexin Decoction on the basis of the control group.The clinical efficacy,TCM syndrome scores,blood glucose(fasting blood glucose,blood glucose at 2 h after meal,glycosylated hemoglobin)level,obesity index(body mass index,visceral fat area,waist-to-hip ratio),blood lipid(total cholesterol,triglycerides,low-density lipoprotein cholesterol)level,serum adipocytokines(serum adiponectin,serum leptin,neuropeptide Y)level before and after treatment and occurrence situation of adverse reactions were observed in the two groups.Results After treatment,the total effective rate in the observation group was 92.59%,which was significantly higher than 79.63%in the control group(P<0.05).The TCM syndrome score,blood glucose level,blood lipid level,obesity index,serum leptin level and neuropeptide Y level after treatment in the two groups were decreased compared with before treatment,moreover the observation group was lower than the control group,the serum adiponectin level after treatment in the two groups was increased compared with before treatment,moreover the observation group was higher than the control group,and the differences were statistically significant(P<0.05).Conclusion Dahuang Huanglian Xiexin Decoction combined with"Tuyu duozhi"acupuncture has significant clinical effect in the treatment of the obese patients with type 2 diabetes mellitus.