平陈汤加减联合火针对2型糖尿病胃轻瘫(湿热困脾型)患者胃肠动力的调控作用及对微血管循环、GLC、Ghrelin和Cx43的影响

Effects of Modified Pingchen Decoction Combined with Fire Needle on Gastrointestinal Motile Regulation,Microvascular Circulation,GLC,Ghrelin and Cx43 in Type 2 Diabetes Mellitus Gastroparesis(Damp Heat Affecting the Spleen Pattern)

目的:观察平陈汤加减联合火针对2型糖尿病胃轻瘫(湿热困脾型)患者胃肠动力的调控作用及对微血管循环、胰高血糖素(GLC)、生长激素释放肽(Ghrelin)和间隙连接蛋白43(Cx43)的影响。方法:选择2021年6月至2023年6月陕西中医药大学附属医院收治的2型糖尿病胃轻瘫(湿热困脾型)患者104例,分组方式为随机数字表法。常规治疗组52例患者给予西医基础治疗,中医联合组52例患者在常规治疗组的基础上给予平陈汤加减联合火针治疗。比较两组患者的临床疗效,治疗前后评价患者的中医证候、胃轻瘫症状严重指数量表(GCSI)评分,检测患者胃排空率、胃窦收缩频率,检测患者血浆黏度、血小板聚集率和纤维蛋白原水平,检测患者GLC、餐后2 h血糖(2 hBG)、Ghrelin及Cx43水平。结果:中医联合组患者的总有效率为96.15%(50/52),较常规治疗组的80.77%(42/52)更高,差异有统计学意义(P<0.05)。治疗后,中医联合组患者的中医证候评分、GCSI评分低于常规治疗组,胃排空率、胃窦收缩频率高于常规治疗组,血浆黏度、血小板聚集率和纤维蛋白原水平低于常规治疗组,GLC、2 hBG水平低于常规治疗组,Ghrelin、Cx43水平高于常规治疗组,差异均有统计学意义(P<0.05)。结论:平陈汤加减联合火针治疗2型糖尿病胃轻瘫(湿热困脾型)患者,可调节血糖,改善GLC、Ghrelin和Cx43水平,改善微血管循环及胃肠动力,缓解患者病情,提高临床疗效。

OBJECTIVE:To observe the effects of modified Pingchen decoction combined with fire needle on gastrointestinal motile regulation,microvascular circulation,glucagon(GLC),Ghrelin and connexin 43(Cx43)in type 2 diabetic gastroparesis(damp heat affecting the spleen pattern).METHODS:Totally 104 patients with type 2 diabetic gastroparesis(damp heat affecting the spleen pattern)treated in Affiliated Hospital of Shaanxi University of Chinese Medicine from Jun.2021 to Jun.2023 were extracted to be divided into two groups through the random number table method.Fifty-two cases in the conventional treatment group were given basic Western medicine treatment,while 52 cases in the traditional Chinese medicine combination group received modified Pingchen decoction combined with fire needle based on the conventional treatment group.The clinical efficacy of two groups was compared.Traditional Chinese medicine syndrome,Gastroparesis Cardinal Symptom Index(GCSI)score before and after treatment were evaluated.Gastric evacuation rate,antrum contraction frequency,plasma viscosity,platelet aggregation rate and fibrinogen level were detected.The levels of GLC,2 h postprandial Blood glucose(2 hBG),Ghrelin,and Cx43 were measured.RESULTS:The total effective rate of traditional Chinese medicine combination group was 96.15%(50/52),higher than 80.77%(42/52)of conventional treatment group,the difference was statistically significant(P<0.05).After treatment,traditional Chinese medicine syndrome score and GCSI score of the traditional Chinese medicine combination group were lower than those in the conventional treatment group,gastric evacuation rate,antrum contraction frequency were higher than those in the conventional treatment group,plasma viscosity,platelet aggregation rate and fibrinogen level were lower than those in the conventional treatment group,GLC and 2 hBG levels were lower than those in the conventional treatment group,Ghrelin and Cx43 levels were higher than those in the conventional treatment group,the differences were statistically significant(P<0.05).CONCLUSIONS:Modified Pingchen decoction combined with fire needle in the treatment of patients with type 2 diabetic gastroparesis(damp heat affecting the spleen pattern)can regulate blood sugar,improve GLC,Ghrelin and Cx43 levels,improve microvascular circulation and gastrointestinal motility,alleviate patients’condition and improve clinical efficacy.