Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency wit...Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.展开更多
Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the tr...Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the treatment of GERD.Spleen deficiency and damp-heat syndrome becomes one of the main syndrome patterns of GERD adapting with the changes of modern lifestyle.Although the therapy of strengthening the spleen,clearing heat and dampness is widely used in treatment of GERD,further studies still need to be conducted.The article comprehensively analyses the theoretical basis,mechanism and clinical efficacy of the therapy in order to provide more ideas for clinical treatment.展开更多
目的:探讨2型糖尿病(T2DM)湿热困脾证、气阴两虚证患者肠道菌群的结构特征和功能差异。方法:选择2018年6月至2020年1月就诊于南京中医药大学附属南京中医院的T2DM湿热困脾证患者62例,气阴两虚证患者60例,收集其血清及粪便样本,比较两证...目的:探讨2型糖尿病(T2DM)湿热困脾证、气阴两虚证患者肠道菌群的结构特征和功能差异。方法:选择2018年6月至2020年1月就诊于南京中医药大学附属南京中医院的T2DM湿热困脾证患者62例,气阴两虚证患者60例,收集其血清及粪便样本,比较两证型患者体质量指数(BMI),糖脂代谢,空腹胰岛素(FINS),空腹C肽(FCP),胰岛素抵抗指数(HOMA-IR),粪便样本提取DNA建库,采用高通量16S rDNA测序技术,对2组肠道菌群及菌群代谢通路分析比较。结果:①与气阴两虚证患者比较,湿热困脾证患者的BMI,空腹血糖(FPG),餐后2 h血糖(2 h PBG),总胆固醇(TC),甘油三酯(TG),低密底脂蛋白(LDL),FINS,FCP,HOMA-IR均明显升高,HDL明显降低(P<0.05,P<0.01)。②两组菌群物种组成及差异,在纲水平上,以拟杆菌纲,梭状芽胞杆菌纲,γ蛋白杆菌纲等为主,气阴两虚证的梭状芽胞杆菌、柔膜菌纲、疣微菌纲的相对丰度明显高于湿热困脾证(P<0.05);目水平下以拟杆菌目、梭菌目、肠杆菌目等为主,气阴两虚证的梭菌目、丹毒丝菌目、疣微菌目的相对丰度明显高于湿热困脾证,而气单胞菌目则在湿热困脾证高于气阴两虚证(P<0.05);科水平下以拟杆菌科、普氏菌科、瘤胃球菌科等为主,其中气阴两虚证的瘤胃球菌科、紫单胞菌科、丹毒丝菌科等的相对丰度明显高于湿热困脾证(P<0.05);属水平下以拟杆菌属、普氏菌属、副拟杆菌属等为主,其中气阴两虚证的副拟杆菌属、丁酸弧菌属、瘤胃梭菌属等的相对丰度显著高于湿热困脾证,而在湿热困脾组的克雷伯菌属、巨球型菌属则高于气阴两虚证(P<0.05)。③基于运算分类单位(OTU)的Venn分析发现湿热困脾证和气阴两虚证患者独有的OUT分别49,47个。④基于OTU的β多样性和α分析,结果Shannon,Simpson指数差异均具有统计学意义,Ace,Chao指数差异无统计学意义,气阴两虚证患者的肠道微生物多样性高于湿热困脾证患者(P<0.05);Anosim分析提示两组β多样性差异具有统计学意义(P<0.05)。⑤线性判别效应(LEfSe)分析发现湿热困脾证可选择克雷伯菌、巨球型菌属、气单胞菌目3种菌群作为关键的生物标志物,气阴两虚证可选择瘤胃梭菌属、伯克氏菌科、劳氏菌属、丁酸弧菌属、丹毒丝菌目等14种菌群作为关键的生物标志物。⑥功能注释及分析可见湿热困脾证涉及精氨酸和脯氨酸代谢、脂多糖生物合成、烟酸和烟酰胺代谢等9个代谢通路,气阴两虚证涉及阿卡波糖和缬草霉素生物合成,胰高血糖素信号通路,NOD样受体信号通路等10个代谢通路。结论:T2DM湿热困脾证和气阴两虚证患者存在肠道菌群明显的差异和功能差异,可作为T2DM中医辨证客观化的参考和中医药治疗的靶点。展开更多
基金This work was supported by Science and Technology Projects of Yunnan Province(No.202101AT070246).
文摘Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.
基金Nursery Project of Xiyuan Hospital,China Academy of Chinese Medical Sciences-Peripheral mechanism of mast cell activation of PAR2/TRPV1 pathway in NERD esophageal hypersensitivity and the intervention of Jianpi Qinghua Granules(2019XYMP-48)。
文摘Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the treatment of GERD.Spleen deficiency and damp-heat syndrome becomes one of the main syndrome patterns of GERD adapting with the changes of modern lifestyle.Although the therapy of strengthening the spleen,clearing heat and dampness is widely used in treatment of GERD,further studies still need to be conducted.The article comprehensively analyses the theoretical basis,mechanism and clinical efficacy of the therapy in order to provide more ideas for clinical treatment.
文摘目的:探讨2型糖尿病(T2DM)湿热困脾证、气阴两虚证患者肠道菌群的结构特征和功能差异。方法:选择2018年6月至2020年1月就诊于南京中医药大学附属南京中医院的T2DM湿热困脾证患者62例,气阴两虚证患者60例,收集其血清及粪便样本,比较两证型患者体质量指数(BMI),糖脂代谢,空腹胰岛素(FINS),空腹C肽(FCP),胰岛素抵抗指数(HOMA-IR),粪便样本提取DNA建库,采用高通量16S rDNA测序技术,对2组肠道菌群及菌群代谢通路分析比较。结果:①与气阴两虚证患者比较,湿热困脾证患者的BMI,空腹血糖(FPG),餐后2 h血糖(2 h PBG),总胆固醇(TC),甘油三酯(TG),低密底脂蛋白(LDL),FINS,FCP,HOMA-IR均明显升高,HDL明显降低(P<0.05,P<0.01)。②两组菌群物种组成及差异,在纲水平上,以拟杆菌纲,梭状芽胞杆菌纲,γ蛋白杆菌纲等为主,气阴两虚证的梭状芽胞杆菌、柔膜菌纲、疣微菌纲的相对丰度明显高于湿热困脾证(P<0.05);目水平下以拟杆菌目、梭菌目、肠杆菌目等为主,气阴两虚证的梭菌目、丹毒丝菌目、疣微菌目的相对丰度明显高于湿热困脾证,而气单胞菌目则在湿热困脾证高于气阴两虚证(P<0.05);科水平下以拟杆菌科、普氏菌科、瘤胃球菌科等为主,其中气阴两虚证的瘤胃球菌科、紫单胞菌科、丹毒丝菌科等的相对丰度明显高于湿热困脾证(P<0.05);属水平下以拟杆菌属、普氏菌属、副拟杆菌属等为主,其中气阴两虚证的副拟杆菌属、丁酸弧菌属、瘤胃梭菌属等的相对丰度显著高于湿热困脾证,而在湿热困脾组的克雷伯菌属、巨球型菌属则高于气阴两虚证(P<0.05)。③基于运算分类单位(OTU)的Venn分析发现湿热困脾证和气阴两虚证患者独有的OUT分别49,47个。④基于OTU的β多样性和α分析,结果Shannon,Simpson指数差异均具有统计学意义,Ace,Chao指数差异无统计学意义,气阴两虚证患者的肠道微生物多样性高于湿热困脾证患者(P<0.05);Anosim分析提示两组β多样性差异具有统计学意义(P<0.05)。⑤线性判别效应(LEfSe)分析发现湿热困脾证可选择克雷伯菌、巨球型菌属、气单胞菌目3种菌群作为关键的生物标志物,气阴两虚证可选择瘤胃梭菌属、伯克氏菌科、劳氏菌属、丁酸弧菌属、丹毒丝菌目等14种菌群作为关键的生物标志物。⑥功能注释及分析可见湿热困脾证涉及精氨酸和脯氨酸代谢、脂多糖生物合成、烟酸和烟酰胺代谢等9个代谢通路,气阴两虚证涉及阿卡波糖和缬草霉素生物合成,胰高血糖素信号通路,NOD样受体信号通路等10个代谢通路。结论:T2DM湿热困脾证和气阴两虚证患者存在肠道菌群明显的差异和功能差异,可作为T2DM中医辨证客观化的参考和中医药治疗的靶点。
