摘要
目的:观察皮内针联合大柴胡汤治疗肝胃郁热证型肥胖2型糖尿病(T2DM)患者的临床效果。方法:纳入100例肥胖型2型糖尿病辨证为肝胃郁热证患者。按照随机数字表法分为两组,对照组给予口服大柴胡汤治疗,治疗组予中药口服加用皮内针。疗程均为12周。比较两组患者中医证候变化,体重(Wt)、体重指数(BMI)、腰臀比(WHR),血糖(FBG、2hPG、HbA1c)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)及血脂(TG、TC、LDL-C、HDL-C)变化。结果:治疗组证候改善总有效率明显高于对照组(87.5%对比66.7%),差异有统计学意义(P<0.05)。治疗后两组Wt、BMI、血糖(FBG、2hPG、HbA1c)、FINS、HOMA-IR、血脂(TG、TC、LDL-C)均较治疗前降低(P<0.05),且治疗组下降更为明显,差异有统计学意义(P<0.05)。治疗后WHR较前均有下降,但组间比较差异无统计学意义(P>0.05)。HDL-C较前有所升高,但差异无统计学意义(P>0.05)。两组治疗后中医形体肥胖、胸胁胀闷、口干口苦、心烦易怒、脘腹痞满证候评分均低于治疗前(P<0.05),且治疗组各证候及总评分均优于对照组(P<0.05)。结论:皮内针联合大柴胡汤治疗肝胃郁热证肥胖型T2DM患者效果显著,可以减轻胰岛素抵抗,能够减重,纠正糖脂代谢紊乱,明显改善患者的临床症状,且安全性良好。
Objective:To observe the clinical effect of intradermal needle combined with Dachaihu decoction in the treatment of obese type 2 diabetes mellitus(T2DM)patients with liver-stomach heat stagnation syndrome.Methods:100 obese patients with type 2 diabetes mellitus diagnosed and treated by outpatient and ward were prospectively included.According to the random number table method,they were divided into two groups.The control group was treated with oral administration of Dachaihu decoction,and the treatment group was treated with oral administration of traditional Chinese medicine combined with intradermal needle.The course of treatment was 12 weeks.The changes of TCM syndromes,body weight(Wt),body mass index(BMI),waist-hip ratio(WHR),blood glucose(FBG,2hPG,HbA1c),fasting insulin(FINS),insulin resistance index(HOMA-IR)and blood lipids(TG,TC,LDL-C,HDL-C)were compared between the two groups.Results:The total effective rate of syndrome improvement in the treatment group was significantly higher than that in the control group(87.5%vs 66.7%),and the difference was statistically significant(P<0.05).After treatment,the Wt,BMI,blood glucose(FBG,2hPG,HbA1c),FINS,HOMA-IR,blood lipids(TG,TC,LDL-C)of the two groups were lower than those before treatment(P<0.05),and the treatment group decreased more significantly,the difference was statistically significant(P<0.05).WHR decreased after treatment,but there was no significant difference between the two groups(P>0.05).HDL-C was higher than before,but the difference was not significant(P>0.05).After treatment,the scores of TCM syndromes of obesity,chest tightness,dry mouth and bitter mouth,irritability and abdominal fullness in the two groups were lower than those before treatment(P<0.05),and the scores of each syndrome and total score in the treatment group were better than those in the control group(P<0.05).Conclusion:Intradermal acupuncture combined with Dachaihu decoction is effective in the treatment of obese T2 DM patients with liver-stomach heat stagnation syndrome.It can reduce insulin resistance,lose weight,correct glucose and lipid metabolism disorders,significantly improve the clinical symptoms of patients,and has good safety.
作者
张秋菊
吴瑞
郭丰年
安然
李勤
许宏亮
ZHANG Qiuju;WU Rui;GUO Fengnian;AN Ran;LI Qin;XU Hongliang(Endocrinology Department of Guang’anmen Hospital South Campus,China Academy of Chinese Medical Sciences,Beijing 102600,China)
出处
《陕西中医》
2026年第1期105-109,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(82004345)
中国中医科学院广安门医院南区院级科研基金资助项目(Y2022-15)
尉淑卿3+3工程基层老中医传承项目。
关键词
2型糖尿病
肥胖
肝胃郁热证
大柴胡汤
皮内针治疗
Type 2 diabetes
Obesity
Liver and stomach heat syndrome
Dachaihu decoction
Intradermal needle therapy
