摘要
目的观察参苓白术散加味对盐酸二甲双胍片所致2型糖尿病(T2DM)腹泻脾胃虚弱证患者血清炎症因子及脑-肠-菌轴的影响。方法将76例盐酸二甲双胍片所致T2DM腹泻脾胃虚弱证患者按照随机数字表法分为2组,对照组38例予盐酸洛哌丁胺胶囊治疗,治疗组38例在对照组治疗基础上联合参苓白术散加味治疗。2组均治疗4周。比较2组疗效;比较2组治疗前后中医证候积分、血清炎症因子、血清脑肠肽相关指标、肠道菌群变化。结果最终治疗组36例、对照组34例完成试验。治疗组总有效率91.67%(33/36),对照组总有效率为73.53%(25/34),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项积分及总积分均较本组治疗前降低(P<0.05);治疗后治疗组大便性状、大便次数、脘腹胀闷、食欲不振积分及总积分均低于对照组(P<0.05)。2组治疗后血清白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)均较本组治疗前降低(P<0.05),治疗后治疗组血清IL-1β、IL-6、TNF-α均低于对照组(P<0.05)。2组治疗后血清5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)、血管活性肠肽(VIP)均较本组治疗前降低(P<0.05),血清神经肽Y(NPY)较本组治疗前升高(P<0.05);治疗后治疗组血清5-HT、CGRP、VIP均低于对照组(P<0.05),血清NPY高于对照组(P<0.05)。2组治疗后双歧杆菌、乳酸杆菌均较本组治疗前升高(P<0.05),大肠杆菌、肠球菌均较本组治疗前降低(P<0.05);治疗后治疗组双歧杆菌、乳酸杆菌均高于对照组(P<0.05),大肠杆菌、肠球菌均低于对照组(P<0.05)。结论参苓白术散加味治疗盐酸二甲双胍片所致T2DM腹泻脾胃虚弱证,能改善患者临床症状,提高疗效,可能与拮抗炎性反应、调节脑-肠-菌轴功能有关。
Objective To observe the effect of modified Shenling Baizhu Powder on serum inflammatory factors and brain-gut-bacteria axis of metformin-associated diarrhea in patients with type 2 diabetes mellitus(T2DM)of spleen-stomach deficiency syndrome.Methods Seventy-six T2DM patients with metformin-associated diarrhea(spleen-stomach deficiency syndrome)were randomized to receive loperamide hydrochloride capsules(control group,38 cases,4 cases dropped off)or modified Shenling Baizhu Powder+loperamide hydrochloride capsules(treatment group,38 cases,2 cases dropped off)for 4 weeks.The curative effects,traditional Chinese medicine(TCM)syndrome scores,serum inflammatory factors,the indexes of brain-gut peptide and intestinal flora were included as comparisons between groups before and after treatment.Results The total effective rate in the treatment group was better than that in the control group(91.67%[33/36]vs 73.53%[25/34],P<0.05).After treatment,the scores of each dimension and total score of TCM syndromes in the both groups were significantly lower than those before treatment(P<0.05),and the scores of stool character,stool frequency,abdominal distension,loss of appetite and total score in the treatment group were significantly lower than those in the control group(P<0.05).The levels of serum interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)in the both groups were significantly lower(P<0.05),which in the treatment group were more prevalent(P<0.05).After treatment,significantly lower serotonin(5-hydroxytryptamine[5-HT]),calcitonin gene-related peptide(CGRP)and vasoactive intestinal peptide(VIP),and significantly higher serum neuropeptide Y(NPY)were detected in the both groups(all P<0.05),and there were significant differences in 5-HT,CGRP,VIP,and NPY between the treatment group and the control group(all P<0.05).After treatment,the levels of Bifidobacterium and Lactobacillus in the two groups were significantly increased than those before treatment(P<0.05),and the increase was more common in the treatment gr
作者
赵世聪
罗廷
曹秋梅
陈健
王诗陶
ZHAO Shicong;LUO Ting;CAO Qiumei;CHEN Jian;WANG Shitao(Department of Spleen and Stomach Endocrinology,ChongQing JiangJin District Hospital of Chinese Medicine,Chongqing 402260;Department of Encephalopathy,ChongQing JiangJin District Hospital of Chinese Medicine,Chongqing 402260)
出处
《河北中医》
2023年第12期2007-2012,共6页
Hebei Journal of Traditional Chinese Medicine
关键词
糖尿病
2型
腹泻
参苓白术散
二甲双胍
Type 2 diabetes mellitus
Diarrhea
Shenling Baizhu Powder
Metformin
