ABSTRACT
Objective:To evaluate the efficacy of Qinggan Bupi Jiangtang Decoction combined with western medicine in the treatment of adult type 2 diabetes mellitus (T2DM) with with liver hyperactivity and spleen deficiency syndrome.Methods:Prospective cohort study. A total of 103 T2DM patients with liver hyperactivity and spleen deficiency syndrome in the Department of endocrinology of Shanghai Municipal Hospital of Traditional Chinese Medicine from February 2020 to February 2021 were randomly divided into the observation group (52 cases) and the control group (51 cases) according to random number table method. Both groups were treated with conventional western medicine, the control group was treated with sitagliptin phosphate on the basis of routine treatment, and the observation group was treated with Qinggan Bupi Jiangtang Decoction on the basis of routine treatment. Both groups were treated for 12 weeks. TCM symptom scores were performed before and after treatment. The FPG, 2hPBG, HbA1c and fasting insulin (FINS) were detected by dry chemistry method and Roche electroluminescence method, and insulin resistance index (HOMA-IR) was calculated. The clinical efficacy was evaluated by dynamic blood glucose monitoring indexes TIR (percentage of time when glucose was in the range of 3.9-10.0 mmol/L), TAR (percentage of time when glucose was higher than the target range ≥ 11.1 mmol/L) and TBR (percentage of time when glucose was lower than the target range <3.9 mmol/L).Results:The total effective rate was 92.3% (48/52) in the observation group and 56.9% (29/51) in the control group ( χ2=15.32, P<0.01). The score of TCM syndrome in the observation group was significantly lower than that of the control group ( t=6.30, P<0.01). The compliance rate of HbA1c in the observation group was 46.2% (24/52) and that of the control group was 23.5% (12/51). There was significant difference between the two groups ( χ2=5.80, P=0.016). Compared with the groups before treatment, MAGE, TAR, TBR significantly decreased and TIR significantly increased in both groups after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 0.78, 1.06, 0.22 and 1.45, respectively, P>0.05). Compared with the groups before treatment, the levels of FPG, 2 hPBG and HbA1c in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.32, 0.18,1.50, respectively, P>0.05). Compared with the groups before treatment, the levels of FINS and HOMA-IR in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.25, 0.51, respectively, P>0.05). There were no adverse reactions in the observation group, 2 cases of mild nausea and 1 case of transient diarrhea in the control group. There was no significant difference between the two groups ( χ2=3.15, P=0.118). Conclusion:Qinggan Bupi Jiangtang Decoction combined with routine treatment can improve the blood glucose level, TIR and blood glucose standard rates of adult T2DM with liver hyperactivity and spleen deficiency syndrome, and the curative effect is equivalent to sitagliptin phosphate tablets.
ABSTRACT
Objective:To evaluate the efficacy of Baduanjin combined with mecobalamin tablets in the treatment of type 2 diabetic peripheral neuropathy. Methods:Eighty patients with type 2 diabetic peripheral neuropathy who met the inclusion criteria were randomly divided into two groups with 40 patients in each group ( n=40). The control group took oral mecobalamin tablets and self-management, and the treatment group were treated with Baduanjin on the basis of the control group. All patients were treated for 12 weeks. The clinical symptoms were evaluated by Toronto Clinical Scoring System (TCSS), and the motor nerve conduction velocity (MCV) of tibial nerve and the sensory conduction velocity (SCV) of superficial peroneal nerve were measured by EMG evoked potential instrument. The hemorheological indexes (whole blood low shear viscosity, whole blood high shear viscosity and plasma viscosity) were measured before and after treatment. The clinical efficacy was evaluated and adverse events were recorded. Results:In the course of treatment, 39 patients in each group completed the study with each one dropout. The total effective rate was 87.2% (34/39) in the treatment group and 64.1% (25/39) in the control group. There was significant difference between the two groups ( χ2=5.64, P=0.018). After treatment, the TCSS score of the treatment group was significantly lower than that of the control group ( t=-6.23, P<0.01), the tibial nerve MCV (43.06 ± 4.19 m/s vs. 39.55 ± 4.30 m/s, t=3.65), the superficial peroneal nerve SCV (43.23 ± 4.31 m/s vs. 39.92 ± 3.74 m/s, t=3.62) in the treatment group were significantly higher than the control group ( P<0.001), while the whole blood high shear viscosity, the whole blood low shear viscosity, and the plasma viscosity in the treatment group were significantly lower than the control group ( t value were -10.36, -14.21, -13.88, all Ps<0.001). During the treatment, no serious adverse events occurred in both groups. Conclusion:Baduanjin combined with mecobalamin tablets in the treatment of type 2 diabetic peripheral neuropathy can reduce blood viscosity, promote blood circulation, increase nerve conduction velocity, improve clinical symptoms and signs, and improve clinical efficacy.
ABSTRACT
Objective:To observe the clinical effect of the Jinshui-Xiangsheng Decoction in treating metabolic syndrome (MS) with yin deficiency and heat. Methods:From October 2018 to May 2020, a total of 60 patients with MS and Yin deficiency and heat syndrome in the Department of Endocrinology, Shanghai Hospital of Traditional Chinese Medicine who met the selection criteria were divided into 2 groups according to a random number table, with 30 in each group. The control group took Western medicine standard treatment and lifestyle intervention, and the observation group took Jinshui-Xiangsheng Decoction on the basis of the control group. Both groups were treated for 12 weeks. TCM syndrome scores were performed before and after treatment, and fasting blood glucose, TG, TC, HDL-C, LDL-C, and fasting insulin (FINS) were detected by automatic biochemical analyzer and enhanced chemiluminescence immunoassay. We aimed to observe and record the patient's waist circumference, BMI, blood pressure level, and evaluate the clinical efficacy. Results:The total effective rate was 93.3% (28/30) in the observation group and 60.0% (18/30) in the control group. There was significant difference between the two groups ( χ2=4.135, P=0.016). After treatment, waist circumference, BMI, systolic blood pressure and diastolic blood pressure in the observation group were significantly lower than those in the control group ( t values were 4.650, 2.687, 2.134 and 2.333, respectively, P<0.01 or P<0.05), and fasting blood glucose, FINS, TG, TC, LDL-C and HDL-C were significantly lower than those in the control group ( t values were 2.812, 2.899, 2.678, 2.485, 2.527 and 2.905, respectively, all Ps<0.05). The score of TCM syndrome [(3.87 ± 2.21) vs. (6.50 ± 2.01), t=-4.827] in the observation group was significantly lower than that of the control group ( P<0.01). Conclusion:Combination of conventional western medicine treatment and Jinshui-Xiangsheng Decoction can improve clinical objective indicators and clinical symptom scores, and improve metabolic disorder state for the patients with metabolic syndrome and Yin deficiency and heat.