半夏泻心汤对老年糖尿病胃轻瘫患者疗效及肠道菌群的影响

Effects of Banxia Xiexin decoction on therapeutic efficacy and intestinal flora in elderly patients with diabetic gastroparesis

中文关键词: 老年, 糖尿病胃轻瘫, 半夏泻心汤, 胃肠激素, 肠道菌群

英文关键词: elderly  diabetic gastroparesis  Banxia Xiexin decoction  gastrointestinal hormone  intestinal flora

中文摘要:

      目的 探索半夏泻心汤治疗寒热错杂型老年糖尿病胃轻瘫(DGP)患者的临床疗效及对肠道菌群的影响.方法 选取2019年1月-2022年9月于南京中医药大学第二附属医院接受治疗的寒热错杂型DGP老年患者80例,随机分为观察组(n=40)和对照组(n=40).2组接受糖尿病基础治疗,观察组口服半夏泻心汤,1剂/d;对照组口服莫沙比利片,5 mg/次,3次/d.2组按要求进行连续治疗,治疗时长为4周.记录2组治疗前后各自的中医症状评分,检测治疗前后空腹血糖(FPG)和餐后2 h血糖(2 hPG),检测血浆中的胃动素(MOL)、胃泌素(GAS)和胆囊收缩素(CCK)水平,检测治疗前后肠道菌群,并比较2组临床疗效及安全性.结果 观察组和对照组各有3例脱落病例,最终2组各有38例完成试验.治疗4周后,观察组治疗总有效率显著优于对照组(P＜0.05).治疗后,观察组中医证候评分低于对照组(P＜0.05);观察组血清FPG、2 h PG水平较对照组降低(P＜0.05);观察组血浆MOL、GAS水平高于对照组(P＜0.05),CCK水平较对照组降低(P＜0.05);与对照组比较,观察组的肠道杆菌、酵母菌、肠球菌的数量明显增加(P＜0.05),双歧杆菌、乳杆菌、拟杆菌的数量明显减少(P＜0.05).2组均未出现明显不良反应.结论 半夏泻心汤治疗寒热错杂型DGP疗效确切,可有效调节血糖和胃肠激素水平,改善肠道菌群紊乱状态,临床疗效优于单纯的西医治疗.

英文摘要:

      Objective To explore the clinical efficacy of Banxia Xiexin decoction in the treatment of elderly patients with diabetic gastroparesis(DGP)of cold-heat complex type and its effect on intestinal flora.Methods 80 elderly patients with DGP of cold-heat complex type who were treated in Second Affiliated Hospital of Nanjing University of Traditional Chi-nese Medicine(TCM)from January 2019 to September 2022 were randomly divided into observation group(n=40)and con-trol group(n=40).Both groups received basic diabetes treatment.Additionally,the observation group took Banxia Xiexin de-coction orally,one dose/day,while the control group took mosapride tablet orally,5 mg/time,3 times/day.Both groups re-ceived continuous treatment for 4 weeks as required.The TCM symptom scores of both groups were recorded before and after treatment.Before and after treatment,the levels of fasting blood glucose(FPG),postprandial 2-hour plasma glucose(2 h PG),plasma motilin(MOL),gastrin(GAS)and cholecystokinin(CCK)were detected,and the changes in intestinal flora were detected.The clinical efficacy and safety of the two groups were compared.Results Three patients in each group withdrew from the study,and 38 patients in each group completed the trial.After 4 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P＜0.05).After treatment,the TCM syn-drome score of the observation group was lower than that of the control group(P＜0.05);the levels of FPG and 2 h PG were lower than those of the control group(P＜0.05);the levels of plasma MOL and GAS were higher than those of the control group(P＜0.05);CCK level was lower than that of the control group(P＜0.05).Compared with the control group,the number of Escherichia coli,yeast,and enterococci in the observation group increased significantly(P＜0.05),while the num-ber of bifidobacterium,Lactobacillus and Bacteroides decreased significantly(P＜0.05).No significant adverse reaction was observed in both groups.Conclusion Banxia Xiexin decoction has a definite therapeutic effect on DGP of cold-heat complex type.It can effectively regulate the levels of blood sugar and gastrointestinal hormone,improve the disorder of intestinal flora,and its clinical effect is better than that of Western medicine alone.