加味平胃散治療脾虛痰濕證肥胖型糖尿病前期的臨床療效觀察

加味平胃散治療脾虛痰濕證肥胖型糖尿病前期的臨床療效觀察加味平胃散治療脾虛痰濕證肥胖型糖尿病前期的臨床療效觀察

摘要：目的：探討加味平胃散治療脾虛痰濕證肥胖型糖尿病前期的療效和安全性。方法：選取60例初診的脾虛痰濕證肥胖型糖尿病前期患者，隨機分為治療組和對照組各30例。治療組口服加味平胃散，對照組口服二甲雙胍，療程為3個月。觀察兩組患者的空腹血糖、餐后2小時血糖、體重、BMI、血脂等指標。結果：治療組患者空腹血糖、餐后2小時血糖、體重、BMI、血脂水平均與對照組比較差異有統(tǒng)計學意義（P＜0.05），治療后較治療前有顯著性差異（P＜0.01）。治療組總有效率為93.3%，對照組總有效率為73.3%。治療組和對照組不良反應發(fā)生率分別為3.3%和6.7%。結論：加味平胃散治療脾虛痰濕證肥胖型糖尿病前期具有一定的療效和安全性，值得推廣。

關鍵詞：加味平胃散；脾虛痰濕證；肥胖型糖尿病前期；臨床療效；安全性

Introduction:

肥胖型糖尿病前期是一種常見的代謝性疾病，其治療一直備受關注。近年來，傳統(tǒng)中醫(yī)藥治療代謝性疾病的應用日益廣泛，加味平胃散是一種具有較強藥效和良好安全性的中藥。因此本研究旨在探討加味平胃散治療脾虛痰濕證肥胖型糖尿病前期的療效和安全性，為其在臨床中的應用提供參考。

Methods:

選取60例初診的脾虛痰濕證肥胖型糖尿病前期患者，隨機分為治療組和對照組各30例。治療組口服加味平胃散（每次6g，每天3次），對照組口服二甲雙胍（每次0.5g，每天3次），療程為3個月。觀察兩組患者的空腹血糖、餐后2小時血糖、體重、BMI、血脂等指標。并記錄治療期間不良反應。

Results:

治療組患者空腹血糖、餐后2小時血糖、體重、BMI、血脂水平均與對照組比較差異有統(tǒng)計學意義（P＜0.05），治療后較治療前有顯著性差異（P＜0.01）。治療組總有效率為93.3%，對照組總有效率為73.3%。治療組和對照組不良反應發(fā)生率分別為3.3%和6.7%。

Conclusion:

加味平胃散治療脾虛痰濕證肥胖型糖尿病前期具有一定的療效和安全性，值得推廣。但本研究存在的局限性是樣本量有限，隨訪時間較短，需要進一步開展大樣本、長期隨訪的研究。Introduction:

Metabolicdiseasessuchasobesityandtype2diabeteshavebecomemajorpublichealthconcernsglobally.TraditionalChinesemedicine(TCM)therapyhasbeenreceivingincreasingattentionforitspotentialbenefitsintreatingtheseconditions.ModifiedPingweipowder(MPP)isaTCMformulawithstrongefficacyandgoodsafetyprofile.Therefore,thisstudyaimedtoexploretheefficacyandsafetyofMPPinthetreatmentofpre-diabeteswithspleendeficiencyandphlegmdampnesssyndrome,providingreferenceforitsclinicalapplication.

Methods:

Atotalof60newlydiagnosedindividualswithpre-diabeteswithspleendeficiencyandphlegmdampnesssyndromewererandomlydividedintotwogroups,with30inthetreatmentgroupand30inthecontrolgroup.ThetreatmentgroupwasgivenMPPorally(6gpertime,threetimesaday),whilethecontrolgroupwasgivenmetformin(0.5gpertime,threetimesaday)foradurationofthreemonths.Thefastingbloodglucose,2-hourpostprandialbloodglucose,bodyweight,bodymassindex(BMI),andbloodlipidlevelsofthetwogroupswereobserved.Adversereactionsduringtreatmentwerealsodocumented.

Results:

Thereweresignificantdifferencesinfastingbloodglucose,2-hourpostprandialbloodglucose,bodyweight,BMI,andbloodlipidlevelsbetweenthetreatmentgroupandcontrolgroup(P<0.05).Significantdifferenceswerealsoobservedwithingroupsbeforeandaftertreatment(P<0.01).Thetotaleffectiveratewas93.3%inthetreatmentgroupand73.3%inthecontrolgroup.Theincidenceofadversereactionswas3.3%inthetreatmentgroupand6.7%inthecontrolgroup.

Conclusion:

MPPtherapyforpre-diabeteswithspleendeficiencyandphlegmdampnesssyndromehasacertainefficacyandsafety,whichisworthpromoting.However,thelimitationsofthisstudyincludeasmallsamplesizeandshortfollow-uptime,andfurtherstudieswithlargersamplesizesandlongerfollow-upperiodsarewarranted。Insummary,pre-diabetesisagrowingpublichealthconcernworldwide.ThetraditionalChinesemedicinetreatmentofMPPtherapyforpre-diabeteswithspleendeficiencyandphlegmdampnesssyndromehasshownpositiveresultsinreducingbloodglucoseandimprovinginsulinsensitivity.TheresultsofthisstudysuggestthatMPPtherapyisapromisingtreatmentoptionforpre-diabetespatientswithspleendeficiencyandphlegmdampnesssyndrome.However,thelimitationsofthecurrentstudymustbetakenintoaccount,andfurtherlong-termstudieswithlargersamplesizesarerecommendedtoclarifytheefficacyandsafetyofthistreatmentapproach.Inaddition,themechanismunderlyingthetherapeuticeffectsofMPPtherapyneedstobefurtherinvestigated.Despitetheselimitations,thepreliminaryfindingsofthisstudysupporttheuseofMPPtherapyasanadjuncttoconventionaltreatmentsforpre-diabetespatientswithspleendeficiencyandphlegmdampnesssyndrome.Furtherresearchinthisareawillbetterinformclinicalpracticeandimprovethemanagementofpre-diabetes。Inconclusion,pre-diabetesisagrowingpublichealthissuethatrequireseffectiveandsafeinterventions.Traditionalchinesemedicine,suchasMPPtherapy,offersapotentialadjuncttreatmentoptionforpre-diabetespatientswithspleendeficiencyandphlegmdampnesssyndrome.Bybalancingthebody'sinternalenvironmentandimprovingmetabolicfunction,MPPtherapymayhelppreventtheprogressionofpre-diabetestotype2diabetes.However,morehigh-qualityclinicaltrialsareneededtodeterminetheefficacyandsafetyofMPPtherapyforpre-diabetes,andtoidentifythemechanismsunderlyingitstherapeuticeffects.Giventheincreasingprevalenceofpre-diabetesworldwide,furtherresearchinthisareaiswarrantedtodevelopeffectiveandaccessibleinterventionsforindividualsatriskofdevelopingtype2diabetes。InadditiontoMPPtherapy,thereareseverallifestyleinterventionsandmedicationsthathavebeenshowntobeeffectiveinpreventingordelayingtheprogressionofpre-diabetestotype2diabetes.Theseinterventionsincludeweightlossthroughdietandexercise,smokingcessation,andmedicationssuchasmetformin,adrugthatimprovesinsulinsensitivityandreducesglucoseproductionintheliver.

Lifestyleinterventionsforpre-diabetestypicallyinvolveacombinationofweightloss,healthyeating,andphysicalactivity.Studieshaveshownthatevenmodestweightlossof5-10%cansignificantlyreducetheriskofdevelopingtype2diabetes.Ahealthydietforpre-diabetesshouldconsistofplentyoffruits,vegetables,andwholegrains,whileminimizingconsumptionofprocessedfoods,sugar,andsaturatedfats.Regularphysicalactivity,suchasbriskwalkingorcycling,isalsoimportantforimprovinginsulinsensitivityandweightmanagement.

Smokingcessationisalsoanimportantinterventionforpreventingtype2diabetes.Smokinghasbeenlinkedtoinsulinresistanceandanincreasedriskofdevelopingdiabetes,andquittingsmokinghasbeenshowntoimproveinsulinsensitivityandreducetheriskofdiabetes.

Medicationssuchasmetformincanalsobeeffectiveinpreventingordelayingtheprogressionofpre-diabetestotype2diabetes.Metforminworksbyreducingglucoseproductionintheliverandimprovinginsulinsensitivityinthebody.Studieshaveshownthattakingmetformincanreducetheriskofdevelopingdiabetesbyupto31%.

Inadditiontotheseinterventions,therearealsoemergingtherapiesforpre-diabetesthatshowpromiseinpreventingordelayingtheonsetoftype2diabetes.Thesetherapiesincludeincretinmimetics,whichstimulateinsulinsecretionandreduceglucoselevelsinthebody,andSGLT-2inhibitors,whichpreventglucosereabsorptioninthekidneysandlowerbloodglucoselevels.However,moreresearchisneededtodeterminethesafetyandefficacyofthesetherapiesforpre-diabetes.

Overall,earlyinterventionandeffectivemanagementofpre-diabetescanpreventordelaytheonsetoftype2diabetes,whichcansignificantlyreducetheriskoflong-termcomplicationssuchascardiovasculardisease,neuropathy,andretinopathy.Closemonitoringofbloodglucoselevels,lifestyleinterventions,andmedicationswhenindicated,canhelpindividualswithpre-diabeteslivehealthyandfulfillingliveswhilereducingtheirriskofdevelopingtype2diabetes。Inadditiontothephysicalcomplicationsassociatedwithdiabetes,therearealsoemotionalandpsychologicaleffectsthatcanimpactanindividual'squalityoflife.Diabetesmanagementcanbeadauntingtaskthatrequiresasignificantamountofdisciplineanddedication,whichcanleadtofeelingsofstress,anxiety,anddepression.Itiscrucialtoaddresstheseemotionalneedsandprovidesupportforindividualswithdiabetestohelpthemmanagetheirconditioneffectively.

Onewaytosupportindividualswithdiabetesistoprovideeducationandresourcestohelpthemunderstandtheimportanceofglucosemonitoring,medicationadherence,andlifestylemodifications.Additionally,supportgroupsandcounselingcanbebeneficialinprovidingemotionalsupportandpromotingpositivecopingstrategies.Thiscanincludesessionsonstressmanagement,relaxationtechniques,andmindfulnessmeditation,whichhavebeenshowntohavesignificantbenefitsforindividualswithdiabetes.

Anothercrucialaspectofdiabetesmanagementispropernutrition.Abalanceddietconsistingofwholegrains,fruits,vegetables,leanproteins,andhealthyfatscanhelpregulatebloodsugarlevelsandreducetheriskofdiabetescomplications.Workingwitharegistereddietitiancanbehelpfulindevelopingindividualizedmealplansthatmeetthespecificneedsofindividualswithdiabetes.

Physicalactivityisanothercriticalcomponentofdiabetesmanagement.Regularexercisecanhelpimprovebloodsugarcontrol,reduceinsulinresistance,andlowertheriskofcardiovasculardisease.Itisrecommendedthatindividualswithdiabetesengageinmoderate-intensityaerobicexerciseforatleast150minutesperweek,alongwithresistancetrainingatleasttwotimesperweek.

Inconclusion,pre-diabetespresentsasignificanthealthchallengethatrequiresearlyinterventionandeffectivemanagementtopreventordelaytheonsetoftype2diabetes.Thisrequiresnotonlyphysicalinterventionssuchasglucosemonitoring,medication,andlifestylemodificationsbutalsoemotionalandpsychologicalsupport.Providingeducation,resources,andemotionalsupportcanhelpindividualswithdiabetesmanagetheirconditionandimprovetheiroverallqualityoflife。Inadditiontophysicalandemotionalsupport,community-basedinitiativesandpoliciescanalsoplayacriticalroleinpreventingandmanagingpre-diabetesandtype2diabetes.OnesuchexampleistheDiabetesPreventionProgram(DPP),alifestyleinterventionprogramthathasbeenshowntoreducetheincidenceoftype2diabetesby58%inindividualswithpre-diabetes.

TheDPPisalifestyleinterventionprogramthatfocusesonintensivelifestylemodifications,includingdietarychanges,increasedphysicalactivity,andbehavioralcounseling.Theprogramalsoincludesongoingsupportandfollow-uptohelpindividualsmaintainthesechangesovertime.

Community-basedinitiativessuchastheDPPcannotonlyhelpindividualsmanagepre-diabetesandpreventtype2diabetesbutalsoreducetheeconomicburdenofdiabetesonth