| Objective:To observe the changes in glucose metabolism and lipid metabolism in patients with type 2 diabetes who are treated with oral drugs and insulin and treated with phlegm and blood stasis combined with Jinmai Wendan Decoction,as well as the effects on gastrin,glucagon and intestinal flora Impact.Methods: A total of 100 patients with type 2 diabetes mellitus with phlegm and blood stasis were collected and divided into oral hypoglycemic drugs(OADs)and insulin groups according to the hypoglycemic treatment plan,50 cases in each group,20 cases in each group were randomly divided into two groups.In the control group,30 cases were the treatment group.The control group did not use traditional Chinese medicine on the conwentional antidiabetic treatment of western medicine,and the treatment group was treated with Jinmaiwendan Decoction on the basis of the original hypoglycemic regimen for 12 consecutive weeks.Analysis and comparison of fasting blood glucose(FPG),2-hour popostprandial blood glucose(2h PG),glycosylated hemoglobin(Hb A1c),triglycerides(TG),total cholesterol(TC),Low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),gastrin(GAS),glucagon(GC)and Enterococcus,Escherichia coli,Firmicutes,Bacteroides,Clostridium tenuis,Lactobacillus,Bifidobacterium as the representative changes of intestinal flora.All data are analyzed and processed by SPSS21.0 statistical software.Results: 1.Blood glucose indicators: After treatment,the levels of 2h PG and Hb A1 c in the Jinmaiwendan decoction + insulin group and the insulin control group were singnificantly lower than before treatment(P<0.05),and after treatment,Jinmaiwendan decoction +insulin the levels of 2h PG and Hb A1 c in the group were significantly lower than those in the insulin control group(P<0.05).There was no significant difference between the two groups before and after the fasting C-peptide and C-peptide 2 hours after a meal(P>0.05);After treatment,the levels of FPG,2h PG,and Hb A1 c in the Jinmaiwendan decoction +OADs group and the OADs control group were lower than before treatment(P<0.05).The comparison between the groups found that the 2h PG,2h PG,2h PG and Hb A1 c in the Jinmaiwendan decoction + OADs group after treatment The level of Hb A1 c was significantly lower than that of the OADs control group(P<0.05),and there was no significant difference between the two groups before and after treatment with fasting C-peptide and 2 hours after meal C-peptide(P>0.05);The Jinmaiwendan decoction + insulin group was compared with the Jinmaiwendan decoction + OADs group.After treatment,the levels of FPG,2h PG and Hb A1 c in the Jinmaiwendan decoction + OADs group were significantly lower than those of the Jinmaiwendan decoction + insulin group(P <0.05).3.Blood lipid indicators: After treatment,the levels of TC,TG,and LDL-C in the Jinmaiwendan Decoction + insulin group were significantly lower than before treatment(P<0.05);after treatment in the insulin control group,TC levels were significantly lower than before treatment(P< 0.05);After treatment,the LDL-C level of Jinmaiwendan Decoction+insulin group was significantly lower than that of the insulin control group(P<0.05).After treatment,TC and TG in the Jinmai Wendan Decoction + OADs group and OADs control group were significantly lower than before treatment(P<0.05);the LDL-C level after treatment in the Jinmai Wendan Decoction + OADs group was significantly lower than before treatment(P<0.05);The comparison between the groups showed that the levels of TG and LDL-C in the Jinmai Wendan Decoction+OADs group were significantly lower than those in the OADs control group after treatment(P<0.05);Comparing the Jinmai Wendan Decoction + Insulin and Jinmai Wendan Decoction +OADs group,it was found that there was no significant difference in TG,LDLC,HDL-C between the two groups after treatment(P>0.05).4.Gastrin: The level of gastrin in the Jinmai Wendan Decoction + insulin group was significantly higher than before treatment(P<0.05),while the insulin control group had no significant difference before and after treatment(P>0.05).After treatment with Jinmaiwendan Decoction + insulin group,the gastrin level was significantly higher than that of the insulin control group(P<0.05);Jinmai Wendan Decoction + OADs group after gastrin treatment was significantly higher than before treatment(P<0.05),while the OADs control group had no significant difference before and after treatment(P>0.05).Comparison of the two groups found that Jinmaiwendan Decoction + OADs group,the gastrin in the oral drug group was significantly higher than that in the OADs control group(P<0.05);Compared with the Jinmaiwendan decoction + insulin group and the Jinmaiwendan decoction + OADs group,there was no significant difference in gastrin levels between the two groups after treatment(P>0.05)5.Glucagon: There was no significant difference in glucagon between the Jinmaiwendan Decoction + insulin group and the insulin control group before and after treatment(P>0.05),and there was no statistical difference in the level of glucagon between the two groups after treatment(P>0.05);There was no significant change in glucagon levels between the Jinmaiwendan Decoction+ OADs group and the oral drug control group before and after treatment(P>0.05),and there was no statistical difference in glucagon levels between the two groups after treatment(P>0.05).There was no significant difference in glucagon levels between the Jinmaiwendan Decocoction + insulin group and the Jinmai Wendan Decoction + OADs group after treatment(P>0.05).6.Intestinal flora: The Jinmaiwendan decoction + insulin group was compared with the insulin control group,and it was found that the number of E.coli in the Jinmaiwendan decoction + insulin group was significantly lower than before treatment(P <0.05),while the insulin control.There was no significant difference in the number of Escherichia coli b-efore and after treatment in the two groups(P>0.05);in comparison between the groups,the number of Escherichia coli in the Jinmai Wendan Decoction + insulin group was significantly lower than that in the insulin control group(P<0.05);There was no statistical difference in the numbers of Coccus,Firmicutes,Bacteroides,Clostridium tenuis,Bifidobaccterium,and Lactobacillus(P>0.05);The Jinmai Wendan Decoction + OADs group was compared with the OADs control group,and it was found that the number of Clostridium tenuiens and Lactobacillus in the Jinmai Wendan Decoction + OADs group was significantly higher than before treatment(P<0.05).The OADs control group was treated the number of Lactobacillus after treatment was significantly increased(P<0.05);the comparison between the two groups showed that the number of Clostridium tenuiens and Lactobacillus in the Jinmaiwendan Decotion + OADs group after treatment was significantly higher than that of the OADs control group(P<0.05);There was no significant difference in the numbers of Escherichia coli,Enterococcus,Firmicutes,Bacteroides,and Bifidobacteria before and after treatment between the two groups(P>0.05).Compared with the Jinmaiwendan decoction + insulin group and the Jinmaiwendan decoction + OADs group,the number of Escherichia coli in the Jinmaiwendan decoction+insulin group was significantly lower than that of the Jinmaiwendan decoction + OADs group(P<0.05).The numbers of Clostridium tenuis and Lactobacillus in the Jinmaiwendan Decoction + OADs group were significantly higher than those in the Jinmaiwendan Decotion + Insulin group(P<0.05);the two groups were treated with Enterococcus,Firmicutes,Bacteroides,and Double There was no significant difference in the number of Fidobacteria(P>0.05).Conclusion: 1.Jinmai Wendan Decoction can further reduce blood glucose(2h PG,Hb A1c)and blood lipids(TG,LDL-C)levels in patients with phlegm and blood stasis type T2 DM on the basis of conventional western medicine hypoglycemic treatment,improve glucose and lipid metabolism,and Jinmai Wendan Decoction combined with oral drugs has better hypoglycemic effect than insulin group;2.Jinmai Wendan Decoction can increase the gastrin level of T2 DM patients with phlegm and blood stasis,but has no obvious intervention on glucagon;3.Jinmai Wendan Decoction can adjust the intestinal environment of T2 DM patients with phlegm and blood stasis,increase the number of Lactobacillus and Soft acid bacteria in the OADs group,and reduce the number of Escherichia coli in the insulin group;4.Jinmai Wendan Decoction in the treatment of T2 DM patients with phlegm and blood stasis has no obvious liver and kidney side effects and is safe. |
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