Clinical Study On The Effect Of Bushen Jianpi Recipe On Adiponectin In Type 2 Diabetes Mellitus

ObjectiveThe study by observing Bushen Jianpi Recipe(a Chinese medicine formula with the actions of nourishing kidney and invigorating spleen)of type 2 diabetes mellitus(T2DM)patients clinical effect,comparing the control group with the treatment group before and after the treatment of clinical symptoms、PG、INS、HbA1c、APN and related indicators of islet function,to explore the efficacy and mechanism of Bushen Jianpi Recipe in treating type 2 diabetes mellitus patients with deficiency of both spleen and kidney and provide basis for TCM treatment of type 2 diabetes mellitus.MethodsFrom January 2019 to January 2020,70 patients with type 2 diabetes mellitus patients with deficiency of both spleen and kidney were collected by random number method from Guangdong Clifford Hospital Endocrinology outpatient and inpatient dep artment.The patients were segmented into control group and treatment group randomly with 35 cases in each group.Both groups were given basic treatment for type 2 diabetes mellitus,The control group was given metformin hydrochloride tablets 0.5g,3 times/day;in the treatment group,200ml of Bushen Jianpi Recipe granules was added on the basis of the control group,both groups were treated for 8 weeks.All patients were treated before treatment underwent fasting plasma glucose(FPG),2 hour postprandial Plasma glucose(2hPG),fasting insulin(FINS),2 hour postprandial insulin(2hINS),glycosylated hemoglobin(HbA1c),adiponectin(APN),urea(BUN),screatinine(SCr),alanine aminotransferase(ALT),aspartate transaminase(AST),Homeostasis-β cells(HOMA-β),Homeostasis-Insulin Resistance(HOMA IR)and TCM symptom score points.Statistical software SPSS22.0 was used to calculate the data,and statistical analysis was conducted according to the calculated results.Results1.clinical indicators①Plasma glucoseCompared with that before treatment,FPG and 2hPG decreased significantly(P<0.01)in both groups.Compared with the control group,The reduction of FPG and 2hPG in the treatment group was better(P<0.01).The treatment group was better at improving plasma glucose control.②InsulinCompared with that before treatment,FINS and 2hINS in the treatment group were significantly increased(P<0.01),while there was no significant difference in the control group(P>0.05).The increased FINS and 2hINS in the treatment group were better than those in the control group(P<0.01).The treatment group was able to improve insulin secretion.③HbAlcIn both groups,HbAlc was significantly decreased(P<0.01).The reduction of HbA1c in the treatment group was better than that in the control group(P<0.01).Bushen Jianpi Recipe combined with metformin hydrochloride tablets was better in the effect of plasma glucose.④HOMA indexCompared with those before treatment,HOMA-β was significantly increased and HOMA-IR was decreased in both groups(P<0.01).Compared with the control group,the treatment group had higher HOMA-β(P<0.01)and lower HOMA-IR(P<0.05)than the control group.⑤APNCompared with before treatment,adiponectin in the treatment group was significantly increased(P<0.01),while no significant difference was found in the control group(P>0.05).The adiponectin level in the treatment group was higher than that in the control group(P<0.01).The control group had no significant effect on adiponectin,while the treatment group.can effectively raise adiponectin levels.It is speculated that Bushen Jianpi Recipe protects the function of islet and improves insulin resistance,which is related to raising the level of adiponectin.2.Clinical syndromesIn terms of the comparison of TCM symptoms and efficacy,the total effective rate(90.6%)of the treatment group was better than that of the control group(46.7%),with a significant difference(P<0.05),and the improvement of TCM symptoms score of the treatment group was more significant(P<0.01).3.Safety analysisThere was no significant difference in renal function(SCr,BUN)and liver function(ALT,AST)in both groups compared with those before treatment(P>0.05).There was no significant difference in SCr,BUN,ALT and AST between the two groups before and after treatment(P>0.05).ConclusionUsing Bush en Jianpi Recipe to treat type 2 diabetes mellitus with deficiency of the spleen and kidney can increase adiponectin level,reduce Plasma glucose and improve insulin secretion and clinical symptoms.In addition,the possible mechanism of Bushen Jianpi Recipe to protect the islet function and improve insulin resistance is related to the elevation of adiponectin.