| Purpose: Discuss TCM understanding of type 2 diabetes in obese patients with insulin resistance, through the method of randomized clinical trials were qingyanghuazhuotang in the type 2 diabetes in obese patients with spleen deficiency deficiency, phlegm stagnation, stasis syndrome and tumor necrosis factor alpha, LEP level and to explore the mechanism.Method:According to the diagnostic standard of 60 cases, were randomly divided into two groups, treatment group, control group 30 cases, 2 groups were given diabetes education, reasonable diet and conventional western medicine oral hypoglycemic therapy, the control group was treated with metformin(0.5g, three times a day, half an hour before meals oral) in the treatment group. The control group based on the use of Chinese medicine Qing Yang Huazhuo. Two groups were treated for 6 weeks, 1 courses were observed. The determination of 2 groups before and after treatment, fasting blood glucose(FBG), 2 hour postprandial blood glucose(2h PG), glycosylated hemoglobin(Hb A1c), blood lipid(glycerin three greases, total cholesterol and low density lipoprotein),(FINS), fasting insulin, tumor necrosis factor alpha(TNF- alpha), the content of leptin, insulin resistance index(HOMA-IR) before and after treatment in the2 groups of TCM clinical symptom score, body mass index(BMI) and other indicators,to investigate the Qingyang mechanism of insulin resistance in patients with obesity and type 2 diabetes mellitus type of turbid method.Result:Before treatment, two groups of gender, age, duration of baseline data showed no statistically significant difference, comparable(P>0.05). In the improvement of TCM syndrome: the treatment group after treatment in patients with TCM syndromes have significantly improved, the total effective rate was 93.33%; the total efficiency of the control group 86.7. Treatment group of traditional Chinese medicine the symptoms of head and body trapped heavy, sticky mouth discomfort, insomnia, poor appetite,abdominal distension, tongue dark spots are significantly higher than those in control group(P<0.01). The blood glucose after treatment, fasting blood glucose and postprandial two hours blood glucose, decreased significantly, by t test(P<0.05). The difference was significant. The changes in glycated hemoglobin, treatment group and control group after treatment, glycated hemoglobin decreased, the treatment group and control group after treatment, by t test(P<0.05), the difference was significant. Lipid changes: glycerin three fat, low density lipoprotein and total cholesterol Alcohol after treatment compared to the control group were reduced by t test P<0.05, the difference was significant. In patients with obesity related indicators, weight, treatment waist circumference, hip circumference, waist to hip ratio before treatment were reduced, the difference was significant(P<0.01), waist circumference difference between groups was significant(P<0.01) BMI; the difference between groups was not significant(P=0.054P>0.05), hip circumference difference between groups was not significant(P=0.081P>0.05); however in the actual observation in the same group of BMI, body weight,waist circumference after treatment than before treatment decreased relatively. Waist to hip ratio comparison between groups P=0.019(P<0.05) has significant difference.Influence on the level of inflammatory factors: two groups after treatment of TNFalpha, LEP were better than those before treatment(P<0.05); group TNF- treatment after treatment, LEP compared with the control group with significant difference(P<0.01). The safety index: liver and kidney function tests were in the normal range. No serious adverse reactions were found in the two groups.Conclusion:Through the preliminary clinical study, Qing Yang Huazhuo decoction combined with western medicine treatment effect is better than pure western medicine treatment, traditional Chinese medicine in the treatment of can improve obese patients with type 2 diabetes clinical symptoms, improve obesity related indexes, reducing blood fat and blood sugar, increase insulin sensitivity, improve insulin resistance, but also can reduce the level of inflammatory factors, safe and effective, worthy of further study. |
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