Clinical Observation Of Jianpi Huatan Huoxue Decoction Combined With Lifestyle Intervention In Patients With Impaired Glucose Tolerance Due To Spleen Deficiency And Phlegm Stasis

Objective: To observe the clinical efficacy of Jianpi Huatan Huoxue Decoction combined with lifestyle intervention in patients with spleen deficiency and phlegm stasis,especially on the efficacy of TCM syndrome,blood glucose,insulin,blood lipid level,BMI and other indicators.And to explore the mechanism of the treatment of IGT,so as to provide an objective basis for the clinical treatment of IGT.Methods: From January 2022 to September 2022,60 patients who met the diagnostic criteria of IGT and syndrome differentiation of spleen-deficiency and phlegm-stasis syndrome were collected from the outpatients of Endocrinology Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine(Shandong Hospital of traditional Chinese medicine).According to the principle of random control,the patients were divided into treatment group(30 cases)and control group(30 cases).Both groups received lifestyle intervention treatment,and the treatment group was added to Jianpi Huatan Huoxue Decoction for 12 weeks.The curative effect of TCM syndrome,blood glucose,HbA1 c,Insulin levelsand safety index were evaluated before and after the observation,and the data were processed by SPSS24.0 statistical software.Results: During the treatment period,2 patients were lost,including 29 completed cases in the treatment group and 29 completed cases in the control group.(1)Evaluation of efficacy of TCM clinical syndrome: the score of TCM syndrome in both groups decreased compared with before treatment(P <0.01),and the effective rate of treatment group and control group was 89.66% and65.52%(P <0.01),there were statistical differences.(2)Analysis of Glucose Metabolism Index: FBG,2 h PG and HbA1 c were significantly lower(P <0.01);when the two groups were compared(P <0.01),the improvement of treatment index was better than that of the control group.(3)Insulin level and IR: Insulin level and IR: FINS and 2h INS decreased significantly compared with before treatment(P <0.01),and the decrease in the treatment group was more significant(P <0.01);IR and before treatment improved(P <0.01),and the treatment group was better than the control group(P <0.01).(4)BMI: BMI decreased in both groups(P <0.01),and showed statistical difference between groups(P <0.05).Both groups significantly reduced body weight,and the treatment group was better than the control group.(5)Lipid levels: TC,TG,and LDL-C decreased in the two groups after treatment,not before treatment(P <0.01 or P <0.05),and HDL-C(P <0.01);compared between groups,the improvement in treatment group was better than that of the control group(P <0.05).(6)Safety indicators: During the test,the general condition,electrocardiogram and the three routine patients had no obvious abnormalities,and the liver and kidney function examination indicators were in the normal range,with no adverse reactions.Conclusion: On the basis of simple life style intervention,it has synergistic effect to add Jianpi Huatan Huoxue Decoction to treat patients with IGT.It can improve the clinical syndrome of patients with IGT of spleen deficiency and phlegm stasis type more effectively,lower fasting and postprandial blood glucose,improve the level of blood lipids,reduce insulin resistance,reduce weight.In the course of the test,no obvious adverse reactions,no liver and kidney function damage,clinical safety and effectiveness,worthy of further promotion and application.