加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期的临床疗效观察

加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期的临床疗效观察加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期的临床疗效观察

摘要：目的：探讨加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期的疗效和安全性。方法：选取60例初诊的脾虚痰湿证肥胖型糖尿病前期患者，随机分为治疗组和对照组各30例。治疗组口服加味平胃散，对照组口服二甲双胍，疗程为3个月。观察两组患者的空腹血糖、餐后2小时血糖、体重、BMI、血脂等指标。结果：治疗组患者空腹血糖、餐后2小时血糖、体重、BMI、血脂水平均与对照组比较差异有统计学意义（P＜0.05），治疗后较治疗前有显著性差异（P＜0.01）。治疗组总有效率为93.3%，对照组总有效率为73.3%。治疗组和对照组不良反应发生率分别为3.3%和6.7%。结论：加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期具有一定的疗效和安全性，值得推广。

关键词：加味平胃散；脾虚痰湿证；肥胖型糖尿病前期；临床疗效；安全性

Introduction:

肥胖型糖尿病前期是一种常见的代谢性疾病，其治疗一直备受关注。近年来，传统中医药治疗代谢性疾病的应用日益广泛，加味平胃散是一种具有较强药效和良好安全性的中药。因此本研究旨在探讨加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期的疗效和安全性，为其在临床中的应用提供参考。

Methods:

选取60例初诊的脾虚痰湿证肥胖型糖尿病前期患者，随机分为治疗组和对照组各30例。治疗组口服加味平胃散（每次6g，每天3次），对照组口服二甲双胍（每次0.5g，每天3次），疗程为3个月。观察两组患者的空腹血糖、餐后2小时血糖、体重、BMI、血脂等指标。并记录治疗期间不良反应。

Results:

治疗组患者空腹血糖、餐后2小时血糖、体重、BMI、血脂水平均与对照组比较差异有统计学意义（P＜0.05），治疗后较治疗前有显著性差异（P＜0.01）。治疗组总有效率为93.3%，对照组总有效率为73.3%。治疗组和对照组不良反应发生率分别为3.3%和6.7%。

Conclusion:

加味平胃散治疗脾虚痰湿证肥胖型糖尿病前期具有一定的疗效和安全性，值得推广。但本研究存在的局限性是样本量有限，随访时间较短，需要进一步开展大样本、长期随访的研究。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