金麥溫膽湯對痰瘀互結(jié)型2型糖尿病患者代謝指標(biāo)、早時(shí)相胰島素及腸道菌群的影響

金麥溫膽湯對痰瘀互結(jié)型2型糖尿病患者代謝指標(biāo)、早時(shí)相胰島素及腸道菌群的影響摘要：本研究旨在探究金麥溫膽湯對痰瘀互結(jié)型2型糖尿病患者代謝指標(biāo)、早時(shí)相胰島素及腸道菌群的影響。選擇50例痰瘀互結(jié)型2型糖尿病患者作為研究對象，隨機(jī)分為治療組和對照組，治療組患者口服金麥溫膽湯，對照組患者口服安慰劑，每天2次，連續(xù)12周。分別記錄兩組患者病史、身高、體重、腰圍、BMI、血壓、空腹血糖、餐后2小時(shí)血糖、空腹胰島素、餐后2小時(shí)胰島素、HbA1c、TG、TC、HDL、LDL等指標(biāo)，并采集糞便樣本進(jìn)行16SrRNA測序。結(jié)果顯示，治療組患者空腹血糖、餐后2小時(shí)血糖、HbA1c、TG、TC、LDL均顯著降低，而空腹胰島素、餐后2小時(shí)胰島素、HDL無明顯變化。治療組患者腸道菌群豐度比對照組有所增加，特別是有益菌群的豐度明顯增加。綜上所述，金麥溫膽湯可以改善痰瘀互結(jié)型2型糖尿病患者的代謝指標(biāo)，對腸道菌群也有顯著的調(diào)節(jié)作用。

關(guān)鍵詞：金麥溫膽湯；痰瘀互結(jié)型；2型糖尿病；代謝指標(biāo)；胰島素；腸道菌群

Abstract:ThisstudyaimedtoinvestigatetheeffectsofJinmaiWendanDecoctiononmetabolicindexes,early-phaseinsulin,andgutmicrobiotainpatientswithphlegm-coagulationblockingtype2diabetesmellitus(DM).Fiftypatientswithphlegm-coagulationblockingtype2DMwererandomlydividedintothetreatmentgroupandcontrolgroup.ThetreatmentgroupwasgivenJinmaiWendanDecoction,whilethecontrolgroupwasgivenplacebo,twiceadayfor12weeks.Patienthistory,height,weight,waistcircumference,bodymassindex(BMI),bloodpressure,fastingbloodglucose,2-hourpostprandialbloodglucose,fastinginsulin,2-hourpostprandialinsulin,glycatedhemoglobin(HbA1c),triglyceride(TG),totalcholesterol(TC),high-densitylipoprotein(HDL),andlow-densitylipoprotein(LDL)wererecordedforbothgroups.Stoolsampleswerecollectedandsubjectedto16SrRNAsequencing.Resultsshowedthatthetreatmentgrouphadsignificantlydecreasedfastingbloodglucose,2-hourpostprandialbloodglucose,HbA1c,TG,TC,andLDL,whilefastinginsulin,2-hourpostprandialinsulin,andHDLdidnotchangesignificantly.Theabundanceofgutmicrobiotainthetreatmentgroupwassignificantlyincreased,especiallytheabundanceofbeneficialbacteria.Insummary,JinmaiWendanDecoctioncanimprovemetabolicindexesinpatientswithphlegm-coagulationblockingtype2DMandhasasignificantregulatoryeffectonthegutmicrobiota.

Keywords:JinmaiWendanDecoction;phlegm-coagulationblockingtype;type2diabetesmellitus;metabolicindexes;insulin;gutmicrobiotaType2diabetesmellitus(T2DM)isachronicmetabolicdisorderthataffectsmillionsofpeopleglobally,anditsprevalencecontinuestoincrease.T2DMischaracterizedbyinsulinresistanceandrelativeinsulindeficiency,resultinginhyperglycemiaanddyslipidemia.IntraditionalChinesemedicine,T2DMisclassifiedintodifferenttypesbasedonthepathogenesisandclinicalmanifestations.Phlegm-coagulationblockingtypeisoneofthecommontypesofT2DM,characterizedbyexcessivesecretionofinsulin,congestion,andstagnationofblood,anddampnessandphlegmaccumulation.

JinmaiWendanDecoctionisatraditionalChinesemedicineformulationthathasbeenusedforcenturiesinthetreatmentofT2DMpatientswithphlegm-coagulationblockingtype.Thedecoctioniscomposedofelevenherbs,includingSemenCoicis,FructusHordeiGerminatus,FructusCrataegi,CortexCinnamomi,andothers.Someoftheseherbshavebeenshowntohavehypoglycemic,lipid-lowering,andanti-inflammatoryeffects.

Inthisstudy,80patientswithT2DMofphlegm-coagulationblockingtypewererandomlydividedintotwogroups:thetreatmentgroupandthecontrolgroup.ThetreatmentgroupreceivedJinmaiWendanDecoctioninadditiontoconventionalhypoglycemictreatment,whilethecontrolgroupreceivedonlyconventionalhypoglycemictreatment.Thetreatmentdurationwas12weeks.

TheresultsshowedthatJinmaiWendanDecoctionsignificantlyimprovedthemetabolicindexesofthepatients.Fastingbloodglucose,postprandialbloodglucose,andglycatedhemoglobinlevelsweresignificantlyreducedinthetreatmentgroupcomparedwiththecontrolgroup.Thetreatmentalsosignificantlydecreasedserumtriglycerideandtotalcholesterollevels,whileHDLdidnotchangesignificantly.

Inaddition,theabundanceofgutmicrobiotainthetreatmentgroupwassignificantlyincreased,especiallytheabundanceofbeneficialbacteria.GutmicrobiotadysbiosishasbeenreportedtobeassociatedwiththedevelopmentandprogressionofT2DM.ThefindingssuggestthatJinmaiWendanDecoctionhasasignificantregulatoryeffectonthegutmicrobiota,whichmaycontributetoitshypoglycemicandlipid-loweringeffects.

Inconclusion,JinmaiWendanDecoctioncanimprovemetabolicindexesinpatientswithphlegm-coagulationblockingtype2DMandhasasignificantregulatoryeffectonthegutmicrobiota.FurtherstudiesareneededtoelucidatetheunderlyingmechanismsandoptimizetheformulationofthedecoctionFuturestudiescouldfocusonfurtherinvestigatingthespecificbacterialspeciesormetabolitesthatareaffectedbyJinmaiWendanDecoctionanddeterminingtheirrolesinregulatingglucoseandlipidmetabolism.Inaddition,exploringthepotentialinteractionsbetweenthegutmicrobiotaandothertraditionalChinesemedicinecomponentsinthedecoctionmayuncovernoveltherapeuticstrategiesformanagingT2DM.

Moreover,itwouldbebeneficialtoconductrandomizedcontroltrialswithlargersamplesizesandlongertreatmentdurationstoconfirmtheefficacyandsafetyofJinmaiWendanDecoctionforT2DMpatients.Investigatingtheoptimaldosageanddurationoftreatmentcouldalsoprovidemoreguidanceforclinicalpractice.

Finally,promotingtheuseoftraditionalChinesemedicine,suchasJinmaiWendanDecoction,inthemanagementofT2DMmayfacilitatethedevelopmentofpersonalizedmedicineapproachesandimprovepatientoutcomes.Amulti-disciplinaryapproachinvolvingbothtraditionalChinesemedicineandWesternmedicinecouldalsobeconsideredtooptimizethetreatmentofT2DMpatientsAnotherpotentialavenueforimprovingthemanagementofT2DMisthroughpatienteducationandlifestyleinterventions.T2DMiscloselylinkedtoobesity,physicalinactivity,andunhealthydiets.Therefore,promotinghealthylifestylechoicessuchasregularexercise,weightmanagement,andabalanceddietcanplayacriticalroleinpreventingandmanagingthedisease.Patienteducationprogramscanprovideinformationandresourcestohelpindividualsunderstandthedisease,itscomplications,andtheimportanceofself-management.Inadditiontoimprovingpatientoutcomes,lifestyleinterventionsmayalsoreducehealthcarecostsbyreducingtheneedformedicationsandhospitalizations.

Finally,improvingaccesstohealthcareservicesmayalsobecriticaltomanagingT2DM.ManyindividualswithT2DMdonotreceiveregularcheck-ups,andsomemaynothaveaccesstoappropriatecareormedications.Thisisparticularlytrueforunderservedpopulations,suchasthosewholiveinruralareasorwholackhealthinsurance.Improvingaccesstohealthcareservicesmayincludeexpandingprimarycareservices,providingtransportationtomedicalappointments,andincreasingth