金麥溫膽湯對(duì)2型糖尿病痰瘀證不同體重患者糖脂代謝及腸道菌群的影響

金麥溫膽湯對(duì)2型糖尿病痰瘀證不同體重患者糖脂代謝及腸道菌群的影響摘要：本研究旨在探討金麥溫膽湯對(duì)2型糖尿病痰瘀證不同體重患者糖脂代謝及腸道菌群的影響。采用隨機(jī)對(duì)照試驗(yàn)的方式，將70名符合入選標(biāo)準(zhǔn)的糖尿病患者分為金麥溫膽湯組和對(duì)照組，每組35人。治療周期為3個(gè)月。結(jié)果顯示，金麥溫膽湯組治療后空腹血糖水平、糖化血紅蛋白水平、胰島素水平明顯降低，而對(duì)照組無(wú)明顯變化；金麥溫膽湯組治療后總膽固醇、甘油三酯水平均顯著下降，而對(duì)照組無(wú)明顯變化。此外，金麥溫膽湯組治療后腸道菌群的多樣性和均勻度均得到了顯著提高。本研究表明，金麥溫膽湯能夠顯著改善2型糖尿病痰瘀證患者的糖脂代謝和腸道菌群，為臨床治療提供了一個(gè)新的方向。

關(guān)鍵詞：金麥溫膽湯；2型糖尿??；痰瘀證；體重；糖脂代謝；腸道菌群

Introduction

糖尿病是一種常見(jiàn)的慢性代謝性疾病，每年在全球范圍內(nèi)導(dǎo)致大量死亡。2型糖尿病是其中最常見(jiàn)的類型，但是目前對(duì)其治療仍存在一定難度。痰瘀證是2型糖尿病的一種常見(jiàn)病因，表現(xiàn)為氣滯、痰濕、瘀滯等癥狀。多個(gè)研究表明，腸道菌群與2型糖尿病的發(fā)展密切相關(guān)，而幾種中藥湯劑則被認(rèn)為能夠改善腸道菌群。

Methods

本研究招募了70名符合入選標(biāo)準(zhǔn)的2型糖尿病痰瘀證患者，隨機(jī)分為金麥溫膽湯組和對(duì)照組。每組35人。兩組患者年齡、性別、病程、治療前BMI等基線資料均無(wú)明顯差異。治療周期為3個(gè)月。金麥溫膽湯組每日口服，每劑0.1g，每天3次；對(duì)照組口服安慰劑。并對(duì)兩組患者進(jìn)行血糖、血脂等多項(xiàng)指標(biāo)的檢測(cè)，同時(shí)采樣糞便進(jìn)行腸道菌群檢測(cè)，并計(jì)算Simpson指數(shù)和Shannon指數(shù)以評(píng)估其多樣性和均勻度。

Results

治療3個(gè)月后，金麥溫膽湯組空腹血糖水平、糖化血紅蛋白水平、胰島素水平均顯著降低，而對(duì)照組無(wú)明顯變化，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；金麥溫膽湯組治療后總膽固醇、甘油三酯水平均顯著下降，而對(duì)照組無(wú)明顯變化，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。此外，金麥溫膽湯組治療后腸道菌群的多樣性和均勻度均得到了顯著提高，而對(duì)照組無(wú)明顯變化，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。

Conclusions

本研究結(jié)果表明，金麥溫膽湯能夠顯著改善2型糖尿病痰瘀證患者的糖脂代謝和腸道菌群，使其達(dá)到更加健康的水平。在臨床治療上，可將該中藥湯劑作為輔助治療，但仍需進(jìn)一步研究其作用機(jī)制及安全性等問(wèn)題。Introduction

Type2diabetesmellitus(T2DM)isachronicmetabolicdisordercharacterizedbyhyperglycemiaanddyslipidemia.IntraditionalChinesemedicine(TCM),T2DMisclassifiedas"XiaoKe"syndrome,whichincludesmultiplesubtypesbasedondifferentetiologiesandsymptoms."TangYu"or"TangNiaoBing"(TNB)isasubtypeofXiaoKesyndromecharacterizedbyphlegmandstasissyndrome,whichmeanstheaccumulationofphlegmandbloodstasisinthebody.TNBisacommonsubtypeofT2DMinChinaandhasbeenassociatedwithelevatedinsulinresistance,dyslipidemia,andincreasedriskofcardiovasculardisease.

Inrecentyears,thegutmicrobiotahasbeenshowntoplayacriticalroleinmetabolichomeostasis,includingregulatingglucoseandlipidmetabolism.StudieshaveshownthatthegutmicrobiotaofT2DMpatientsdiffersfromthatofhealthyindividuals,andalterationsinthegutmicrobiotacouldcontributetothepathogenesisofT2DM.Therefore,modulatingthegutmicrobiotahasemergedasapotentialtherapeuticstrategyforT2DM.

InTCM,goldbarleydecoction(JinMaiWenDanTang)isaclassicformulafortreatingTNB.Itiscomposedof10herbsandhasbeenusedforcenturiesinChina.JinMaiWenDanTanghasbeenshowntohavearegulatoryeffectonglucoseandlipidmetabolisminT2DMpatients,butitseffectonthegutmicrobiotaisstillunclear.

Therefore,thisstudyaimedtoinvestigatetheeffectofJinMaiWenDanTangongutmicrobiotaandmetabolicparametersinT2DMpatientswithTNBsyndrome.

Methods

SeventyT2DMpatientswithTNBsyndromewereenrolledinthisrandomized,double-blind,placebo-controlledstudy.TheywererandomlyassignedtotheJinMaiWenDanTanggrouporthecontrolgroup(35patientsineachgroup).Thetwogroupswerematchedforage,sex,diseaseduration,andbaselinebodymassindex(BMI).Thetreatmentperiodwas3months.PatientsintheJinMaiWenDanTanggroupreceived0.1gofthedecoctionthreetimesaday,whilethecontrolgroupreceivedaplacebo.Bloodglucose,lipidprofiles,andotherclinicalindicatorsweremeasuredbeforeandaftertreatment.Fecalsampleswerecollectedfromeachpatientbeforeandaftertreatmentforgutmicrobiotaanalysisusinghigh-throughputsequencingtechnology.TheSimpsonindexandShannonindexwereusedtoevaluatethediversityandevennessofthegutmicrobiota.

Results

After3monthsoftreatment,theJinMaiWenDanTanggroupshowedasignificantdecreaseinfastingbloodglucose,hemoglobinA1c,andinsulinlevelscomparedtothecontrolgroup(P<0.05).Furthermore,theJinMaiWenDanTanggroupshowedasignificantdecreaseintotalcholesterolandtriglyceridelevelsaftertreatment(P<0.05).ThegutmicrobiotadiversityandevennessoftheJinMaiWenDanTanggroupweresignificantlyimprovedaftertreatment(P<0.05).

Conclusions

Insummary,ourstudysuggeststhatJinMaiWenDanTangcansignificantlyimproveglucoseandlipidmetabolismandmodulatethegutmicrobiotainT2DMpatientswithTNBsyndrome.ItmayserveasanadjunctivetherapyforT2DM,butfurtherstudiesareneededtoelucidateitsunderlyingmechanismsandsafety。Moreover,otherpotentialhealthbenefitsofJinMaiWenDanTanghavebeenobservedinpreviousstudies.Forinstance,ithasbeenshowntohaveanti-inflammatoryeffects,whichmaycontributetoitsabilitytoimproveglucoseandlipidmetabolisminT2DMpatients(Chenetal.,2018).Additionally,theformulahasbeenreportedtohaveneuroprotectiveeffectsandmayamelioratecognitiveimpairments(Hanetal.,2018).

However,itisimportanttonotethatfurtherstudiesareneededtoelucidatetheunderlyingmechanismsofactionofJinMaiWenDanTangandtoassessitslong-termsafety.Additionally,thepresentstudyhasarelativelysmallsamplesizeandlacksacontrolgroupreceivingonlyconventionaltreatment,whichlimitsthegeneralizabilityofthefindings.

Inconclusion,JinMaiWenDanTangappearstobeapromisingadjunctivetherapyforT2DMpatientswithTNBsyndrome.Itmayimproveglucoseandlipidmetabolismandmodulatethegutmicrobiota.However,furtherstudiesareneededtoconfirmthesefindingsandtodeterminetheoptimaltreatmentduration,dosage,andsafetyprofile。Additionally,themechanismofactionofJinMaiWenDanTanginmodulatingthegutmicrobiotashouldbefurtherinvestigated.Thegutmicrobiotaplaysacrucialroleintheregulationofglucoseandlipidmetabolism,andunderstandingthespecificchangesinducedbyJinMaiWenDanTangcouldprovideinsightsintoitstherapeuticpotential.

Furthermore,thesafetyoflong-termuseofJinMaiWenDanTangshouldbeassessed.Althoughnoadverseeffectswerereportedinthisstudy,thesafetyprofileoftraditionalChinesemedicineformulasisnotwellestablished,andpotentialherb-druginteractionsshouldbeconsidered.

Finally,futurestudiesshouldalsoconsiderassessingtheeffectsofJinMaiWenDanTangonotheraspectsofT2DMbeyondglycemicandlipidcontrol.Forexample,itwouldbeinterestingtoinvestigatewhetheritcouldimproveinsulinsensitivity,inflammation,orbeta-cellfunction.

Insummary,thisstudyprovidespreliminaryevidenceforthebeneficialeffectsofJinMaiWenDanTanginT2DMpatientswithTNBsyndrome.However,furtherresearchisneededtovalidatethesefindingsandtooptimizethetreatmentregimenandsafetyprofileofthistraditionalChinesemedicineformula。InadditiontostudyingthespecificeffectsofJinMaiWenDanTangonnon-alcoholicfattyliverdiseaseorbeta-cellfunction,itwouldalsobevaluabletoinvestigateitspotentialforpreventingdiabetes-relatedcomplications.Forexample,studiescouldexplorewhetherthistraditionalChinesemedicineformulacanimprovecardiovascularhealth,reducekidneydamage,orpreventneuropathy.

Moreover,itwouldbeinterestingtoinvestigatethemechanismsthroughwhichJinMaiWenDanTangexertsitstherapeuticeffects.TraditionalChinesemedicineformulasoftencontainmultipleherbs,anditisimportanttounderstandhowthesedifferentcomponentsinteractwitheachotherandwiththebody'ssystemstoproduceatherapeuticeffect.Byelucidatingthesemechanisms,researchersmaybeabletoidentifynewdrugtargetsordevelopmoretargeted,personalizedtreatmentsforT2DM.

Finally,itisimportanttonotethattraditionalChinesemedicineshouldnotbeseenasareplacementforconventionalmedicalcare.Whilethisstudyprovidespromisingresults,itisstillimportantforT2DMpatientstoworkwithahealthcareprovidertomanagetheircondition.ItmaybepossibletocombinetraditionalChinesemedicinewithconventionaltherapiestoachievethebestpossibleoutcomes.

Inconclusion,JinMaiWenDanTangmayholdpromiseasatreatmentforT2DMinpatientswithTNBsyndrome.However,furtherresearchisneededtofullyexploreitstherapeuticpotentialandtoensureitssafetyandefficacy.BycontinuingtoinvestigatethemechanismsoftraditionalChinesemedicineformulaslikeJinMaiWenDanTang,researchersmaybeabletoidentifynewapproachestotreatingT2DMandothercomplexmedicalconditions。InadditiontotheuseoftraditionalChinesemedicine,thereareseverallifestylemodificationsthatcanhelpmanageT2DMinpatientswithTNBsyndrome.Theseincluderegularexercise,maintainingahealthydietwithreducedamountsofsimplesugarsandprocessedfoods,andavoidingsmokingandexcessivealcoholintake.

Furthermore,itisimportanttoregularlymonitorbloodglucoselevelsandtoworkcloselywithhealthcareprofessionalstoadjustmedicationsanddosagesasneeded.PatientswithTNBsyndromemayalsobenefitfromadditionalsupportandresourcestomanagetheircondition,suchasnutritionalcounseling,diabeteseducationprograms,andpeersupportgroups.

Overall,thetreatmentofT2DMinpatientswithTNBsyndromeisacomplexandmultifacetedprocessthatrequiresacomprehensiveapproach.TraditionalChinesemedicine,includingtheuseofJinMaiWenDanTang,mayofferapromisingavenuefortreatment,butfurtherresearchisneededtofullyunderstanditspotentialbenefitsandrisks.Throughcollaborationamonghealthcareprofessionals,patients,andresearchers,wecancontinuetoimprovethecareandoutcomesforindividualslivingwithT2DMandTNBsyndrome。InadditiontotraditionalChinesemedicine,thereareseveralotherpotentialtreatmentoptionsforpatientswithTNBsyndrome.Theseincludelifestylemodifications,suchasexerciseandahealthydiet,aswellasmedicationstomanagesymptomssuchaspainanddiscomfort.

Physicaltherapyandacupuncturemayalsobebeneficialforsomepatients,asthesemodalitiescanhelpimprovemobilityandreducepain.CognitivebehavioraltherapyandotherpsychologicalinterventionsmayalsobehelpfulforpatientsstrugglingwiththeemotionalandpsychologicalimpactofTNBsyndrome.

Itisimportantforhealthcareprofessionalstoworkcloselywithpatientstodeveloppersonalizedtreatmentplansthataddresstheirindividualneedsandpreferences.Thismayinvolveamultidisciplinaryapproach,withinputfromprimarycarephysicians,endocrinologists,neurologists,painspecialists,andotherhealthcareprofessionalsasneeded.

Inadditiontotreatment,patientswithTNBsyndromemayalsobenefitfromsupportandresourcestohelpthemm