金麦温胆汤对痰瘀互结型2型糖尿病患者代谢指标、早时相胰岛素及肠道菌群的影响

金麦温胆汤对痰瘀互结型2型糖尿病患者代谢指标、早时相胰岛素及肠道菌群的影响摘要：本研究旨在探究金麦温胆汤对痰瘀互结型2型糖尿病患者代谢指标、早时相胰岛素及肠道菌群的影响。选择50例痰瘀互结型2型糖尿病患者作为研究对象，随机分为治疗组和对照组，治疗组患者口服金麦温胆汤，对照组患者口服安慰剂，每天2次，连续12周。分别记录两组患者病史、身高、体重、腰围、BMI、血压、空腹血糖、餐后2小时血糖、空腹胰岛素、餐后2小时胰岛素、HbA1c、TG、TC、HDL、LDL等指标，并采集粪便样本进行16SrRNA测序。结果显示，治疗组患者空腹血糖、餐后2小时血糖、HbA1c、TG、TC、LDL均显著降低，而空腹胰岛素、餐后2小时胰岛素、HDL无明显变化。治疗组患者肠道菌群丰度比对照组有所增加，特别是有益菌群的丰度明显增加。综上所述，金麦温胆汤可以改善痰瘀互结型2型糖尿病患者的代谢指标，对肠道菌群也有显著的调节作用。

关键词：金麦温胆汤；痰瘀互结型；2型糖尿病；代谢指标；胰岛素；肠道菌群

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