茵陈五苓散加减治疗2 型糖尿病临床研究

目的：观察茵陈五苓散加减治疗脾虚痰湿型2型糖尿病（T2DM） 的临床疗效。方法：选取27例T2DM患者，按照完全随机的方法分为二甲双胍组（A组）、茵陈五苓散加减组（B组） 及二甲双胍联合茵陈五苓散加减组（C组） 各9例。治疗28 d后，比较3组治疗前后空腹血糖（FBG） 水平、胃肠道不良反应评分，并分别采集其治疗前后的粪便样本，利用PacBio测序平台对粪便标本进行高通量测序，比较3组菌群丰度。结果：治疗后，3组FBG水平均降低（P＜0.05），且3组间FBG水平比较，差异无统计学意义（P＞0.05）。治疗后，A组胃肠道不良反应评分升高（P＜0.05），B组、C组胃肠道不良反应评分降低（P＞0.05），且A组高于B组、C组（P＜0.05）。治疗后，A组瘤胃球菌（科水平）、梭菌目（目水平）、梭菌纲（纲水平）、普氏栖粪杆菌（种水平） 丰度均降低（P＞0.05），B组及C组上述菌群丰度均升高（P＞0.05），但3组间比较，差异无统计学意义（P＞0.05）。结论：茵陈五苓散加减能降低FBG，调节肠道菌群失调，增加有益菌的菌群丰度并保护胃肠道。

Clinical Study on Modified Yinchen Wuling San for Type 2 Diabetes Mellitus

Abstract：Objective：To observe the clinical effect of modified Yinchen Wuling San on type 2 diabetesmellitus (T2DM) of spleen-deficiency and phlegm-damp type. Methods： A total of 27 cases of T2DMpatients were randomly divided into the Metformin group (Group A)， the modified Yinchen Wuling Sangroup (Group B) and the Metformin combined with modified Yinchen Wuling San group (Group C)，with ninecases in each group. After 28 days of treatment，fasting blood glucose (FBG) and scores of gastrointestinaladverse reactions in the three groups were compared before and after treatment； fecal samples werecollected before and after treatment， respectively； high-throughput sequencing of fecal samples wasperformed by the PacBio sequencing platform； the abundance of microflora was compared among thethree groups. Results：After treatment，FBG in the three groups was decreased (P＜0.05)，and there wasno significant difference in the comparison of FBG among the three groups (P＞0.05). After treatment，thescore of gastrointestinal adverse reactions in Group A was increased (P＜0.05)， and the scores ofgastrointestinal adverse reactions in Group B and Group C were decreased (P＞0.05)； the score ofgastrointestinal adverse reactions in Group A was higher than that in Group B and Group C (P＜0.05). Aftertreatment，the abundances of ruminococcus (family level)，Clostridium (order level)，clostridia (class level)and Faecalibacterium prausnitzii (species level) in Group A were decreased (P＞0.05)， and the aboveabundances in Group B and Group C were increased (P＞0.05)， but there was no significant differenceamong the three groups (P＞0.05). Conclusion： Modified Yinchen Wuling San can reduce FBG， regulateintestinal flora disorder，increase the abundance of beneficial bacteria and protect gastrointestinal tract.