Study On The Effect Of Banxia Xiexin Decoction On Intestinal Flora And Glucose And Lipid Metabolism In Patients With T2DM Based On The Theory Of "Common Soil"

Objective: To observe the changes of intestinal flora and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM),and to explore the effect of "Banxia Xiexin Decoction" on intestinal flora and glycolipid metabolism under the guidance of "common soil" theory.To explain the possible mechanism and clinical significance of regulating gastric(spleen)intestinal correction of T2 DM.Methods:A total of 66 patients who met the inclusion criteria were randomized into two groups and randomized into a treatment group and a control group.Both of them received basic treatment and insulin treatment.The treatment group was treated with " "Banxia Xiexin Decoction" granules,and the control group was treated with "Banxia Xiexin Decoction" granule mimic.Taking 12 weeks as the observation course,the changes of body mass index(BMI),islet β-cell function index(HOMA-β),insulin resistance index(HOMA-IR),blood lipids and blood glucose related indexes were evaluated before and after treatment.Clinical symptoms and signs,safety indicators and adverse reactions during the treatment were recorded,and all data were statistically analyzed using SPSS 23.0 software.Results:(1)Evaluation of medical efficacy: After treatment,the scores of TCM syndromes decreased in both groups,among which the effective rate of the treatment group was about 90.63%,the score of TCM syndrome was significantly decreased,and the effective rate of the control group was 16.67%.The total effective rate of the treatment group was obvious.Compared with the control group,the difference was statistically significant(P<0.01).(2)Blood glucose index: After treatment,the HbA1 c,FPG and P2 hPG indexes were significantly lower than those before treatment,and the difference was statistically significant(P<0.01).There were significant differences between the two groups in the FPG and P2 hPG groups(P<0.01).There was significant difference between the two groups(P<0.05).(3)Blood lipid index: The TG,TC,LDL-C and HCY indexes in the treatment group were significantly lower than before,and HDL-C was significantly higher than before(P<0.01).There were no significant changes in the TG,TC,LDL-C and HCY indexes in the control group.The difference was not statistically significant(P>0.05),and the HDL-C index was higher than the previous one(P<0.05).There were significant differences between the two groups in TG and LDL-C groups(P<0.01).There was no significant difference between the two groups in TC,HDL-C and HCY groups(P>0.05).(4)Islet β-cell function and insulin resistance index: Compared with before treatment,the islet β-cell function index(HOMA-β)and insulin insulin resistance index(HOMA-IR)were improved after treatment.The difference was statistically significant(P<0.01).There was no significant difference between HOMA-β and HOMA-IR in the control group,and the difference was not statistically significant(P>0.05).Compared with the control group,the islet β-cell function after treatment in the treatment group The index improved,the difference was statistically significant(P<0.05).Compared with the control group,the insulin resistance index of the treatment group improved significantly,the difference was statistically significant(P<0.01).(5)BMI changes: Compared with before treatment,the BMI decreased after treatment in the treatment group,the difference was statistically significant(P<0.01).There was no significant change in the control group compared with before treatment,and the difference was not statistically significant(P> 0.05),there was no significant difference between the two groups(P>0.05).(6)Intestinal flora index: "Banxia Xiexin Decoction" can increase the diversity of intestinal flora and increase the number of dominant bacteria,such as Lactobacillus,and reduce the proportion of inferior bacteria,such as Escherichia(Escherichia-Shigella).(7)Safety indicators: The three routine,liver and kidney function,electrocardiogram and other indicators of the two groups before and after treatment were within the normal range,and the use of "Banxia Xiexin Decoction" was used as a safe and non-toxic side effect.Research conclusion:(1)dysfunction of the spleen and stomach,small intestine,"meat paste" turbidity and overflow,soil deterioration is the key to the pathogenesis of diabetes hyperglycemia,dyslipidemia,dysbacteriosis,reconciling the stomach(spleen)intestine,reducing soil essence,It is the basic rule.(2)Based on the "common soil" theory,"Banxia Xiexin Decoction" can significantly improve the clinical manifestations of patients,and can improve insulin resistance and islet βcell function,regulate intestinal flora imbalance,and effectively control blood sugar and blood lipids.In terms of mechanism of action,its hypoglycemic and lipid-lowering effects may be related to the improvement of insulin resistance and islet β-cell function,and may also be related to the improvement of intestinal flora.(3)The diagnosis and treatment of type 2 diabetes with dyslipidemia combined with insulin based on the "common soil" theory has obvious advantages compared with insulin therapy alone,and is worthy of clinical research.