| ObjectiveTo observe the efficacy and safety of "invigorating the spleen and transforming the turbidity"massage method on T2DM and its influence on intestinal flora,so as to provide new ideas and methods for the prevention and treatment of T2DM.MethodsA total of 60 T2DM patients with "spleen deficiency and turbidity stagnation syndrome"were admitted in the massage department of Jiangsu traditional Chinese medicine hospital and the Nanjing Jiqingmen hospital from March 2019 to July 2019.They were divided into control group,traditional massage group and "invigorating the spleen and transforming the turbidity,by random number table,and there were 20 patients in each group.All the patients in the three groups were given regular health education,dietary habits and exercise guidance by professionals,and maintained the pre-trial treatment plan.The drug usage and dosage of patients using hypoglycemic drugs were consistent with those before the test.Among them,control group only maintained the pre-trial treatment plan;Traditional massage group mainly used the treatment plan from Massage therapeutics published by China Traditional Chinese Medicine Press;"invigorating the spleen and transforming the turbidity,massage group mainly used the"invigorating the spleen and transforming the turbidity,massage method.All the patients in the three groups were treated for 8 weeks,three times a week,one time every other day,and rest on Sunday.To observe the safety of patients in the whole treatment process,and to measure and analyze the TCM symptom scores and its efficacy evaluation,fasting blood glucose,Postprandial blood glucose,glycosylated hemoglobin and intestinal flora represented by Enterococcus,Enterobacteriaceae,Bifidobacterium and Lactobacillus detected by fluorescence quantitative PCR.Results(1)Before treatment,there were no significant differences among the three groups in exclusion,gender,age,course,TCM symptom scores and clinical efficacy,glucose metabolism index and intestinal flora level among the three groups(P>0.05).(2)TCM symptom scores decreased to some extent in all groups after treatment and there were significant differences when compared before treatment(P<0.01).The comparison of the integral changes of the three groups after treatment showed that:the scores change in traditional massage group and“invigorating the spleen and transforming the turbidity,massage group were higher than control group(P<0.05,P<0.01),and comparison between the two shows that the scores change of "invigorating the spleen and transforming the turbidity" massage group is larger(P<0.01).The results of clinical efficacy evaluation based on TCM symptom scores calculation efficacy index showed that the clinical efficacy of the "invigorating the spleen and transforming the turbidity" massage group,traditional massage group and control group were 48.15%,73.68%,50%and 17.65%.Compared with the traditional massage and the control group,the"invigorating the spleen and transforming the turbidity" massage group had statistical significance(P<0.05,P<0.01),and there was no significant difference between the traditional massage group and the control group(P>0.05).(3)The results of FBG,PBG and HbAlc before and after intervention showed that there was no statistical significance in the control group before and after treatment(P>0.05).There was significant difference between the traditional massage group and the "invigorating the spleen and transforming the turbidity" massage group(P<0.01).Comparison of glucose metabolism indexes among three groups after treatment,the decrease of FBG,PBG and HbAlc in traditional massage group and "invigorating the spleen and transforming the turbidity" massage group were significantly higher than those in control group(P<0.01),and there was no significant difference between the traditional massage group and the "invigorating the spleen and transforming the turbidity" group(P>0.05).(4)The results of enterococci,enterobacteriaceae,bifidobacteria and lactobacilli before and after intervention showed that there was significant difference in the "invigorating the spleen and transforming the turbidity"group(P<0.01).There was no significant difference in the level of enterococci before and after treatment in the traditional massage group(P>0.05),and there was no significant difference in the other three bacteria(P<0.05).There was no significant difference in the control group(P>0.05).After treatment,enterococci in the three groups showed that:compared with the control group,"invigorating the spleen and transforming the turbidity" massage group and traditional massage group have no statistical significance(P>0.05),and there was no statistical significance in the "invigorating the spleen and transforming the turbidity" massage group compared with the traditional massage group(P>0.05).After treatment,enterobacteriaceae in the three groups showed that:the reduction effect of the "invigorating the spleen and transforming the turbidity"massage group was better than that of the control group,with significant difference(P<0.01).Compared with the control group,traditional massage group have no statistical significance(P>0.05),and there was no statistical significance in the "invigorating the spleen and transforming the turbidity" massage group compared with the traditional massage group(P>0.05).After treatment,bifidobacteria in the three groups showed that:the effect of the two massage groups was better than that in the control group,with a significant difference(P<0.01)and there was no significant difference between the two massage groups(P>0.05).After treatment,lactobacilli in the three groups showed that:the effect of the two massage groups was better than that in the control group(P<0.05)and there was no significant difference between the two massage groups(P>0.05).(5)Before and after intervention,the safety evaluation indexes of liver and kidney function,vital signs and adverse reactions of the three groups did not show abnormal fluctuations.Conclusions(1)The three methods are safe and effective in improving TCM symptoms of patients with T2DM,among which the "invigorating the spleen and transforming the turbidity" massage method is the best for the improvement of TCM symptoms.In the aspect of improving the index of glucose metabolism,both traditional massage method and "invigorating the spleen and transforming the turbidity",massage method can significantly reduce FBG,PBG and HbAlc of T2DM,and the therapeutic effect is equivalent,but the simple propaganda and guidance has no significant therapeutic effect.(2)In T2DM patients,there is a general imbalance of intestinal flora homeostasis,which is manifested in the decrease of the beneficial bacteria represented by Bifidobacteria and Lactobacillus,and the increase of the harmful bacteria represented by Enterobacteria and Enterococcus.Among them,the simple propaganda and instruction has no obvious therapeutic effect on the four bacteria.Traditional massage method and "invigorating the spleen and transforming the turbidity" method can improve the level of bifidobacteria and lactobacilli,and the curative effect is the same.Traditional massage method and“invigorating the spleen and transforming the turbidity,method also can improve the level of enterobacteriaceae,and the effect of“invigorating the spleen and transforming the turbidity,i5 better than that of traditional massage group.The“invigorating the spleen and transforming the turbidity,method also has a certain therapeutic effect on enterococcus.(3)Combined with TCM symptom scores and its efficacy evaluation,glucose metabolism index and intestinal flora level,“invigorating the spleen and transforming the turbidity' massage method is superior to traditional massage method in clinical efficacy,and "invigorating the spleen and resolving the turbid,massage method has the obvious advantages of refining the operation,accurate acupoint selection and easy clinical promotion. |
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