Clinical Observation On The Treatment Of Type 2 Diabetes With Obesity Based On The Theory Of "Earth Blocking And Wood Stagnation"

Objective: To explore the distribution characteristics of TCM syndromes of type 2 diabetes with obesity.Based on the theory of "Earth Stagnation and Wood Depression",observed the clinical efficacy of Dachaihu Decoction and Pingwei Powder in the treatment of patients with type 2 diabetes with obesity of stagnation of heat in the liver and stomach,Objectively evaluate its safety and therapeutic effects,and provide idea and method for the treatment of type2 diabetes with obesity.Methods: From November 1,2019 to October 1,2020,200 patients with type2 diabetes mellitus complicated with obesity who met the inclusion criteria from the Department of endocrinology of The Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected as the research objects.General information and TCM syndrome manifestations were collected to observe the distribution characteristics of TCM syndrome types.In addition,60 cases of the stagnant heat of the liver and stomach were selected and randomly divided into experimental group(30 cases)and control group(30cases).The control group was treated with basic treatment and oral metformin,while the experimental group was treated with Dachaihu Decoction and Pingwei Powder on the basis of the control group.Both groups were treated for 12 weeks.The efficacy indexes such as body weight,body mass index,waist circumference,fasting and 2h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,insulin resistance index,TCM syndrome score,liver function,renal function,blood and urine routin,electrocardiogram and other safety indexes were observed and compared before and after treatment in the experimental group and the control group.All test results and other data were analyzed by spss 26.0.Results: 1.The distribution characteristics of TCM syndrome types: From more to less,they were the stagnant heat of the liver and stomach syndrome,internal accumulation of phlegm and dampness syndrome,Qi and yin deficiency syndrome,blood stasis obstructing collaterals syndrome,spleen and kidney deficiency syndrome,accounting for 47%,24%,11%,9.5% and 8.5% respectively.2.Comparison of laboratory indexes: After treatment,all indexes of the two groups decreased,the differences of FBG,2h PBG and Hb A1 c in the experimental group were significant(P<0.01),and the curative effect was significantly different from that in the control group(P<0.01).The curative effect of the experimental group in reducing body weight,BMI and waist circumference was different from that in the control group(P<0.05).There was no significant difference in reducing FINS between the two groups(P>0.05),but the experimental group was more significant in HOMA-IR improvement than the control group(P<0.05).3.TCM syndrome score and curative effect: The scores were decreased,and the difference between the two groups was significant(P<0.01).From the perspective of clinical efficacy,through statistical analysis,the overall efficacy of the experimental group was significantly different from that of the control group(P<0.01).4.No obvious discomfort occurred in both groups during clinical observation,and no abnormality was found in safety index.Conclusion: The most common TCM syndrome type of type 2 diabetes with obesity is stagnation of heat in liver and stomach.Dachaihu Decoction and Pingwei Powder which used to treat patients with type 2 diabetes obesity of stagnation of heat in liver and stomach syndrome can effectively reduce fasting and postprandial blood glucose,lower body weight,BMI,waist circumference,improve insulin resistance,and improve TCM symptoms.