| 吴静.从“痰瘀互结,毒损入络”探讨二陈合会厌逐瘀汤治疗痰瘀型糖尿病并OSAHS的疗效及机制研究[J].浙江中西医结合杂志,2026,36(1): |
| 从“痰瘀互结,毒损入络”探讨二陈合会厌逐瘀汤治疗痰瘀型糖尿病并OSAHS的疗效及机制研究 |
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| 投稿时间：2024-11-29 修订日期：2025-10-17 |
| DOI： |
| 中文关键词: 二陈合会厌逐瘀汤 痰瘀型糖尿病 阻塞性睡眠呼吸暂停低通气综合征 炎症因子 网络药理学 |
| 英文关键词:Erchen Decoction uiyan Zhuyu Decoction Diabetes mellitus Phlegm-stasis type Obstructive sleep apnea hypopnea syndrome inflammation Inflammatory Factors Network Pharmacology |
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| 中文摘要: |
| 目的:本研究旨在探讨二陈合会厌逐瘀汤在痰瘀型糖尿病并发阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用效果及其对血糖、血脂、炎症因子、睡眠质量等的影响,同时结合网络药理学分析其潜在的作用机制。方法:本研究选取2021年1月至2023年12月期间,住院或就诊于丽水市中医院的80例痰瘀型糖尿病合并OSAHS患者,采用随机数字表法将患者分为两组:对照组(40例)给予常规治疗,观察组(40例)在常规治疗基础上加用二陈合会厌逐瘀汤。治疗前后,评估两组的疗效、血糖水平(包括空腹血糖、餐后2小时血糖、糖化血红蛋白)、胰岛素抵抗(HOMA-IR)、血脂水平(总胆固醇、甘油三酯、低密度脂蛋白、高清度脂蛋白)、体质量指数(BMI)、炎症因子(MIF、MCP-1)、OSAHS相关指标(如呼吸暂停低通气指数AHI、最大氧减时间、平均血氧饱和度SpO2)以及嗜睡症状(通过Epworth嗜睡量表ESS评分评定)。同时,利用网络药理学方法,通过构建药物-靶点-疾病的网络,筛选潜在的作用靶点,并分析其在调节糖尿病和OSAHS中的生物学机制。结果:观察组的总有效率为90.00%,明显高于对照组的72.50%(P＜0.05)。治疗后,观察组的中医证候积分显著低于对照组(P＜0.05)。在血糖控制、胰岛素抵抗、血脂调节等方面,观察组的改善均优于对照组(P＜0.05)。此外,观察组的SpO2明显高于对照组,ESS评分、MIF、最大氧减时间、AHI和MCP-1水平显著低于对照组(P＜0.05)。通过网络药理学分析,二陈合会厌逐瘀汤可能通过多靶点作用,调节与糖尿病、OSAHS相关的关键生物通路,包括炎症反应、氧化应激、脂质代谢等通路,从而发挥治疗作用。两组在不良反应发生率上无显著差异(P＞0.05)。结论:二陈合会厌逐瘀汤在痰瘀型糖尿病并发OSAHS患者中具有显著的治疗效果,能够有效改善血糖、血脂水平,减轻嗜睡症状,调节炎症因子,并改善OSAHS相关指标。网络药理学分析表明,二陈合会厌逐瘀汤的治疗效果可能通过多靶点、多通路机制实现,具有较好的安全性。 |
| 英文摘要: |
| Objective: This study aims to investigate the therapeutic effect of Erchen Hehui Yan Zhuyu Decoction in patients with phlegm-stasis type diabetes complicated by obstructive sleep apnea hypopnea syndrome (OSAHS), and its impact on blood glucose, blood lipids, inflammatory factors, and sleep quality. Additionally, we performed a network pharmacology analysis to explore the potential mechanisms underlying its effects.Methods: A total of 80 patients with phlegm-stasis type diabetes combined with OSAHS, who were hospitalized or visited Lishui Traditional Chinese Medicine Hospital between January 2021 and December 2023, were selected for the study. The patients were randomly divided into two groups using a random number table: the control group (40 cases) received conventional treatment, and the observation group (40 cases) was treated with Erchen Hehui Yan Zhuyu Decoction in addition to conventional treatment. Before and after treatment, the efficacy, blood glucose levels (including fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin), insulin resistance (HOMA-IR), blood lipid levels (total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein), body mass index (BMI), inflammatory factors (MIF, MCP-1), and OSAHS-related indicators (such as apnea-hypopnea index (AHI), maximal oxygen desaturation time, average blood oxygen saturation (SpO2)) were assessed. Additionally, sleepiness symptoms were evaluated using the Epworth Sleepiness Scale (ESS). Network pharmacology was used to construct a drug-target-disease network, identify potential therapeutic targets, and analyze the biological mechanisms regulating diabetes and OSAHS.Results: The total effective rate in the observation group was 90.00%, significantly higher than the 72.50% in the control group (P<0.05). After treatment, the Traditional Chinese Medicine (TCM) symptom scores in the observation group were significantly lower than those in the control group (P<0.05). The observation group showed greater improvements in blood glucose control, insulin resistance, and blood lipid regulation compared to the control group (P<0.05). Additionally, the SpO2 in the observation group was significantly higher, while ESS scores, MIF, maximal oxygen desaturation time, AHI, and MCP-1 levels were significantly lower than in the control group (P<0.05). Network pharmacology analysis suggested that Erchen Hehui Yan Zhuyu Decoction might exert its effects through multiple targets by regulating key biological pathways associated with inflammation, oxidative stress, and lipid metabolism, which are related to both diabetes and OSAHS. No significant differences in adverse event rates were observed between the two groups (P>0.05).Conclusion: Erchen Hehui Yan Zhuyu Decoction shows significant therapeutic effects in patients with phlegm-stasis type diabetes complicated by OSAHS. It effectively improves blood glucose and lipid levels, alleviates sleepiness symptoms, regulates inflammatory factors, and improves OSAHS-related indicators. Network pharmacology analysis indicates that the therapeutic effects of the decoction may be achieved through multi-target and multi-pathway mechanisms, and it demonstrates good safety. |
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