[1]张秋菊,吴瑞,郭丰年,等.皮内针联合大柴胡汤治疗肥胖型2型糖尿病肝胃郁热证临床研究[J].陕西中医,2026,(1):105-109.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.019]
　ZHANG Qiuju,WU Rui,GUO Fengnian,et al.Intradermal needle combined with Dachaihu decoction in the treatment of obese type 2 diabetes mellitus with liver and stomach stagnation heat syndrome[J].,2026,(1):105-109.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.019]
点击复制

皮内针联合大柴胡汤治疗肥胖型2型糖尿病肝胃郁热证临床研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年1期
页码:
105-109
栏目:
针灸经络
出版日期:
2026-01-05

文章信息/Info

Title:
Intradermal needle combined with Dachaihu decoction in the treatment of obese type 2 diabetes mellitus with liver and stomach stagnation heat syndrome
作者:
张秋菊; 吴瑞; 郭丰年; 安然; 李勤; 许宏亮
（中国中医科学院广安门医院南区内分泌科，北京 102600）
Author(s):
ZHANG Qiuju; WU Rui; GUO Fengnian; AN Ran; LI Qin; XU Hongliang
(Endocrinology Department of Guang’anmen Hospital South Campus,China Academy of Chinese Medical Sciences, Beijing 102600,China)
关键词:
2型糖尿病; 肥胖; 肝胃郁热证; 大柴胡汤; 皮内针治疗
Keywords:
Type 2 diabetes; Obesity; Liver and stomach heat syndrome; Dachaihu decoction; Intradermal needle therapy
分类号:
R 459.9
DOI:
DOI:10.3969/j.issn.1000-7369.2026.01.019
文献标志码:
A
摘要:
目的：观察皮内针联合大柴胡汤治疗肝胃郁热证型肥胖2型糖尿病（T2DM）患者的临床效果。方法：纳入100例肥胖型2型糖尿病辨证为肝胃郁热证患者。按照随机数字表法分为两组，对照组给予口服大柴胡汤治疗，治疗组予中药口服加用皮内针。疗程均为12周。比较两组患者中医证候变化，体重（Wt）、体重指数（BMI）、腰臀比（WHR），血糖（FBG、2hPG、HbA1c）、空腹胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）及血脂（TG、TC、LDL-C、HDL-C）变化。结果：治疗组证候改善总有效率明显高于对照组（87.5%对比66.7%），差异有统计学意义（P＜0.05）。治疗后两组Wt、BMI、血糖（FBG、2hPG、HbA1c）、FINS、HOMA-IR、血脂（TG、TC、LDL-C）均较治疗前降低（P＜0.05），且治疗组下降更为明显，差异有统计学意义（P＜0.05）。治疗后WHR较前均有下降，但组间比较差异无统计学意义（P＞0.05）。HDL-C较前有所升高，但差异无统计学意义（P＞0.05）。两组治疗后中医形体肥胖、胸胁胀闷、口干口苦、心烦易怒、脘腹痞满证候评分均低于治疗前（P＜0.05），且治疗组各证候及总评分均优于对照组（P＜0.05）。结论：皮内针联合大柴胡汤治疗肝胃郁热证肥胖型T2DM患者效果显著，可以减轻胰岛素抵抗，能够减重，纠正糖脂代谢紊乱，明显改善患者的临床症状，且安全性良好。
Abstract:
Objective:To observe the clinical effect of intradermal needle combined with Dachaihu decoction in the treatment of obese type 2 diabetes mellitus (T2DM) patients with liver-stomach heat stagnation syndrome.Methods:100 obese patients with type 2 diabetes mellitus diagnosed and treated by outpatient and ward were prospectively included.According to the random number table method, they were divided into two groups.The control group was treated with oral administration of Dachaihu decoction, and the treatment group was treated with oral administration of traditional Chinese medicine combined with intradermal needle.The course of treatment was 12 weeks.The changes of TCM syndromes, body weight (Wt), body mass index (BMI), waist-hip ratio (WHR), blood glucose (FBG, 2hPG, HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR) and blood lipids (TG, TC, LDL-C, HDL-C) were compared between the two groups.Results:The total effective rate of syndrome improvement in the treatment group was significantly higher than that in the control group (87.5% vs 66.7% ), and the difference was statistically significant (P<0.05).After treatment, the Wt, BMI, blood glucose (FBG, 2hPG, HbA1c), FINS, HOMA-IR, blood lipids (TG, TC, LDL-C) of the two groups were lower than those before treatment (P<0.05),and the treatment group decreased more significantly, the difference was statistically significant (P<0.05).WHR decreased after treatment, but there was no significant difference between the two groups (P>0.05).HDL-C was higher than before, but the difference was not significant (P>0.05).After treatment, the scores of TCM syndromes of obesity, chest tightness, dry mouth and bitter mouth, irritability and abdominal fullness in the two groups were lower than those before treatment (P<0.05), and the scores of each syndrome and total score in the treatment group were better than those in the control group (P<0.05).Conclusion:Intradermal acupuncture combined with Dachaihu decoction is effective in the treatment of obese T2 DM patients with liver-stomach heat stagnation syndrome.It can reduce insulin resistance, lose weight, correct glucose and lipid metabolism disorders, significantly improve the clinical symptoms of patients, and has good safety.

参考文献/References:

[1]李虹,刘维新.肠道菌群与肥胖相关性的研究进展[J].医学综述,2020,16（17）:3386-3393.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南（2020年版）（上）[J].中国实用内科杂志,2021,41(8):668-695.
[3]纪立农,陆菊明,郭晓蕙,等.中国2型糖尿病药物治疗现状与血糖控制的调查研究[J].中华糖尿病杂志,2012,4(7):397-401.
[4]高瑞,高飞,苏妍,等.贝那鲁肽联合西格列汀治疗肥胖2型糖尿病疗效分析[J].长春中医药大学学报,2020,36(6):1226-1228.
[5]黄书晨,汪一波.肥胖发病机制的研究进展[J].中国分子心脏病学杂志,2019,27(5):3105-3108.
[6]尚祥岭.健脾降糖汤治疗肥胖型2型糖尿病痰瘀气虚证临床研究[J].中医学报,2017,32(5):743-746.
[7]张慧,杨柳,刘丹,等.达格列净改善超重及肥胖2型糖尿病患者内脏脂肪含量及脂代谢的探讨[J].医学食疗与健康,2022,20(2):94-96,100.
[8]李东玲,陈小燕,黄炯强,等.肥胖及超重2型糖尿病患者代谢手术后5年疗效随访研究[J].中国糖尿病杂志,2022,30(2):101-105.
[9]刘晓倩,金剑虹,王保法,等.2型糖尿病合并肥胖患者的相关危险因素和中医证素分析[J].世界科学技术-中医药现代化,2021,23(9):3095-3101.
[10]刘珍秀,郭俊瑞,金昕,等.中药治疗单纯性肥胖患者有效性和安全性Meta分析[J].海南医学院学报,2020,23(12):1-14.
[11]魏秀秀,苟筱雯,赵林华,等.态靶辨证在肝胃郁热型肥胖2型糖尿病中的运用——大柴胡汤加黄连、知母、赤芍[J].辽宁中医杂志,2020,47(3):1-3.
[12]赵丽,彭艳华,张永乐,等.组合皮内针结合针刺治疗单纯性肥胖的临床效果研究[J].中国实用医药,2024,19(12):149-151.
[13]陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:1-35.
[14]国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:233-237.
[15]白煜,白宇宁,连凤梅,等.仝小林辨治肥胖型2型糖尿病脂代谢紊乱临证思路[J].中华中医药杂志,2017,32(3):1114-1116.
[16]姚淑红,黄武松,李茜羽.2型糖尿病肥胖患者中医证型分布及代谢特点研究[J].光明中医,2020,35(17):2626-2629.
[17]宋军,邓岚,仝小林.开郁清热方通过调节INS/IGF-1信号通路保护胰岛功能的研究[J].湖北中医药大学学报,2020,22(1):17-20.
[18]张卫欢,李秋云,杨春伟,等.大柴胡汤加减联合利拉鲁肽对肥胖2型糖尿病患者胰岛素抵抗、β-细胞功能和低度炎症反应的影响[J].现代中西医结合杂志,2018,27(1):23-26，30.
[19]宋小雪,黄金凤,田明,等.大柴胡汤的药理及临床应用[J].中医药学报,2019,17（4）:112-116.
[20]王妮,付婷,张勇.五行能量罐疗法治疗单纯性肥胖的临床观察[J].光明中医,2020,25（8）:1198-1200.
[21]阮勤,谢敏.腹针疗法治疗腹型肥胖糖耐量异常的临床效果观察[J].黑龙江科学,2020,11(16):32-36.
[22]唐家威,谢芳.揿针疗法的临床应用研究进展[J].中医研究,2023,36(1):92-96.
[23]金银,徐章猛,王理臻,等.胡玲香教授针刺治疗肥胖经验[J].云南中医中药杂志,2022,43(1):10-12.
[24]张晓林,陈邵涛,刘辉辉,等.“合募配穴”针刺对肥胖胰岛素抵抗大鼠骨骼肌组织SIRT1及PGC-1α表达的影响[J].世界科学技术-中医药现代化,2022,24(8):3234-3241.
[25]林莹宣,李康,李卉.皮内针疗法联合七味白术散对中心性肥胖糖尿病患者血糖及血清人脂联素、Apelin的影响[J].世界中西医结合杂志,2020,15(5):936-938，942.
[26]唐杰,李卉.大柴胡汤联合穴位埋线治疗肝胃郁热证肥胖临床观察[J].光明中医,2023,38(13):2522-2524.

相似文献/References:

[1]李向辉,卢文杰.葛黄降糖汤治疗2型糖尿病合并颈动脉硬化临床研究*[J].陕西中医,2019,(5):580.
　LI Xianghui,LU Wenjie..Effect of Gehuang Jiangtang decoction on mellitus complicated with carotid arteriosclerosis in type 2 diabetes patients[J].,2019,(1):580.
[2]赵 倩,闻新丽△,段盛蕾,等.轻身消脂汤联合穴位埋线治疗脾虚湿阻型单纯性肥胖临床研究*[J].陕西中医,2019,(6):796.
[3]李海霞,史秀英,王璀瑛,等.益肾化痰方治疗肥胖型多囊卵巢综合征不孕临床研究[J].陕西中医,2019,(7):839.
　LI Haixia,SHI Xiuying,WANG Cuiying,et al.Clinical study of Yishen Huatan decoction in the treatment of obese polycystic ovarian syndrome infertility[J].,2019,(1):839.
[4]杨斯皓,马方霞,詹 云.一贯煎合六味地黄汤配合西药治疗2型糖尿病合并非酒精性脂肪肝临床疗效及对患者生活质量的评价*[J].陕西中医,2019,(8):1006.
　YANG Sihao,MA Fangxia,ZHAN Yun..Clinical efficacy and quality of life evaluation of Yiguanjian plus Liuwei Dihuang decoction with western medicine in the treatment of type 2 diabetes with nonalcoholic fatty liver disease[J].,2019,(1):1006.
[5]孙晓红,陈学彬△.芪精丹兰汤对伴有左心室舒张功能不全的2型糖尿病合并代谢综合征患者糖脂代谢、心率变异性的影响*[J].陕西中医,2019,(10):1336.
　SUN Xiaohong,CHEN Xuebin..Effect of Qijing Danlan decoction on glucose and lipid metabolism and heart rate variability in patients with type 2 diabetes mellitus complicated with MS with left ventricular diastolic dysfunction[J].,2019,(1):1336.
[6]訾 璐,胡小军△,王 玉,等.针刺中脘穴联合自拟茶方对2型糖尿病患者血糖水平的影响*[J].陕西中医,2019,(10):1460.
　ZI Lu,HU Xiaojun,WANG Yu,et al.Effect of zhong wan acupuncture combined with selfdesigned tea prescription on blood glucose level in patients with type 2 diabetes mellitus[J].,2019,(1):1460.
[7]张 萍,金 昕,陶 枫△.从胃肠肽角度论中药抑制食欲研究进展*[J].陕西中医,2020,(2):261.
　ZHANG Ping,JIN Xin,TAO Feng..Progress on appetite suppression of traditional Chinese medicine from the perspective of gastrointestinal peptides[J].,2020,(1):261.
[8]文启友,周 伶,马若梦,等.化瘀利尿法论治2型糖尿病探析[J].陕西中医,2021,(6):761.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.021]
[9]谢兆桃,周卓宁,郑 鹏,等.从中焦论治2型糖尿病患者餐后血糖波动[J].陕西中医,2021,(6):764.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.022]
[10]胡全穗,伍宗明.运用中药药对配伍优化消渴病中医防治方案临床研究[J].陕西中医,2021,(8):1084.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.024]
　HU Quansui,WU Zongming.Clinical research on optimizing the TCM prevention and treatment of Xiaoke by using compatibility of herb-partners[J].,2021,(1):1084.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.024]

备注/Memo

备注/Memo:
国家自然科学基金资助项目(82004345)；中国中医科学院广安门医院南区院级科研基金资助项目(Y2022-15)；尉淑卿3+3工程基层老中医传承项目
更新日期/Last Update: 2026-01-08