摘要
目的 探讨参芪地黄汤化裁联合胰岛素治疗在二甲双胍控制血糖不佳气阴两虚证糖尿病患者中的应用价值.方法 选取2019 年3 月—2022 年6 月就诊的100 例二甲双胍控制血糖不佳气阴两虚证糖尿病开展回顾性研究,均为2 型糖尿病.根据治疗方法不同分为研究组和常规组,每组50 例.研究组采用参芪地黄汤化裁联合胰岛素治疗,常规组采用胰岛素治疗.比较2 组疗效、中医证候积分、血糖相关指标[糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR)、餐后2h血糖(2hPBG)、空腹血糖(FBG)、胰岛β细胞功能指数(HOMA-β)]、炎性指标[C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、白血病抑制因子(LIF)、高迁移率族蛋白B1(HMGB1)]、预后指标[脂蛋白相关磷脂酶A2(Lp-PLA2)、血尿酸(SUA)、甲状腺球蛋白(TG)]及安全性.结果 研究组临床总有效率94.00%(47/50)高于常规组80.00%(40/50)(P＜0.05).治疗后研究组各中医证候积分及总积分低于常规组(P＜0.05).治疗后研究组HbA1c、2hPBG、FBG、HOMA-IR低于常规组,HOMA-β高于常规组(P＜0.05).治疗后研究组CRP、MCP-1、LIF、HMGB1、Lp-PLA2、SUA、TG低于常规组(P＜0.05).2 组不良反应发生率比较差异无统计学意义(P＞0.05).结论 参芪地黄汤化裁联合胰岛素治疗二甲双胍控制血糖不佳气阴两虚证糖尿病患者效果显著,可有效降低血糖水平,改善临床症状,减轻炎症反应,且安全性高.
Abstract
Objective To investigate the application value of Shenqi Dihuang decoction combined with insulin in the treatment of patients with diabetes mellitus(DM)and poor control of Qi-yin deficiency syndrome by metformin.Methods A retrospective study was conducted on 100 DM patients with poor control of with Qi-yin deficiency syndrome by metformin from March 2019 to June 2022,all of whom had type 2 diabetes mellitus(T2DM).According to different treatment methods,the patients were divided into research group and conventional group,with 50 cases in each group.The research group was treated with Shenqi Dihuang decoction combined with insulin,and the conventional group was treated with insulin.The therapeutic effect,traditional Chinese medicine(TCM)syndrome score,blood glucose-related indexes[glycated hemoglobin A1c(HbA1c),homeostasis model assessment-insulin resistance index(HOMA-IR),2 h postprandial blood glucose(2 h PBG),fasting blood glucose(FBG),islet beta cell function index(HOMA-β)],inflammatory indicators[C reactive protein(CRP),monocyte chemotactic protein-1(MCP-1),leukemia inhibitory factor(LIF),high mobility group protein B1(HMGB1)],prognostic indicators[lipoprotein-associated phospholipase A2(Lp-PLA2),serum uric acid(SUA),thyro-globulin(TG)]and safety were compared between the two groups.Results The total clinical effective rate of the research group was 94.00%(47/50),which was higher than that of the conventional group[80.00%(40/50)](P＜0.05).After treatment,the TCM syndrome scores and total scores of the research group were lower than those of the conventional group(P＜0.05).After treatment,HbA1c,2 h PBG,FBG and HOMA-IR in the research group were lower than those in the con-ventional group,while HOMA-β was higher than that in the conventional group(P＜0.05).After treatment,CRP,MCP-1,LIF,HMGB1,Lp-PLA2,SUA and TG in the research group were lower than those in the conventional group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Shenqi Dihuang decoction combined with insulin in the treatment of DM patients with poor control of Qi-yin deficiency syn-drome by metformin has significant effects,which can effectively reduce blood sugar level,improve clinical symptoms,allevi-ate inflammation,and have a good prognosis and high safety.
基金项目
第一批安徽省中医药学术流派传承工作室建设项目(皖中医药发展秘202130号)
维普
万方数据