目的 探究参芪降糖颗粒辅治对2型糖尿病(Diabetes mellitus type 2,T2DM)患者糖脂代谢平衡的作用效果,并分析对其转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、胰高糖素样肽-1(Glucagon-like peptide-1,GLP-1)的影响.方法 选取2018年12月—2021年12月期间在四川省眉山市中医医院初诊为T2DM患者96例为研究对象,按随机数字表法分为对照组和观察组,每组各48例.对照组采取常规西药治疗,观察组在对照组基础上采用参芪降糖颗粒加以辅治.治疗4周后,观察比较两组患者临床疗效、治疗前后糖脂[空腹血糖(Fasting plasma glucose,FPG)、餐后 2 h 血糖(2 h postprandial glucose,2 h PG)、糖化血红蛋白(Glycosy-lated hemoglobin,HbA1c)以及甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)]代谢情况、TGF-β1及GLP-1水平变化,同时探究药物安全性.结果 治疗后观察组显效43.75%(21/48)、总有效率95.83%(46/48)均明显高于对照组22.92%(11/48)、83.33%(40/48),差异有统计学意义(P<0.05).治疗4周后两组患者糖代谢指标FPG、2 h PG、HbA1c和脂代谢指标TG、TC、LDL-C均较治疗前明显降低,HDL-C较治疗前明显升高,差异有统计学意义(P<0.05);且观察组糖代谢指标FPG、2 h PG、HbA1c和脂代谢指标TG、TC、LDL-C均低于对照组,HDL-C高于对照组,差异有统计学意义(P<0.05).治疗4周后两组患者TGF-β1水平较治疗前降低,GLP-1水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TGF-β1水平低于对照组,GLP-1水平高于对照组,差异有统计学意义(P<0.05).时点效应可显著影两项指标水平,且两项指标随时点变化趋势受到治疗方法的干预(P<0.05).结论 在西药基础上辅以参芪降糖颗粒可以明显降低T2DM患者的血糖和血脂水平,有效改善机体糖脂代谢和胰岛素代谢,从而提高整体疗效.
Effects of Shenqi Jiangtang Granule as Adjuvant Therapy on Glycolipid Metabo-lism,TGF-β1 and GLP-1 in T2DM patients
Objective To explore the effect of Shenqi Jiangtang Granule as adjuvant therapy on the balance of glycolipid metabolism in patients with type 2 diabetes mellitus(T2DM),and analyze its effects on transforming growth fac-tor-β1(TGF-β1)and glucagon-like peptide-1(GLP-1).Methods A total of 96 newly diagnosed T2DM patients in Meishan Hospital of Traditional Chinese Medicine of Sichuan Province from December 2018 to December 2021 were se-lected as the research subjects,and divided into control group and observation group according to random number table method,with 48 cases in each group.The control group was treated with conventional western medicine,and the observation group was supplemented with Shenqi Jiangtang Granule as adjuvant therapy in addition to the control group.After 4 weeks of treatment,the clinical efficacy,changes in glycolipid metabolism[Fasting plasma glucose(FPG)before and after treat-ment,2 h postprandial glucose(FPG),glycosylated hemoglobin(HbA1c),Triglyceride(TG),Total cholesterol,TC,high-density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C)],as well as TGF-β1 and GLP-1 levels were compared between the two groups,and safety of the medication was investigated.Results After treat-ment,the marked effectiveness of 43.75%(21/48)and the total effective rate of 95.83%(46/48)in the observation group were significantly higher than those in the control group(22.92%(11/48)and 83.33%(40/48)of the control group,and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the glycemic parameters FPG,2 h PG,HbAlc and lipid parameters TG,TC,LDL-C were significantly decreased in both groups compared to before treatment,and HDL-C was significantly increased compared to before treatment,and the differences were statistically significant(P<0.05).The glycemic parameters FPG,2 h PG,HbAlc and lipid parameters TG,TC and LDL-C in observation group were lower than those in control group,and HDL-C was higher than those in control group,with statistically different sig-nificance(P<0.05).After 4 weeks of treatment,the levels of TGF-β1 decreased and GLP-1 increased in both groups compared to before treatment,and the difference was statistically significant(P<0.05);The levels of TGF-β1 in the ob-servation group were lower than that in the control group,and the levels of GLP-1 were higher than those in the control group,with statistical significance(P<0.05).The time-point effect could significantly affect the levels of the two indica-tors,and the change trend of the two indicators at any time point was affected by the treatment method(P<0.05).Conclu-sions Shenqi Jiangtang Granules,in addition to western medicine,can significantly reduce the blood glucose and lipid lev-els in T2DM patients,effectively improve glycolipid metabolism and insulin metabolism,thereby improving the overall ther-apeutic efficacy.
Type 2 diabetes mellitusGlycolipid metabolismShenqi Jiangtang GranulesTransforming growth fac-torInsulin