目的 分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响.方法 选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例.对照组常规服用二甲双胍0.5g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗.治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后 2 h 血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobi-nA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeo-stasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛 β 细胞功能指数(Homeostatic model assessment of β-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏 C 反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平.结果 治疗后观察组临床总有效率94.00％(47/50)明显高于对照组78.00％(39/50),差异有统计学意义(P＜0.05).治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P＜0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P＜0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P＜0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P＜0.05).结论 脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著.
Clinical Effects of Modified Pidan Recipe Combined with Metformin on Obese Type 2 Diabetes and Its Influence on Serum Lipids and Insulin Resistance Index
Objective To analyze the clinical effects of a modified Pidan Recipe combined with metformin on obese type 2 diabetes(T2DM)and its influence on blood lipid and insulin resistance index.Methods A total of 100 obese T2DM patients admitted to Jining Hospital of Traditional Chinese Medicine from January 2022 to February 2023 were se-lected as the study objects,and they were divided into a control group and an observation group by random number table method,with 50 cases in each group.The control group was routinely given metformin 0.5 g/time,three times a day.On the basis of the control group,the observation group was treated with a modified Pidan Recipe.After 12 weeks of treatment,the clinical effects,blood glucose indexes before and after treatment[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG),and glycosylated hemoglobinA1c(HbA1c)],TCM syndrome scores,serum lipid parameters[total cho-lesterol(TC),triglycerides(TG),and low density lipoprotein(LDL-C)],insulin indexes[fasting insulin(FINS),homeo-stasis model assessment-insulin resistance(HOMA-IR),and homeostatic model assessment of β-cell function(HOMA-β)],and the levels of inflammatory factors[interleukin-6(IL-6)and highsensitivity C-reactive protein(hs-CRP)]of the two groups were observed and compared.Results After treatment,the total clinical effective rate of the observation group was 94.00％(47/50),significantly higher than that of the control group(78.00％(39/50)),and the difference was statistically significant(P＜0.05).After treatment,FBG,2 h PBG,HbAlc,and TCM syndrome scores of the two groups were lower(P＜0.05),and the FBG,2 h PBG,HbAlc,and TCM syndrome scores of the observation group were lower than those of the control group(P＜0.05).After treatment,TG,TC,and LDL-C of the two groups were reduced(P＜0.05),and TG,TC,and LDL-C of the observation group were lower than those of the control group(P＜0.05).After treatment,FINS)and HOMA-IR in both groups were lower than those before treatment,and HOMA-β in both groups was higher(P＜0.05).The FINS and HOMA-IR of the observation group were lower than those of the control group,and HOMA-βOwas higher than the control group(P＜0.05).After treatment,the levels of inflammatory factors IL-6 and hs-CRP of the two groups were lower(P＜0.05),and the levels of inflammatory factors of the observation group were lower than those of the control group(P＜0.05).Conclusion Modified Pidan Recipe combined with metformin can treat obese T2DM pa-tients.It can effectively regulate blood sugar and lipid levels,improve insulin resistance,and alleviate inflammatory reac-tions,with significant clinical effects.
Pidan RecipeMetforminObese Type 2 DiabetesBlood LipidsInsulin Resistance Index
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