摘要
目的:探究黄芪四君子汤联合沙格列汀治疗老年2型糖尿病患者的临床疗效及对血清人新饱食分子蛋1(Nesfatin-1)、性激素结合球蛋白(sex hormone-binding globulin,SHBG)水平的影响。方法:选择老年2型糖尿病患者共90例,随机分为对照组和观察组。对照组使用沙格列汀治疗,观察组使用黄芪四君子汤联合沙格列汀治疗。比较两组患者治疗前后血糖、胰岛素和胰岛素抵抗相关指标,检测并比较治疗前后血清Nesfatin-1、SHBG表达水平。结果:治疗后两组血糖生化指标均显著降低(P<0.05),并且观察组血糖生化指标显著低于对照组(P<0.05)。治疗后观察组稳态β细胞功能指数(homeostasisβCell function index,HOMA-β)显著高于对照组,而胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)显著低于对照组(P<0.05)。治疗前两组炎症因子和氧化应激指标无显著差异(P>0.05),治疗后均显著改善(P<0.05),观察组超敏C反应蛋白(hypersensitive C-reactive protein,hs-CPR)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)以及丙二醛(malondialdehyde,MDA)水平显著低于对照组,超氧化物歧化酶水平(superoxide orgotein dismutase,SOD)显著高于对照组(P<0.05)。治疗前两组血清Nesfatin-1、SHBG无显著差异(P>0.05),治疗后均有好转,观察组血清Nesfatin-1水平显著低于对照组而SHBG显著高于对照组(P<0.05)。两组不良反应发生情况比较,无显著差异(P>0.05)。结论:黄芪四君子汤联合沙格列汀可更有效地降低血糖水平并改善胰岛素相关指标。同时联合使用可调节Nesfatin-1和SHBG水平,可有效改善胰岛素抵抗,降低糖尿病并发症的风险。
Objective:To investigate the clinical efficacy of Huangqi Sijunzi Decoction combined with saxagliptin in treatment of elderly patients with type 2 diabetes and the effect on the level of serum human neonatal protein 1(Nesfatin-1)and sex hormone?binding globulin(SHBG).Methods:A total of 90 elderly patients with type 2 diabetes were randomly divided into control group and observation group.The control group was treated with saxagliptin,and the observation group was treated with Huangqi Sijunzi Decoction combined with saxagliptin.The indexes of blood glucose,insulin and insulin resistance before and after treatment were compared between the two groups.The expression levels of serum Nesfatin-1 and SHBG were detected and compared before and after treatment.Results:After treatment,the blood glucose biochemical indexes of the two groups were significantly decreased(P<0.05),and the blood glucose biochemical indexes of the observation group were significantly higher for the control group(P<0.05).After treatment,the homeostasis pCell function index(HOMA-p)was significantly higher than the control group and the homeostasis model assessment for insulin resistance(HOMA-IR)was significantly lower than the control group(P<0.05).There were no significant differences in inflammatory factors and oxidative stress between the two groups before treatment(P>0.05),and significant improvement after treatment(P<0.05).Hypersensitive C-reactive protein(hs-CPR)in the observation group),tumor necrosis factor-a(TNF-a)and malondialdehyde(MDA)levels were significantly lower than the control group,superoxide orgotein dismutase(SOD)was significantly higher than Control group(P<0.05).There was no significant difference in serum Nesfatin-1 and SHBG between the two groups before treatment(P>0.05).After treatment,the serum levels of Nesfatin-1 in the observation group were significantly lower than those in the control group and SHBG was significantly higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Huangqi Sijunzi Decoction combined with saxagliptin can effectively lower the blood sugar levels and improve the insulin-related indicators.At the same time,combined use of adjustable levels of Nesfatin-1 and SHBG can effectively improve insulin resistance and reduce the risk of complications of diabetes.
作者
张杰
肖艳
宋趣兰
谢利芳
ZHANG Jie;XIAO Yan;SONG Qulan;XIE Lifang(The 988 Hospital of Chinese People's Liberation Army,Zhengzhou Henan China 450042)
出处
《中医学报》
CAS
2019年第10期2198-2202,共5页
Acta Chinese Medicine
基金
国家自然科学基金项目(30572426)
