摘要
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0.5 g/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 hemoglobinA1c,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(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-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。
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 selected 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 cholesterol(TC),triglycerides(TG),and low density lipoprotein(LDL-C)],insulin indexes[fasting insulin(FINS),homeostasis model assessment-insulin resistance(HOMA-IR),and homeostatic model assessment ofβ-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-βin 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 patients.It can effectively regulate blood sugar and lipid levels,improve insulin resistance,and alleviate inflammatory reactions,with significant clinical effects.
作者
张爱民
赵燕燕
胡磊磊
曹艳华
ZHANG Ai-min;ZHAO Yan-yan;HU Lei-ei;CAO Yan-hua(Department of Endocrinology,Jining Hospital of Traditional Chinese Medicine,Jining Shandong 272000)
出处
《世界中西医结合杂志》
2024年第3期591-595,共5页
World Journal of Integrated Traditional and Western Medicine
基金
山东省中医药科技项目(2021Q025)。
