参芪降糖颗粒联合吡格列酮治疗2型糖尿病的临床研究

Clinical study on Shenqi Jiangtang Granules combined with pioglitazone in treatment of type 2 diabetes mellitus

目的探讨参芪降糖颗粒联合吡格列酮治疗2型糖尿病的临床疗效。方法选取2017年3月—2018年3月在川北医学院附属医院治疗的2型糖尿病患者94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服盐酸吡格列酮片,起始剂量15 mg/次,1次/d,根据血糖变化调整剂量,最大剂量45 mg/次;治疗组在对照组基础上口服参芪降糖颗粒,3g/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血糖相关指标、肾功能指标、稳态模型评估-β细胞功能(HOMA-β)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)和血清学指标。结果治疗后,对照组和治疗组临床有效率分别为80.85%和95.74%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)和胰岛素水平(FINS)水平均显著降低(P<0.05),且治疗组FPG、2 h PG、HbAlc和FINS水平明显低于对照组(P<0.05)。治疗后,两组HOMA-β显著升高(P<0.05),HOMA-IR显著降低(P<0.05),且治疗组HOMA-β和HOMA-IR水平明显优于对照组(P<0.05)。治疗后,两组半胱氨酸的酸性分泌蛋白(SPARC)、γ-谷氨酰转肽酶(γ-GT)、转化生长因子-β1(TGF-β1)和单核细胞趋化蛋白-1(MCP-1)水平均显著降低(P<0.05),且治疗后治疗组这些指标比对照组降低的更明显(P<0.05)。结论参芪降糖颗粒联合盐酸吡格列酮片治疗2型糖尿病可有效控制患者血糖水平,降低机体炎症反应,改善胰岛素抵抗及提高胰岛素敏感性,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Shenqi Jiangtang Granules combined with pioglitazone in treatment of type 2 diabetes mellitus. Methods Patients(94 cases) with type 2 diabetes mellitus in Affiliated Hospital of North Sichuan Medical College from March 2017 to March 2018 were divided into control(47 cases) and treatment(47 cases) groups based on different treatments. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets, and the initial dose was 15 mg/time, and the dose was adjusted according to blood sugar change, the maximum dose was 45 mg/time, once daily. Patients in the treatment group were po administered with Shenqi Jiangtang Granules on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose related indexes, renal function indexes, HOMA-β, HOMA-IR, and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.85% and 95.74%, respectively, and there were differences between two groups(P < 0.05). After treatment, the FBG, 2 h PG, HbAlc, and FINS levels in two groups were significantly decreased(P < 0.05), and the FBG, 2 h PG, HbAlc and FINS levels in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the HOMA-β in two groups was significantly increased(P < 0.05), but HOMA-IR was significantly decreased(P < 0.05), and the HOMA-β and HOMA-IR in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the SPARC, γ-GT, TGF-β1, and MCP-1 levels in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Shenqi Jiangtang Granules combined with pioglitazone in treatment of type 2 diabetes mellitus can effectively control the blood glucose level, reduce inflammatory response, improve insulin resistance and increase the sensitivity of insulin, which has a certain clinical application value.