从脾经论治2型糖尿病合并高尿酸血症临床疗效观察

Clinical Curative Observation of Differentiating and Treatment of Type 2 Diabetes Combined with Hyperuricemia from Spleen Meridian

目的:观察从脾经论治2型糖尿病合并高尿酸血症(脾虚痰湿内阻证)的临床疗效。方法:选取我院2020年2月至2021年1月60例2型糖尿病合并高尿酸血症患者,随机分成两组即治疗组30例、对照组30例。2组均在生活方式干预下低嘌呤、糖尿病饮食,常规降糖治疗;治疗组生活方式干预基础上给予口服中药汤剂(健脾化湿方)联合针灸治疗,对照组在生活方式干预基础上给予口服非布司他,共治疗4周。检测并观察两组治疗前后临床疗效、空腹血糖(FBG)、早餐后2h血糖、胰岛素抵抗指数(HOMA-IR)、血尿酸(UA)、血尿素氮(BUN)、血清肌酐(Cr)、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)等指标变化。结果:治疗后,治疗组总有效率优于对照组(P<0.05);治疗后,治疗组FPG、早餐后2hPG、HOMA-IR水平均低于对照组(P<0.05);治疗组TC、TG和LDL-C水平均低于对照组(P<0.05);治疗后,治疗组与对照组血尿酸水平均明显下降,两组降尿酸水平比较差异不显著,无统计学意义(P>0.05)。结论:从脾经论治2型糖尿病合并高尿酸血症(脾虚痰湿内阻证),针药结合可有效调节患者糖脂代谢,降低UA,减轻胰岛素抵抗,是一种有效的治疗方法,值得临床推广应用。

Objective:To observe the clinical effect of treating type 2 diabetes mellitus with hyperuricemia(syndrome of spleen deficiency and phlegm dampness internal obstruction)through spleen meridian.Methods:60 patients with type 2 diabetes mellitus complicated with hyperuricemia in our hospital from February 2020 to January 2021 were randomly divided into two groups,namely treatment group(n=30)and controlled group(n=30).Both groups received lifestyle intervention with hypopurine and diabetic diet and routine hypoglycemic treatment.The treatment group was given oral Chinese medicine decoction(Jianpi Huashi Prescription)combined with acupuncture treatment,and the controlled group was given oral febuxostat for 4 weeks.Clinical efficacy,fasting blood glucose(FBG),blood glucose 2 h after breakfast,insulin resistance index(HOMA-IR),blood uric acid(UA),BUN,Cr,serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and other indexes of the two groups were detected and observed before and after treatment.Results:After treatment,the total effective rate of the treatment group was better than that of the controlled group(P<0.05).After treatment,the levels of FPG,2 hPG and HOMA-IR in the treatment group were lower than those in the controlled group(P<0.05).The levels of TC,TG and LDL-C in the treatment group were lower than those in the controlled group(P<0.05).After treatment,the serum uric acid level of the treatment group and the controlled group decreased significantly,and there was no significant difference in the uric acid lowering level between the two groups(P>0.05).Conclusion:Treating type 2 diabetes mellitus with hyperuricemia(spleen deficiency and internal obstruction of phlegm and dampness)from the spleen meridian,acupuncture combined with medicine can effectively regulate glucose and lipid metabolism,reduce UA and reduce insulin resistance.It is an effective treatment method worthy of clinical promotion and application.