三黄清幽汤结合利拉鲁肽对2型糖尿病(脾虚胃热证)合并高脂血症患者脂代谢的影响

Effect of Sanhuang Qingyou Decoction(三黄清幽汤)Combined with Lialulutide on Lipid Metabolism in Type 2 Diabetes Mellitus(Syndrome of Spleen Deficiency and Stomach Heat)Complicated with Hyperlipidemia

目的观察三黄清幽汤结合利拉鲁肽对2型糖尿病(脾虚胃热证)合并高脂血症患者脂代谢的影响。方法以2017年8月—2019年11月该院收治的105例2型糖尿病合并高脂血症患者为研究对象,依据治疗方法的不同分为研究组(54例)和对照组(51例),两组均继续糖尿病教育,严格控制饮食和基础性锻炼。对照组口服盐酸二甲双胍,0.5 g/次,2次/d。皮下注射利拉鲁肽,1次/d,起始剂量0.6 mg/d,后根据血糖症状进行调整,最大剂量可达1.8 mg/d。研究组在对照组治疗的基础上,口服三黄清幽汤治疗。两组均规范治疗3个月。比较两组治疗疗效,脾虚胃热证相关中医证候积分,血糖指标,包括空腹血糖(FBG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c),血脂指标,包括总胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(FFA)、高密度脂蛋白胆固醇(HDL-C)水平。结果研究组治疗疗效高于对照组(P<0.05);两组治疗后中医证候积分较治疗前降低,研究组降低幅度优于对照组(P<0.05);两组治疗后血糖较治疗前下降,研究组降低幅度大于对照组(P<0.05);两组治疗后TC、TG和FFA水平较治疗前降低,研究组降低幅度大于对照组。HDL-C水平较治疗前升高,研究组升高幅度大于对照组(P<0.05)。结论三黄清幽汤结合利拉鲁肽治疗2型糖尿病合并高脂血症疗效确切,能有效改善患者的临床症状,调节血糖,能提高摄取胆固醇的能力,调控脂类代谢平衡,提高治疗疗效。

Objective To observe the effect of Sanhuang Qingyou Decoction(三黄清幽汤)combined with lialulutide on lipid metabolism in patients with type 2 diabetes(syndrome of spleen deficiency and stomach heat)complicated with hyperlipidemia.Methods A total of 105 patients with type 2 diabetes and hyperlipidemia admitted to our hospital from August 2017 to November 2019 were divided into study group(n=54)and control group(n=51)according to different treatment methods.Both groups con⁃tinued diabetes education and strictly controlled diet and basic exercise.The control group took metformin hydrochloride orally,0.5 g once and twice a day.The drug was injected subcutaneously,once a day,with an initial dose of 0.6 mg/d,and then adjusted according to the symptoms of blood glucose.The maximal dose was up to 1.8 mg/d.In the study group on the basis of treatment in the control group,oral Sanhuang Qingyou Decoction treatment was used.Both groups received standard treatment for 3 months.The therapeutic effects of the two groups were compared,including TCM syndrome scores related to spleen deficiency and stomach heat syndrome,blood glucose indexes FBG,2 h PG and HbA1c,blood lipid levels TC,TG,FFA and HDL-C.Results The thera⁃peutic effect of the study group was higher than that of the control group(P<0.05).The scores of TCM syndromes in the two groups were lower after treatment than those before,and the reduction in the study group was better than that in the control group(P<0.05).After treatment,blood glucose of the two groups was decreased compared with that before treatment,and the decrease amplitude of the study group was greater than that of the control group(P<0.05).The levels of TC,TG and FFA in the two groups were lower after treatment than those before treatment,and the reduction in the study group was greater than that in the control group.HDL-C level was higher in the study group than that in the control group(P<0.05).Conclusion Sanhuang Qingyou De⁃coction combined with lialulutide has a definite therapeutic effect on type 2 diabetes with hyperlipidemia,which can effectively im⁃prove the clinical symptoms of patients,regulate blood glucose,improve the ability of cholesterol intake,regulate lipid metabolism balance,and improve the therapeutic effect.