2型糖尿病病证结合诊疗方案多中心临床观察与研究

Clinical Study of Combined Disease and Syndrome on Treatment of Type 2 Diabetes

目的评价2型糖尿病病证结合诊疗方案的临床价值。方法根据文献调研和临床流行病学调查结果,将2型糖尿病分为阴虚热盛证、气阴两虚证、肝肾阴虚证、湿热内蕴证、阴阳两虚证,建立病证结合诊疗方案,同时在3家省级“三甲”医院进行临床观察与研究。结果在186例临床观察病例中,方案治疗组92例在FPG、PPG、GHbAlc 3项实验检测指标,以及临床症状积分改善方面,均明显优于单纯西药对照组72例。湖南中医药大学第一附属医院所设单纯中药组22例,对FPG、PPG 2项指标疗效不如方案治疗组,也不如单纯西药组,但对GHbAlc的指标疗效与临床症状积分的改善优于单纯西药组,与方案治疗组相似。结论病证结合诊疗方案治疗组对2型糖尿病的临床疗效肯定,不但优于单纯西药对照组,也优于单纯中药组。有一定的示范作用与推广价值。

Objective To assess the clinical value of project combining disease and syndrome for treatment of type 2 diabetes. Methods According to the literature study and the clinical epidemiological investigation, the type 2 diabetes was divided into 5 syndromes as： deficient yin and excessive heat, both qi and yin deficiency, yin deficiency in liver and kidney, internal accumulating damp-heat and both yin and yang deficient syndromes; the 186 patients were divided into integrated treating group （ITG）, 92 patients, and western medicine group （WMG）, 94; and the treatment scheme integrated identifying disease and syndrome was set up and observed clinically in 3 provincial hospitals. Results All the test indexes of FPG, PPG and GHbAls and the improving integral of clinical symptoms in 72 patienis of ITG were better than those in all the patients of WMG. About 22 patients with Chinese medicine only in the First Affiliated Hospital of TCM University of Hunan, the test indexes of both FPG and PPG were not good than those in ITG and WMG, but the index of GHhAls and the improving integral of clinical symptoms were better than that in WMG and similar to ITG. Condusion The project is effective for type 2 diabetes and has the demonstration effect to be used in the clinic.