健脾增敏汤治疗磺脲类药继发性失效2型糖尿病40例临床观察

Therapeutic Effect of Jianpi Zengmin Decoction on Type 2 Diabetes Mellitus with Secondary Sulfonylurea Failure

目的:观察健脾增敏汤治疗磺脲类降糖药继发性失效2型糖尿病的临床疗效。方法:将80例患者随机分为2组.各40例。在原常规治疗方案的基础上治疗组加用健脾增敏汤治疗,对照组加用中效优泌林治疗。观察疗程结束后临床疗效、空腹血糖(FBG)、餐后2小时血糖(P2hBG)、糖化血红蛋白(GHbAlc)、空腹血浆胰岛素水平(FINS)变化,同时计算稳态模型胰岛素抵抗指数(HOMA-IR)变化。结果:治疗组血糖达到控制理想11例。控制良好22例,控制差7例,控制总有效为33例(82.5%);对照组血糖达到控制理想17例,控制良好19例,控制差4例,控制总有效为36例(90.0%)。2组控制理想率及控制总有效率比较,差异均无显著性意义(P>0.05)。2组治疗后FBG、P2hBG、GHbAlc均明显降低,与治疗前比较,差异均有显著性意义(P<0.05),但治疗后2组比较,差异无显著性意义(P>0.05);治疗后治疗组FINS明显升高(P<0.01),对照组未见明显改变(P>0.05)。2组比较,差异有显著性意义(P<0.05)。治疗组治疗后HOMA-IR明显降低,与治疗前比较,差异有显著性意义(P<0.05),治疗后2组比较,差异有显著性意义(P<0.05)。结论:健脾增敏汤治疗磺脲类降糖药继发性失效2型糖尿痛,在降血糖、改善胰岛素抵抗等方面具有明显疗效,在一定程度上可替代胰岛素的应用。

Objective:To observe the therapeutic effect of Jianpi Zengmin Decoction (JZD) on type 2 diabetes mellitus (T2DM) with secondary sulfonylurea failure (SSF).Methods:The T2DM-SSF patients were randomized into 2 groups:the treatment group received JZD based on the preliminary regimen,and the control group received median-effect human monocomponent insulin based on the preliminary regimen.After treatment,the therapeutic effect was evaluated,and the changes of fasting blood glucose (FBG),blood glucose 2 hours after meal (2hBG),glycosylated hemoglobin (HbAlc),fasting plasma insulin (FINS),and homeostatic insulin resistance index (HOMA-IR) were observed.Results:In the treatment group,effect on controlling T2DM was excellent in 11(27.5%),good in 22(55.0%),and bed in 7(17.5%),and the total effective rate was 82.5%;in the control group,effect on controlling T2DM was excellent in 17(42.5%), good in 19(47.5%),and bad in 4(10.0%),and the total effective rate was 90.0% (36),the difference being insignificant between the two groups (P>0.05).After treatment,FBG,2hBG and HbAlc were decreased in the two groups (P<0.05 compared with those before treatment), but the difference was insignificant between the two groups (P>0.05).FINS was increased in the treatment group (P<0.01 compared with that before treatment and P<0.05 compared with that in the control group).HOMA-IR was decreased in the treatment group (P<0.05 compared with that before treatment and in the control group).Conclusion:JZD exerts a certain effect on de- creasing blood glucose and improving insulin resistanre,and can be used for the replacement of in- sulin to some extent.