自拟降糖饮联合注射胰岛素治疗儿童1型糖尿病的临床研究

Jiangtang decoction in combination with insulin in the treatmnet of type 1 diabetes memtus in children

目的：探讨自拟降糖饮配合注射胰岛素治疗儿童1型糖尿病（type 1 diabetes mellitus, T1DM）的临床疗效。方法收集2010年1月－2014年1月河北友爱医院内四科门诊T1DM患者43例，按随机数字表法分为2组，对照组23例注射胰岛素治疗，治疗组20例在对照组治疗基础上加服自拟降糖饮。2组均治疗2个月后观察患者体质量指数（BMI）、餐后2 h血糖、糖化血红蛋白（HbAlc）。结果治疗组FPG、餐后2 h血糖、HbAlc均较同组治疗前降低（t值分别为3.376、54.493、2.798，P＜0.01）；对照组餐后2 h血糖较治疗前降低（t＝29.714，P＝0.000）。治疗组FPG、餐后2 h血糖、HbAlc下降程度均低于对照组（t值分别为2.715、2.191、5.627，P＜0.05或P＜0.01）。治疗后，治疗组HbAlc控制良好率为60.0%（12/20），优于对照组的26.1%（6/23），2组比较差异有统计学意义（χ2＝5.055，P＝0.025）。结论自拟降糖饮联合注射胰岛素可有效降低儿童T1DM患者FPG、餐后2 h血糖、HbAlc水平，其疗效优于单用胰岛素注射。

Objective To investigate the efficacy of the combination ofJiangtang decoction and insulin in the treatment of type 1 diabetes mellitus in children.Methods A total of 43 children with type 1 diabetes mellitus were enrolled and randomly allocated to either a insulin group （control group） and a insulin plusJiangtang decoction group （treatment group） using the table of random digits, with 23 patients in the control group and 20 in the treatment group. The patients in the control group were treated with insulin, and those in the treatment group were administrated withJiangtangdecoction on the basis of the treatment in the control group for 2 months. Body mass index （BMI）, fasting plasma glucose （FPG）, postprandial blood glucose （PBG） and hemoglobin A1c （HbA1c） were measured.Results The levels of FPG, PBG and HbA1c were significantly decreased in the treatment group （twere 3.376, 54.493, and 2.798, respectively; allP〈0.01）, and the PBG level was significantly decreased in the control group （t=29.714,P=0.000）. The levels of FPG, PBG and HbA1c in the treatment group were significantly lower than those in the control group （twere 2.715, 2.191 and 5.627, respectively;P〈0.05 orP〈0.01）. There was no difference in BMI between the treatment group and the control group （t=0.159,P=0.874）. The proportion of patients with HbA1c 〈7.5% in the treatment group （60.0%, 12/20） was higher than that in the control group （26.1%, 6/23;χ2=5.055,P=0.025）.Conclusion Combination ofJiangtang decoction and insulin can decrease the level of FPG, PBG and HbAlc, and its therapeutic effect is superior to insulin alone for type 1 diabetes in children.