黄芪汤加减联合埋针疗法治疗糖耐量减低临床观察

Clinical observation of modified Huangqi decoction combined with needle-embedding therapy on impaired glucose tolerance

目的观察黄芪汤加减联合埋针疗法治疗糖耐量减低(IGT)的临床疗效。方法将300例IGT患者随机分为2组,对照组150例予西医常规治疗,治疗组150例在对照组治疗基础上不加盐酸二甲双胍肠溶片,予黄芪汤加减联合埋针疗法治疗。2组均治疗1年,观察2组治疗前后血糖指标、体质量指数(BMI)、腰围、中医证候积分、血脂指标、肝肾功能指标变化,比较2组疗效。结果治疗组治疗后口服75 g葡萄糖后2 h血浆血糖(2 h PG)、糖化血红蛋白(Hb A1c)均较本组治疗前降低(P<0.05),对照组治疗后2 h PG较本组治疗前降低(P<0.05);治疗组治疗后2 h PG、Hb A1c均低于对照组治疗后(P<0.05)。2组治疗后BMI、腰围均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组治疗后中医证候积分较本组治疗前、对照组治疗后均降低(P<0.05)。2组治疗后血清总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)均较本组治疗前降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)较本组治疗前升高(P<0.05)。治疗组治疗后TC、TG及LDL-C均低于对照组治疗后(P<0.05),HDL-C高于对照组治疗后(P<0.05)。2组治疗前后血肌酐(Cr)、血尿素氮(BUN)、血尿酸(UA)及丙氨酸氨基转移酶(ALT)比较差异均无统计学意义(P>0.05),2组治疗后Cr、BUN、UA及ALT比较差异均无统计学意义(P>0.05)。治疗组总有效率98.7%,对照组92.0%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。治疗组2型糖尿病(DM)发病率1.3%,对照组8.0%,治疗组2型DM发病率低于对照组(P<0.05)。结论黄芪汤加减联合埋针疗法治疗IGT,疗效优于西医常规治疗,未见肝肾功能损害,2型DM发病率较对照组明显下降。

Objective To observe the clinical effects of modified Huangqi decoction combined with needle-embedding therapy on impaired glucose tolerance（IGT）. Methods 300 IGT subjects were randomly divided into two groups. 150 subjects in control group were treated by western routine treatment,and 150 subjects in treatment group were treated by modified Huangqi decoction combined with needle-embedding therapy on the basis of control group treatment except the metformin hydrochloride enteric-coated tablets,continuously treatment for 1 year. The indexes related to plasma glucose,body mass index（BMI）,waistline,traditional Chinese medicine（TCM） syndrome score,blood lipid and hepatorenal function before and after treatment were observed in two groups,and the curative effect was compared. Results The 2 h plasma glucose（2 h PG） and Hb A1 c after 75 g oral glucose tolerance test in treatment group after treatment were decreased as compared with before treatment（P〈0. 05）,the 2 h PG after treatment in control group was decreased（P〈0. 05）. The 2 h PG and Hb A1 c after treatment in treatment group were lower than those in control group at the same period（P〈0. 05）. The BMI and waistline after treatment were decreased in two groups（P〈0. 05）,and the decrease in treatment group was more obvious（P〈0. 05）. The TCMsyndrome score after treatment in treatment group was decreased as compared with that in before treatment and the same period in control group（P〈0. 05）. The total cholesterol（TC）,triglyceride（TG） and low-density lipoprotein cholesterin（LDL-C） after treatment were decreased in twogroups（P〈0. 05）,and the high-density lipoprotein cholesterin（HDL-C） was increased（P〈0. 05）. The TC,TG and LDL-C after treatment in treatment group were lower than those in control group at the same period（P〈0. 05）,and the HDL-C was higher（P〈0. 05）. There were no statistical differences on Cr,BUN,UA and alanine aminotransferase（ALT） between before and after treatment in two groups（P〈0. 05）,and there were also no statistical differences after treatment between two groups（P〈0. 05）. The total effective rate in treatment group（98. 7%）was superior to that in control group（92. 0%,P〈0. 05）. The morbidity of type 2 diabetes mellitus（DM） in treatment group（1. 3%） was lower than that in control group（8. 0%）. Conclusion Modified Huangqi decoction combined with needle-embedding therapy have better effects on IGT than western routine treatment,without function lesion of liver and kidney,and the morbidity of type 2 DM is significantly decreased in treatment group as compared with control group.