六味地黄丸联合伏格列波糖治疗2型糖尿病的临床研究

Clinical study on Liuwei Dihuang Pills combined with voglibose in treatment of type 2 diabetes

目的探讨六味地黄丸联合伏格列波糖片治疗2型糖尿病的临床疗效。方法选取2016年10月—2017年11月吉林大学校医院内分泌科收治的92例2型糖尿病患者作为研究对象,根据随机区组设计法将患者分为对照组和治疗组,每组各46例。对照组餐前口服伏格列波糖片,0.2 mg/次,3次/d。治疗组在对照组治疗的基础上口服六味地黄丸,8丸/次,3次/d。以4周为1个疗程,所有患者均进行3个疗程治疗。观察两组患者临床疗效,比较治疗前后两组的血糖水平、体质量指数(BMI)、血清指标、内皮功能和不良反应发生情况。结果治疗后,治疗组的总有效率为93.5%,显著高于对照组的73.9%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、BMI水平均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组FPG、2 h PG、HbA1c均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、胰岛素抵抗指数(HOMA-IR)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组血清指标均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组一氧化氮(NO)、超氧化物歧化酶(SOD)水平均显著升高,内皮素-1(ET-1)水平显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组内皮功能显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗期间,治疗组不良反应发生率为19.6%,显著低于对照组的8.7%,两组比较差异具有统计学意义(P<0.05)。结论六味地黄丸联合伏格列波糖片治疗2型糖尿病疗效显著,可有效控制血糖水平,降低体质量,改善胰岛功能,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Liuwei Dihuang Pills combined with Voglibose Tablets in treatment of type 2 diabetes. Methods Patients（92 cases） with type 2 diabetes in Jilin University Hospital from October 2016 to November 2017 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were po administered with Voglibose Tablets before meals, 0.2 mg/time, three times daily. Patients in the treatment group were po administered with Liuwei Dihuang Pills on the basis of the control group, 8 pills/time, three times daily. Four weeks was a treatment course, and patients in two groups were treated for 3 courses. After treatment, the clinical efficacy was evaluated, and the blood glucose level, BMI, serum indexes, endothelial function, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the treatment group was 93.5%, which was significantly higher than 73.9% in the control group, and there were differences between two groups（P〈0.05）. After treatment, the levers of FPG, 2hPG, HbA1c, and BMI in two groups were significantly decreased, and there were differences in the same group（P〈0.05）. After treatment, FPG, 2hPG, and HbA1 c in the treatment group were lower than those in the control group, and there were differences between two groups（P〈0.05）. After treatment, the levers of IL-6, TNF-α and HOMA-IR in two groups were significantly decreased, and there were differences in the same group（P〈0.05）. After treatment, serum indexes in the treatment group were lower than those in the control group, and there were differences between two groups（P〈0.05）. After treatment, No and SOD levels in two groups were significantly increased, but ET-1 levels were obviously decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, endothelial function was better than that in the control group, with significant difference between two groups（P〈0.05）. During the treatment, the adverse reaction rate in the treatment group was 19.6%, which was significantly lower than 8.7% in the control group, with significant difference between two groups（P〈0.05）. Conclusion Liuwei Dihuang Pills combined with Voglibose Tablets has significant clinical efficacy in treatment of type 2 diabetes, can effectively control blood glucose level, reduce the weight of patients, and improve islet function, which has a certain clinical application value.