摘要
目的研究达格列净片联合肝脾肾同治法辨证治疗2型糖尿病(T2DM)的临床疗效。方法选择2017年10月至2018年10月收治的78例T2DM患者为研究对象,依据治疗措施的不同将其随机分为对照组与治疗组,对照组39例服用达格列净片治疗,治疗组39例服用达格列净片联合降糖消渴方治疗,比较治疗前与治疗12周后两组患者临床疗效、中医证候积分、糖化血红蛋白(GHb)、空腹血糖(FBG)、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)、餐后2h血糖(2h PBG)、总胆固醇(TC)、胰高血糖素样肽-1(GLP-1)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)。结果治疗后治疗组总有效率高于对照组(P<0.05),差异有统计学意义。治疗后两组中医证候积分较治疗前明显降低(P<0.05),差异有统计学意义;且治疗组中医证候积分较对照组明显降低(P<0.05),差异有统计学意义。治疗后两组FBG、2h PBG、GHb较治疗前明显降低(P<0.05),差异有统计学意义;且治疗组FBG、2h PBG、GHb明显低于对照组(P<0.05),差异有统计学意义。治疗后两组GLP-1、FIns较治疗前明显升高(P<0.05),HOMA-IR较治疗前明显降低(P<0.05),差异有统计学意义;且治疗组GLP-1、FIns明显高于对照组(P<0.05),HOMA-IR明显低于对照组(P<0.05),差异有统计学意义。治疗后两组HDL-C较治疗前明显升高(P<0.05),TC、LDL-C、TG较治疗前明显降低(P<0.05),差异有统计学意义;且治疗组HDL-C明显高于对照组(P<0.05),TC、LDL-C、TG明显低于对照组(P<0.05),差异有统计学意义。结论达格列净片联合肝脾肾同治法辨证治疗2型糖尿病的临床疗效较好,可有效降低血糖,减轻胰岛素抵抗,改善脂代谢情况,且服用安全,值得推广。
Objective To explore the clinical effect on type 2 diabetes mellitus(T 2DM)treated with dapagliflozin tablets and the simultaneous treatment for liver,spleen and kidney.Methods A total of 78 patients of T2DM were collected as the subjects from October 2017 to October 2018.According to the different treatment measures,they were randomized into a control group and a treatment group.In the control group,39 cases were treatment with the oral administration of dapagliflozin tablets.In the treatment group,39 cases were treatment with combined medication,dapagliflozin tablets and jiangtang xiaoke formula.Before and in 12 weeks of treatment,the clinical effect,TCM symptom score,GHb,FBG,FLNS,HOMA-IR,2 h PBG,TC,GLP-1,LDL-C,TG and HDL-C were compared in the two groups.Results After treatment,the total effective rate was 97.44%in the treatment group,significantly higher than 79.49%in the control group,indicating the statistical difference(P<0.05).After treatment,TCM symptom score was reduced obviously in either of the groups,indicating the significant difference(P<0.05).After treatment,FBG,2 h PBG and GHb were all reduced obviously as compared with the values before treatment in the two groups,indicating the significant difference(P<0.05).These values in the treatment group were lower obviously than the control group,indicating the significant difference(P<0.05).After treatment,GLP-1 and FLINS were all increased obviously and HOMA-IR was reduced in the two groups as compared with the values before treatment,indicating the significant difference(P<0.05).GLP-1 and FLNS in the treatment group were higher obviously than the control group and HOMA-IR was lower than the control group,indicating the significant difference(P<0.05).After treatment,HDL-1 was increased,TC,LDL-C and TG were reduced obviously as compared with those before treatment in the two groups,indicating the significant difference(P<0.05).HDL-1 in the treatment group was higher than the control group and TC,LDL-C and TG were lower obviously than the control group,indicating the significant difference(P<0.05).Conclusion The combined treatment with dapagliflozin tablets and the simultaneous treatment for liver,spleen and kidney achieves the satisfactory clinical effect on T 2DM.Such combined medication effectively reduces blood glucose and insulin resistance and improves lipid metabolism.It is safe in oral administration,and thus,it deserves to be promoted.
作者
沈珂珂
李华
吉金荣
宋瑞捧
SHEN Ke-ke;LI Hua;JI Jin-rong;SONG Rui-peng(Henan Provincial Third People′s Hospital,Zhengzhou He′nan 450006;First Affiliated Hospital of Zhengzhou University,Zhengzhou He′nan 450052)
出处
《世界中西医结合杂志》
2019年第10期1456-1459,1463,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河南省重大公益性科研项目(H.ZB[2010]91号)
河南省基础与前沿技术研究计划(112300410041)
关键词
达格列净片
肝脾肾同治法
降糖消渴方
2型糖尿病
Dapagliflozin Tablets
Simultaneous Treatment for Liver
Spleen and Kidney
Jiangtang Xiaoke Formula
Type 2 Diabetes Mellitus