消渴清颗粒联合门冬胰岛素治疗2型糖尿病的临床研究

Clinical study on Xiaokeqing Granules combined with insulin aspart in treatment of type 2 diabetes mellitus

目的探讨消渴清颗粒联合门冬胰岛素30注射液治疗2型糖尿病的临床疗效。方法选取2018年1月-2019年9月天津市北辰医院收治的86例糖尿病患者作为实验对象,将全部患者按照随机数字表法分为对照组和治疗组,每组各43例。对照组皮下注射门冬胰岛素30注射液,初始剂量12 U,每周至少血糖监测3 d根据餐前血糖水平调整胰岛素剂量,每3~5天调整1次,调整剂量为-2~6U,直至血糖水平达标后保持,1次/d。治疗组在对照组治疗的基础上温水冲服消渴清颗粒,6 g/次,3次/d。两组患者连续治疗3个月。观察两组的临床疗效,比较两组的糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 h BG)、空腹胰岛素(INS)、胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平。结果治疗后,治疗组患者的总有效率95.35%比对照组(81.40%)高,差异有统计学意义(P<0.05)。治疗后,两组的HbA1c、FBG、2 hBG明显降低(P<0.05),且治疗组血糖相关指标降低的更明显(P<0.05)。治疗后,两组的INS、HOMA-β显著升高,HOMA-IR显著降低(P<0.05);治疗后治疗组的INS、HOMA-β比对照组高,HOMA-IR比对照组低(P<0.05)。治疗后,两组的ICAM-1、TNF-α、IL-6水平明显低于治疗前(P<0.05);治疗后治疗组的ICAM-1、TNF-α、IL-6水平比对照组低(P<0.05)。结论消渴清颗粒联合门冬胰岛素30注射液治疗2型糖尿病有较好的疗效,可降低血糖水平,改善胰岛β细胞功能,降低炎症因子的水平,具有一定的临床研究价值。

Objective To explore the effect of Xiaokeqing Granules combined with Insulin Aspart 30 Injection in treatment of type 2 diabetes mellitus. Methods Patients(86 cases) with type 2 diabetes mellitus in Tianjin Beichen Hospital from January 2018 to September 2019 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were sc administered with Insulin Aspart 30 Injection, starting dosage 12 U, the insulin dose was adjusted according to the level of blood glucose before meals at least 3 d weekly, adjust once every 3-5 days, adjust the dose to-2 - 6 U until the blood glucose level reached the standard, once daily. Patients in the treatment group were po administered with Xiaokeqing Granules on the basis of the control group, 6 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the levels of HbA1c, FBG, 2 hBG, INS, HOMA-β, HOMA-IR, ICAM-1, TNF-α, and IL-6 in two groups were compared. Results After treatment, the total effective rate in the treatment group was 95.35% higher than that in the control group(81.40%), and the difference was statistically significant(P < 0.05). After treatment, the levels of HbA1c, FBG and 2 hBG in the two groups were significantly decreased(P < 0.05), and the related indexes of blood glucose in the treatment group were significantly reduced(P < 0.05). After treatment, the INS and the HOMA-β in two groups were significantly increased, but the HOMA-IR in two groups were significantly decreased(P < 0.05). The INS and the HOMA-β in the treatment group were higher than those in the control group, and the HOMA-IR was lower than that in the control group(P < 0.05). After treatment, the levels of ICAM-1, TNF-α, and IL-6 in two groups were significantly decreased(P < 0.05). And the levels of ICAM-1, TNF-α, and IL-6 in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Xiaokeqing Granules combined with Insulin Aspart 30 Injection has clinical curative effect in treatment of type 2 diabetes mellitus, can reduce the level of blood glucose, improve the function of islet β cells, and reduce the level of inflammatory factors, which has a certain clinical research value.