清热益气化瘀法治疗2型糖尿病的实用性随机对照研究

Clinical observation of method of clearing heat,replenishing qi and removing blood stasis for type 2 diabetes:a randomized controlled trial

目的探讨在糖尿病治疗中采用中医清热益气化瘀法结合西医常规治疗的临床效果。方法选取2016年10月至2017年10月我院收治的患者120例,采用“加载”试验设计方法,区组随机法分为治疗组和对照组各60例,其中治疗组在西医常规治疗的基础上,加用清热益气化瘀中医治法类基本方,并随症加减用药,10 d为1个疗程,治疗3个疗程。分别于治疗30 d,60 d,90 d观察比较2组患者的临床疗效、空腹血糖及餐后2 h血糖和糖化血红蛋白控制情况。结果治疗组的总有效率98%,对照组78%,差异有统计学意义(P<0.05)。2组患者治疗后治疗组空腹血糖、餐后2 h血糖和糖化血红蛋白控制明显优于对照组(P<0.05);60 d和90 d随访,治疗组空腹血糖餐后2 h血糖控制明显优于对照组(P<0.05)。治疗组1例,对照组5例口服药物疗效不佳,采用注射胰岛素治疗。结论在糖尿病的治疗中,采用西医常规治疗结合中医清热益气化瘀法中药治疗,可以有效改善患者的临床症状,提高生活质量,减缓并发症的发生,更加有效稳定地控制患者的空腹血糖、餐后2 h血糖和糖化血红蛋白,值得临床推广应用。

Objective To explore the clinical effects of traditional Chinese medicine treatment of clearing heat,replenishing qi and removing blood stasis,combined with regular methods of western medicine in the treatment of diabetes.Method In this add-on trial,120 patients admitted to our hospital from October 2016 to October 2017 were randomly divided into treatment group and control group with 60 cases in each.The treatment group were treated with,based on regular methods of western medicine,basic prescriptions of the traditional Chinese medicine treatment of clearing heat,replenishing qi and removing blood stasis.The amount of medication prescribed was adjusted according to the symptoms.One course of treatment was 10 days.After three courses of treatment,the clinical curative effect,fasting blood glucose,postprandial 2 h blood glucose,and HbA1c were observed at 60 and 90 days after treatment.Results The total effective rate was 98%in the treatment group and 78%in the control group.The rate of the treatment group was significantly higher than that of the control group,(P<0.05).The fasting blood glucose,the postprandial blood glucose at 2 h and HbA1c in the treatment group were significantly improved better than those in the control group after treatment(P<0.05).At the 60 and 90 days follow-up,the fasting blood glucose and 2 h postprandial blood glucose in the treatment group were significantly better than those in the control group(P<0.05).One case in the treatment group and 5 cases in the control group were treated with insulin due to poor effects of oral medicine.Conclusion In the treatment of diabetes,the use of regular western medicine methods combined with the traditional Chinese medicine treatment of clearing heat,replenishing Qi and removing blood stasis can effectively improve the patient′s clinical symptoms,improve patient′s quality of life,slow down the occurrence of complications,and control more effectively and stably the patient′s fasting blood glucose,2 h postprandial blood glucose and HbA1c,and is worthy of extensive clinical application.