健脾渗湿法联合利拉鲁肽治疗对2型糖尿病合并肥胖患者病情控制及血管内皮功能的影响

Therapeutic effects of Jianpi Shenshi method combined with liraglutide on disease control and vascular endothelial function in obese patients complicated with type 2 diabetes mellitus

目的探讨健脾渗湿法联合利拉鲁肽治疗2型糖尿病合并肥胖患者的临床疗效,并分析其对患者血管内皮功能的影响。方法回顾性分析96例2型糖尿病合并肥胖患者的临床资料,将接受利拉鲁肽治疗的48例患者纳入对照组,接受健脾渗湿中药制剂联合利拉鲁肽治疗的48例患者纳入研究组。比较两组患者治疗前和治疗2个月后的空腹血糖水平、糖化血红蛋白(HbA1c)水平、稳态模型胰岛素抵抗(HOMA-IR)指数、体质指数,以及血清内皮素、可溶性内皮糖蛋白(sEng)、一氧化氮和内皮型一氧化氮合酶(eNOS)水平。结果治疗后,两组患者的空腹血糖水平、HbA1c水平、HOMA-IR指数、体质指数、血清内皮素和sEng水平均低于治疗前,且研究组以上指标均低于对照组(均P<0.05)。治疗后,两组患者的血清一氧化氮和eNOS水平均高于治疗前,且研究组以上指标均高于对照组(均P<0.05)。结论健脾渗湿法联合利拉鲁肽可有效控制2型糖尿病合并肥胖患者的体重和血糖水平,并具有保护血管内皮功能的作用,且效果优于单纯应用利拉鲁肽。

Objective To explore the clinical efficacy of Jianpi Shenshi method combined with liraglutide for the treatment of obese patients complicated with type 2 diabetes mellitus,and to analyze its effect on vascular endothelial function of the patients.Methods The clinical data of 96 obese patients complicated with type 2 diabetes mellitus were retrospectively analyzed.Forty-eight patients receiving liraglutide therapy were enrolled in the control group,whereas 48 patients receiving Jianpi Shenshi preparation of Chinese medicine combined with liraglutide therapy were enrolled in the study group.The pre-and two-month post-treatment levels of fasting blood glucose and glycosylated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR)index,body mass index,as well as serum levels of endothelin,soluble endoglin(sEng),nitric oxide,and endothelial nitric oxide synthase(eNOS)were compared between the two groups.Results The levels of fasting blood glucose and HbA1c,HOMA-IR index,body mass index,and serum levels of endothelin and sEng of patients in the two groups were lower after treatment than before treatment,and the aforesaid indicators were lower in the study group than in the control group(all P<0.05).Serum levels of nitric oxide and eNOS of patients in the two groups were higher after treatment than before treatment,and the study group expressed higher levels mentioned above as compared with the control group(all P<0.05).Conclusion Jianpi Shenshi method combined with liraglutide can effectively control the weight and blood glucose level of obese patients complicated with type 2 diabetes mellitus,exerting a beneficial effect of protecting vascular endothelial function,which has superior effects to liraglutide alone.