格列齐特和二甲双胍联合养血祛风汤治疗血热风型2型糖尿病并发皮肤瘙痒症的临床研究及对预后的影响

Clinical study of gliclazide and metformin combined with Yangxue Qufeng decoction in treatment of blood heat wind type 2 diabetes mellitus complicated with skin pruritus and its effect on prognosis

目的探讨格列齐特、二甲双胍联合养血祛风汤治疗血热生风型2型糖尿病(T2DM)并发皮肤瘙痒症患者的临床价值。方法回顾性分析2019年1月至2020年1月景德镇市皮肤病医院和景德镇市第一人民医院收治的80例血热生风型T2DM并发皮肤瘙痒症患者的临床资料,根据治疗方法不同分为两组,每组40例。对照组接受格列齐特和二甲双胍治疗,研究组在对照组基础上联合养血祛风汤治疗,比较两组治疗前后糖化血红蛋白(HbA_(1)c)、服糖后1 h血糖(1 h PG)、空腹血糖(FBG)、12项瘙痒症严重程度量表(12-PSS)评分及不良反应发生情况。结果治疗前,两组HbA_(1)c、FBG、1 h PG水平比较差异无统计学意义;治疗后,研究组FBG水平低于对照组,差异有统计学意义(P<0.05),两组HbA_(1)c、1 h PG水平比较差异无统计学意义。治疗前,两组瘙痒程度、瘙痒症状、对情绪的影响评分比较差异无统计学意义;治疗后,研究组瘙痒程度、瘙痒症状、对情绪的影响评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论格列齐特、二甲双胍联合养血祛风汤治疗T2DM并发皮肤瘙痒症疗效显著,可有效改善患者瘙痒症状及程度,降低血糖及HbA_(1)c水平,值得临床推广应用。

Objective To explore the clinical value of gliclazide and metformin combined with Yangxue Qufeng decoction in the treatment of blood heat wind type 2 diabetes mellitus(T2DM)complicated with skin pruritus.Methods The clinical data of 80 patients with blood heat wind type T2DM complicated with skin pruritus treated in Jingdezhen Dermatology Hospital and Jingdezhen First People's Hospital from January 2019 to January 2020 were analyzed retrospectively,and they were divided into two groups according to different treatment methods,with 40 cases in each group.The control group was treated with gliclazide and metformin,and the study group was treated with Yangxue Qufeng decoction on the basis of the control group.The glycosylated hemoglobin(HbA_(1)c),1 h blood glucose(1 h PG),fasting blood glucose(FBG),12 item pruritus severity scale(12-PSS)scores before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results Before treatment,there was no significant difference in HbA_(1)c,FBG and 1 h PG between the two groups;after treatment,FBG level in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05),there was no significant difference in HbA_(1)c and 1 h PG between the two groups.Before treatment,there was no significant difference between the two groups in degree of itching,itching symptoms,and emotional impact score;after treatment,the scores of pruritus degree,pruritus symptoms and influence on emotion in the study group were lower than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Gliclazide and metformin combined with Yangxue Qufeng decoction is effective in the treatment of T2DM with skin pruritus,can effectively improve the frequency and degree of pruritus,reduce the level of blood glucose and glycosylated hemoglobin,and which is worthy of clinical application.