中西医结合治疗糖尿病酮症酸中毒急症的临床疗效分析

Clinical Efficacy Analysis of Combined Chinese and Western Medicine in the Treatment of Acute Diabetic Ketoacidosis

目的 分析中西医结合治疗糖尿病酮症酸中毒急症的临床疗效。方法 选取2019年1月—2020年1月泉州市急救指挥中心急救科收治的50例糖尿病酮症酸中毒急症患者,按照治疗方法将其分为参照组(n=25)和研究组(n=25),参照组给予补液、胰岛素等基础治疗,研究组在此基础上联合中药养阴清热活血方治疗。分析两组病情控制时间(血糖复常时间、酸中毒改善时间等)、主要证候积分(口干、恶心呕吐等)、临床有效率及不良反应。结果 研究组血糖复常时间、尿酮体消失时间、酸中毒改善时间均短于参照组,差异有统计学意义(P<0.05)。研究组口干、恶心呕吐、胸闷气促、舌紫黯、脉细弱评分均低于参照组,差异有统计学意义(P<0.05)。研究组临床总有效率(92.00%)高于对照组(64.00%),差异有统计学意义(P<0.05)。用药1周期间,两组不良反应发生率差异无统计学意义(P>0.05),采取对症处理后均得以缓解,不影响临床效果。结论养阴清热活血方联合常规西药治疗糖尿病酮症酸中毒,有利于控制病情,降低主要证候积分,临床应用价值高。

Objective To analyze the clinical efficacy of combining Chinese and Western medicine in the treatment of diabetic ketoacidosis emergencies.Methods 50 cases of emergency diabetic ketoacidosis patients admitted to the Emergency Department of Quanzhou Emergency Command Center from January 2019 to January 2020 were selected.They were divided into the reference group(n=25) and the study group(n=25) according to the treatment methods. The reference group was given basic treatment such as rehydration and insulin, and the study group was treated with Yangyin Qingre Huoxue Recipe on this basis.. The time to control the disease(time to normalization of blood glucose, time to improvement of acidosis, etc.), the main symptoms(dry mouth, nausea and vomiting, etc.), and the clinical efficiency and adverse effects were analyzed in the two groups.Results The time to normalization of blood glucose, time to disappearance of urinary ketone bodies and time to improvement of acidosis in the study group were shorter than in the reference group, the difference was statistically significant(P<0.05). The scores of dry mouth, nausea and vomiting, chest tightness and shortness of breath, purple and dull tongue, and weak pulse in the study group were all lower than those in the reference group, the difference was statistically significant(P<0.05). The total clinical effective rate(92.00%) in the study group was higher than(64.00%) in the control group, the difference was statistically significant(P<0.05). During one week of medication, there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05), which were alleviated after symptomatic treatment, and did not affect the clinical effect. Conclusion The combination of Yangyin Qingre Huoxue Recipe and conventional western medicine in the treatment of diabetic ketoacidosis is beneficial to control the disease and reduce the main evidence points, and has high clinical application value.