养阴通脉汤联合赖脯胰岛素对2型糖尿病患者血清炎性因子及氧化应激指标的影响

Effect of Yangyin Tongmai Decoction Combined with Insulin Lispro on Serum Inflammatory Factors and Oxidative Stress Indicators of Type 2 Diabetes Patients

目的:探讨养阴通脉汤联合赖脯胰岛素对2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清炎性因子及氧化应激指标的影响。方法:选取120例T2DM患者,随机分为对照组和联合组,每组各60例。对照组单纯采用赖脯胰岛素治疗。在此基础上,联合组加用养阴通脉汤治疗。比较两组临床疗效及低血糖发生率,评估两组用药安全性,治疗前后中医症状积分、血糖指标、血清炎性因子[白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)]及氧化应激指标[超氧化物歧化酶(superoxide dismutase,SOD)、总活性氧(total reactive oxygen species,ROS)、丙二醛(malondialdehyde,MDA)]的变化。结果:联合组有效率(95.00%)与对照组(70.00%)比较显著升高(P<0.05);治疗后联合组乏力倦怠、口渴喜饮、多食易饥及五心烦热的积分与对照组比较均显著降低(P<0.05);治疗后联合组空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)与对照组比较显著降低(P<0.05);治疗后联合组血清IL-1β、IL-6、CRP、MDA、ROS水平与对照组比较显著降低(P<0.05),血清SOD水平与对照组比较显著升高(P<0.05);治疗期间两组患者未出现明显药物不良反应,联合组和对照组低血糖的发生率分别为8.33%(5/60)和21.67%(13/60),两组比较差异有统计学意义(P<0.05)。治疗期间两组均未出现电解质紊乱、药物过敏、血细胞减少、心律失常等严重不良反应,且未出现糖尿病并发症如高渗状态、酮症酸中毒等。结论:养阴通脉汤联合赖脯胰岛素治疗T2DM的效果显著,能明显改善临床症状,控制血糖,可能与调节炎性因子水平及氧化应激指标有关,且安全可靠。

Objective:To investigate the effect of Yangyin Tongmai Decoction combined with insulin lispro on serum inflammatory factors and oxidative stress indicators in patients with type 2 diabetes mellitus(T2DM).Methods:120 T2DM patients were selected and randomly divided into control group and combination group,with 60 cases in each group.The control group was treated with insulin lispro alone,and the combined group was additionally treated with Yangyin Tongmai Decoction.The clinical curative effect and incidence of hypoglycemia were compared between the two groups,and the drug safety of the two groups was evaluated.And TCM symptom scores,blood sugar indexes,serum inflammatory factors [Interleukin-1β(IL-1β),Interleukin-6(IL-6),C-reactive protein(CRP),malondialdehyde(MDA)] and oxidative stress indicators [Superoxide dismutase(SOD),total reactive oxygen species ROS) were compared.Results:The effective rate of the treatment group(95.00%) was significantly higher than that of the control group(70.00%)(P<0.05).After treatment,the scores of fatigue and tiredness,thirst for drink,excessive hunger for food,and burning sensation of five centers scores in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),and fasting insulin(FINS) in the treatment group were significantly lower than those in the control group(P<0.05).And after treatment,the serum levels of IL-1β,IL-6,CRP,MDA,and ROS in the treatment group were significantly lower than those in the control group,and the serum SOD level was significantly higher than that in the control group(P<0.05).During the treatment,no obvious adverse drug reactions occurred in the two groups of patients.The incidences of hypoglycemia in the treatment group and the control group were 8.33%(5/60) and 21.67%(13/60),respectively,and the difference between the two groups was statistically significant(P<0.05).During the treatment period,there were no serious adverse reactions such as electrolyte disorder,drug allergy,cytopenia,arrhythmia,etc.in both group,and there were no complications of diabetes such as hyperosmolar state,ketoacidosis,etc.Conclusion:Yangyin Tongmai Decoction combined with insulin lispro has a significant effect in the treatment of T2DM.It can significantly improve clinical symptoms,control blood sugar,which may be related to the regulation of inflammatory factor levels and oxidative stress indicators,and is safe and reliable.