芪灵方改善气阴两虚型2型糖尿病胰岛素抵抗临床研究

Clinical Study of Qiling Prescription to Improve Insulin Resistance in Type 2 Diabetes with Deficiency of both Qi and Yin

目的探讨芪灵方治疗气阴两虚型2型糖尿病(type 2 diabetes mellitus,T2DM)患者的临床疗效。方法选取2018年2月—2019年3月上海中医药大学附属岳阳中西医结合医院收治的气阴两虚型T2DM患者68例,按照随机数字表法分为芪灵组和对照组,每组34例。在维持原有西医降糖方案的基础上,芪灵组患者予芪灵方治疗,对照组患者予以安慰剂。治疗12周后,比较2组患者治疗前后空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hours postprandial plasma glucose,2 hPG)、空腹胰岛素(fasting insulin,FINS)、餐后2 h胰岛素(2 hours postprandial insulin,2 hFINS)、空腹C肽(fasting C-peptide,C-P)、餐后2 hC肽(C-peptide 2 hours after meal,2 hC-P)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、对数化的稳态模型评估胰岛素抵抗指数(homeostasis model assessment of insulin resistant index,HOMA-IR)水平变化,比较2组患者临床疗效。结果治疗后,芪灵组患者FPG、2 hPG、FINS、C-P、TG、TC、LDL-C、对数化的HOMA-IR水平显著低于对照组(P<0.05),HDL-C水平显著高于对照组(P<0.05)。治疗后,芪灵组临床治疗总有效率为84.85%,显著高于对照组的45.45%(P<0.05)。结论气阴两虚型T2DM患者在维持原有西医降糖方案的基础上联合芪灵方治疗可有效缓解患者临床症状,改善糖脂代谢紊乱,减轻胰岛素抵抗程度,提高临床疗效。

Objective To explore the clinical efficacy of Qiling prescription in the treatment of type 2 diabetes mellitus(T2DM)patients with deficiency of both qi and yin.Methods A total of 68 patients with T2DM of qi-yin deficiency type admitted to Yueyang integrated traditional Chinese and Western medicine hospital affiliated to Shanghai university of traditional Chinese medicine from February 2018 to March 2019 were randomly divided into Qiling group and control group,with 34 cases in each group.On the basis of maintaining the original Western medicine hypoglycemic plan,patients in the Qiling group were treated with Qiling prescription,while patients in the control group were given a placebo.After 12 weeks of treatment,the level change of fasting plasma glucose(FPG),2 hours postprandial plasma glucose(2 hPG),fasting insulin(FINS),2 hours postprandial insulin(2 hFINS),fasting C-peptide(C-P),C-peptide 2 hours after meal(2 hC-P),glycosylated hemoglobin(HbA 1 c),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),logarithmic steady-state model assessment of insulin resistance index(HOMA-IR)were compared between the two groups before and after treatment,and the clinical efficacy of the two groups was compared.Results After treatment,the levels of FPG,2 hPG,FINS,C-P,TG,TC,LDL-C and logarithmic HOMA-IR in the Qiling group were significantly lower than those in the control group(P<0.05),while the levels of HDL-C were significantly higher than those in the control group(P<0.05).After treatment,the total clinical effective rate of the Qiling group was 84.85%,which was significantly higher than the control group's 45.45%(P<0.05).Conclusion On the basis of maintaining the original Western medicine hypoglycemic plan,combined with Qiling prescription could effectively alleviate qi-yin deficiency type T2DM patients'clinical symptoms,improve glucose and lipid metabolism disorders,reduce insulin resistance,and improve clinical efficacy.