生脉散合六味地黄丸治疗2型糖尿病效果分析

Analysis of the effects of Shengmai powder with Liuwei Dihuang pill in the treatment of type 2 diabetes mellitus

目的探究生脉散合六味地黄丸联合盐酸二甲双胍对2型糖尿病(T2DM)气阴两虚证的疗效及对糖脂代谢和胰岛素抵抗的影响。方法选取安徽中医药大学附属太和中医院2020年1月-2021年12月收治的90例T2DM患者为研究对象,按照随机数字表法分为联合组和对照组,各45例,对照组给予西药盐酸二甲双胍治疗,联合组在对照组基础上加用生脉散合六味地黄丸治疗,比较治疗12周后2组临床疗效,治疗前后中医症候积分、糖代谢、脂代谢、胰岛细胞功能、血清生化因子变化及药物不良反应发生情况。结果联合组临床疗效显著高于对照组(P<0.05);治疗12周后,2组中医证候积分、血液FPG、2 h PG、FCP、2 h PCP及血清HbAlc、TG、TC、LDL-C水平均显著降低(P<0.05),HDL-C水平均显著升高(P<0.05),2组FINS、HOMA-IR均显著降低(P<0.05),HOMA-β、ISI值均显著升高(P<0.05),血清IFN-γ、IL-2水平均显著升高(P<0.05),IL-4、TNF-α水平均显著降低(P<0.05),且上述指标组间对比有统计学意义(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论生脉散合六味地黄丸联合盐酸二甲双胍治疗T2DM疗效明显,有利于改善糖脂代谢及胰岛细胞功能,提高胰岛素敏感性。

Objective To explore the therapeutic effect of Shengmai powder with Liuwei Dihuang pill combined with Metformin hydrochloride on type 2 diabetes mellitus(T2DM)of syndrome of deficiency of both qi and yin,and its effects on glucolipid metabolism and insulin resistance.Methods 90 patients with T2DM admitted to Taihe County Hospital of Chinese Medicine Affiliated to Anhui University of Chinese Medicine from January 2020 to December 2021 were selected as the research subjects,and were divided into the combined group(45 cases)and the control group(45 cases)according to the random number table method.The control group was treated with Metformin hydrochloride,and the combined group was treated with Shengmai powder with Liuwei Dihuang pill on the basis of the treatment of the control group.The clinical efficacy after 12 weeks of treatment,and traditional Chinese medicine(TCM)syndromes scores,glucose metabolism,lipid metabolism,islet cell function,changes in serum biochemical factors before and after treatment and occurrence of adverse drug reactions were compared between the two groups.Results The clinical efficacy of the combined group was significantly higher than that of the control group(P<0.05).TCM syndromes scores and levels of blood fasting plasma glucose(FPG),2 hour plasma glucose(2h PG),fasting c-peptide(FCP),2 hour postprandial serum C peptide(2 h PCP)and serum glycosylated hemoglobin(HbAlc),triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL-C)of the two groups were significantly decreased(P<0.05),and high density lipoprotein(HDL-C)level was significantly increased(P<0.05).And fasting serum lisulin(FINS)level and homeostasis model assessment of insulin resistance(HOMA-IR)in both groups were significantly decreased(P<0.05),HOMA-βand insulin sensitivity index(ISI)values were significantly increased(P<0.05),and serum levels of interferonγ(IFN-γ)and interleukin-2(IL-2)were significantly increased(P<0.05),levels of IL-4 and tumor necrosis factor alpha(TNF-α)were significantly decreased(P<0.05),and there were significant differences in the above indicators between groups(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Shengmai powder with Liuwei Dihuang pill combined with Metformin hydrochloride has the obvious therapeutic effect in the treatment of T2DM,which can improve glucolipid metabolism and islet cell function,and increase insulin sensitivity.