桃仁承气汤化裁联合西医序贯治疗2型糖尿病患者的效果

Effect of modified Taoren Chengqi Decoction combined with sequential treatment of western medicine in type 2 diabetes patients

目的探讨桃仁承气汤化裁联合西医序贯治疗对2型糖尿病(T2DM)患者中医证候积分及血糖波动、血清白脂素(Asprosin)水平的影响。方法选取90例T2DM患者,并将其随机分成序贯组(n=45)和中医组(n=45)。序贯组44例(脱落1例)先开展胰岛素强化治疗,之后改用度拉糖肽治疗;中医组44例(脱落1例)在序贯组基础上加用桃仁承气汤化裁方治疗。比较2组治疗前、治疗8周后中医证候积分、血糖波动参数及空腹血糖(FPG)、胰岛功能指标及血清Asprosin水平。结果治疗8周后,2组中医证候积分、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)及FPG、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰高血糖素、空腹和餐后2 h C肽、血清Asprosin水平与治疗前比较,差异有统计学意义(P<0.05);中医组除SDBG以外的其他指标水平与序贯组比较,差异有统计学意义(P<0.05)。结论桃仁承气汤化裁方联合西医序贯治疗可明显下调T2DM患者血清Asprosin水平及中医证候积分,有效控制血糖波动,显著改善胰岛功能。

Objective To investigate the impacts of modified Taoren Chengqi Decoction combined with sequential treatment of western medicine on TCM syndromes score,blood sugar fluctuations and serum asprosin level in patients with type 2 diabetes mellitus(T2DM).Methods Ninety T2DM patients were selected,and were divided into sequential group(n=45)and TCM group(n=45).In the sequential group,44 cases(1 case dropped out)were given intensive insulin therapy first,and then changed to dulaglutide therapy;44 cases(1 case dropped out)in the TCM group were additionally treated with modified Taoren Chengqi Decoction based on sequential group.The TCM syndrome scores,blood glucose fluctuation parameters,fasting blood glucose(FPG),islet function index and serum asprosin level were compared between the two groups before treatment and after 8 weeks of treatment.Results After 8 weeks of treatment,the TCM syndrome score,standard deviation of blood glucose(SDBG),mean fluctuation of blood glucose(MAGE),FPG,fasting insulin(FINS),insulin resistance index(HOMA-IR),glucagon,fasting and 2 h postprandial C-peptide,serum asprosin levels of the two groups showed significant differences between the two groups compared with those before treatment(P<0.05);there were significant statistical differences between the TCM group and the sequential group in levels of other indicators except SDBG(P<0.05).Conclusion Modified Taoren Chengqi Decoction combined with sequential treatment of western medicine for T2DM patients can greatly reduce serum asprosin level and TCM syndrome scores,effectively control blood sugar fluctuations,and greatly improved islet function.