七味白术散合补阳还五汤对肥胖症合并2型糖尿病患者糖脂代谢和胰岛素抵抗的影响

Effect of Qiwei Baizhu Powder combined with Buyang Huanwu Decoction on glucose and lipid metabolism and insulin resistance in patients with obesity and type 2 diabetes mellitus

目的:观察七味白术散合补阳还五汤对肥胖症合并2型糖尿病(T2DM)患者糖脂代谢和胰岛素抵抗的影响。方法:选取2020年1月~2022年10月我院收治的肥胖症合并T2DM患者86例,以随机数表法分成研究组(n=43)与对照组(n=43),对照组给予常规治疗,研究组在此基础上予以七味白术散合补阳还五汤治疗。比较两组患者临床疗效,治疗前后中医证候积分、糖脂代谢指标及胰岛素抵抗水平。结果:治疗后研究组临床疗效的总有效率为90.70%,高于对照组的74.42%(P<0.05),且研究组各中医证候积分低于对照组(P<0.05)。治疗后两组患者餐后2h血糖(P2hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、体质量指数(BMI)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)水平较治疗前低,且研究组较对照组低(P<0.05);高密度脂蛋白(HDL)水平较治疗前高,且研究组较对照组高(P<0.05)。此外两组患者不良反应发生率之间的差异不显著(P>0.05)。结论:七味白术散合补阳还五汤治疗肥胖症合并T2DM患者疗效确切,能有效改善血糖、血脂代谢,并有助于减轻胰岛素抵抗。

Objective:To observe the effect of Qiwei Baizhu Powder combined with Buyang Huanwu Decoction on glucose and lipid metabolism and insulin resistance in patients with obesity and type 2 diabetes mellitus(T2DM).Methods:A total of 86 patients with obesity and T2DM who were admitted to the hospital from January 2020 to October 2022 were selected,and divided into the study group(n=43)and the control group(n=43)by random number table method.The control group was given conventional treatments,while the study group was treated with Qiwei Baizhu Powder combined with Buyang Huanwu Decoction on this basis.Clinical effects,TCM syndrome scores,glucose and lipid metabolism indicators and insulin resistance were compared between the two groups.Results:After treatment,the total clinical response rate in the study group(90.70%)was higher than that in the control group(74.42%)(P<0.05).TCM syndrome scores were lower than those in the control group(P<0.05).The levels of 2h postprandial blood glucose(P2hPG),glycated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL),body mass index(BMI),fasting insulin(FINS)and insulin resistance index(HOMAIR)in both groups decreased.These indicators in the study group were lower than those in the control group(P<0.05).The levels of high density lipoprotein(HDL)increased,and the level in study group was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Qiwei Baizhu Powder combined with Buyang Huanwu Decoction is effective in the treatment of patients with obesity and T2DM,which can effectively improve glucose and lipid metabolism,thereby alleviating insulin resistance.