通脉降糖胶囊联合达格列净片治疗2型糖尿病的疗效及对患者胰岛功能的影响

Efficacy of Tongmai Jiangtang capsules combined with dagliflozin tablets in the treatment of type 2 diabetes mellitus and its effect on patients′ islet function

目的 观察通脉降糖胶囊联合达格列净片治疗2型糖尿病患者的疗效及对胰岛功能的影响。方法 选取2022年1月—2023年1月中国人民解放军陆军第七十三集团军医院收治的2型糖尿病患者100例,按随机数字表法分为达格列净组(n=50)和联合治疗组(n=50)。达格列净组给予达格列净片治疗,联合治疗组在达格列净组基础上联合通脉降糖胶囊治疗,2组均用药3个月。比较2组用药前、用药3个月后血糖[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)]、血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、胰岛β细胞功能指标[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)],不良反应。结果 用药3个月后,2组FBG、HbA1c、2 hPG及TG、TC、LDL-C水平低于用药前,HDL-C水平高于用药前,且联合治疗组降低/升高幅度大于达格列净组(P<0.01);2组HOMA-β高于用药前,HOMA-IR低于用药前,且联合治疗组升高/降低幅度大于达格列净组(P<0.01);联合治疗组LVEF高于用药前,LVEDD小于用药前,且联合治疗组升高/缩小幅度大于达格列净组(P<0.01)。联合治疗组与达格列净组不良反应总发生率比较,差异无统计学意义(6.00%vs. 8.00%,P=1.000)。结论 通脉降糖胶囊联合达格列净片治疗2型糖尿病患者的临床疗效较佳,可更有效地调节患者血糖血脂水平,改善胰岛素抵抗,提高胰岛β细胞功能与心功能,且安全性较高。

Objective To observe the efficacy of Tongmai Jiangtang capsules combined with dagliflozin tablets in the treatment of type 2 diabetes mellitus and its effect on patients′islet function.Methods A total of 100 patients with type 2 diabetes mellitus admitted to the Army 73rd Group Military Hospital from January 2022 to January 2023 were selected and they were divided into the dagliflozin group(n=50)and the combined treatment group(n=50)according to the method of randomised numerical table.The dagliflozin group was given dagliflozin tablets for treatment,and the combined treatment group was treated with Tongmai Jiangtang capsules on the basis of the dagliflozin group,and both groups were given medication for 3 months.Blood glucose(FBG,HbA 1c,2 hPG),lipid indexes(TG,TC,HDL-C,LDL-C),pancreaticβ-cell function indexes(HOMA-β,HOMA-IR),cardiac function indexes(LVEF,LVEDD)before and after 3 months of drug administration,and adverse reactions were compared in the two groups.Results After 3 months of drug administration,the levels of FBG,HbA 1c,2 hPG and TG,TC,LDL-C were lower than those before drug administration in the two groups,and the level of HDL-C was higher than that before drug administration,and the magnitude of the decrease/increase in the combined treatment group were greater than those in the dagliflozin group(P<0.01);HOMA-βin the two groups was higher than that before drug administration,and HOMA-IR was lower than that before drug administration,the magnitude of the decrease/increase in the combined treatment group were greater than those in the dagliflozin group(P<0.01);LVEF was higher than pre-drug and LVEDD was less than pre-drug of the two groups,and the magnitude of increase/decrease combined treatment group were greater than those in the dagliflozin group(P<0.01).The difference in the total incidence of adverse reactions between the combined treatment group and the dagliflozin group was not statistically significant(6.00%vs.8.00%,P=1.000).Conclusion The clinical efficacy of Tongmai Jiangtang capsules combined with dagliflozin tablets in the treatment of type 2 diabetes mellitus patients is better,which can more effectively regulate the patients′blood glucose and blood lipid levels,improve insulin resistance,and enhance the pancreaticβ-cell function and cardiac function,and the safety is higher.