经方六君子汤加减对新发2型糖尿病伴脾气壅塞、痰瘀阻络型肥胖的干预作用

Clinical Observation on the Intervention Effect of Modified Classic Prescription Liujunzi Decoction on New Type 2 diabetes with Spleen Stagnation,Phlegm and Blood Stasis Blocking Collateral Type Obesity

目的 探讨经方六君子汤加减对新发2型糖尿病伴脾气壅塞、痰瘀阻络型肥胖患者的临床效果。方法 选择2023年1月-2023年9月南京市六合区中医院收治的60例新发2型糖尿病合并肥胖患者随机分为观察组和对照组各30例。对照组予德谷门冬双胰岛素、盐酸二甲双胍治疗,观察组在对照组的基础上加用经方六君子汤加减治疗。比较两组治疗前后中医证候积分、腰围、体质量、身体质量指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、血脂四项(甘油三酯[TG]、总胆固醇[TC]、低密度脂蛋白[LDL]、高密度脂蛋白[HDL])、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及不良反应。结果 治疗后,观察组总有效率明显高于对照组(P<0.05);两组中医证候积分、腰围、体质量、BMI、FBG、2 hPBG、HbA1c、TG、TC、LDL、HDL均明显改善(P<0.05),观察组均优于对照组(P<0.05)。治疗期间两组均出现低血糖1例,对照组腹泻1例,对症处理后好转,未出现明显血常规、肝肾功能异常。结论 新发2型糖尿病合并肥胖患者中加用经方六君子汤加减较单用德谷门冬双胰岛素联合盐酸二甲双胍片疗效更显著,可改善患者中医证侯积分、糖脂代谢相关指标等,不良反应少,效果满意。

Objective To explore the clinical effect of Liujunzi Decoction on newly obese patients with type 2 diabetes accompanied by stagnation of spleen qi and phlegm and blood stasis.Methods From January 2023 to September 2023,60 newly diagnosed type 2 diabetes patients with obesity in our outpatient and ward were randomLy divided into an observation group of 30 cases and a control group of 30 cases.The control group was given subcutaneous injection of DeGu MenDong double insulin combined with oral administration of 0.5 g bid of metformin hydrochloride tablets.The observation group was treated with modified classic formula Liujunzi Tang in addition to the control group.Compare the traditional Chinese medicine syndrome scores,waist circumference,weight,BMI,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,blood lipids,fasting insulin,HOMA-IR,blood lipids includes triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL),fasting insulin(FINS),insulin resistance index(HOMA-IR),and adverse reactions before and after treatment between two groups.Result After treatment,the total effective rate of the observation group was significantly higher than that of the control group,with a statistical difference(P<0.05),the traditional Chinese medicine syndrome scores,waist circumference,weight,BMI,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,and blood lipids of both groups were significantly improved.During the treatment,there was 1 case of hypoglycemic reaction and 1 case of diarrhea symptoms,which improved after symptomatic treatment.There were no significant abnormalities in blood routine or liver and kidney function.Conclusion In newly diagnosed type 2 diabetes patients with obesity,Liujunzi Decoction is more effective than the combination of Degu Mendong insulin and Metformin Hydrochloride Tablets alone.It can improve patients TCM syndrome scores,glucose and lipid metabolism related indicators,with less adverse reactions and satisfactory results.