COPD慢性呼吸衰竭合并2型糖尿病胰岛素抵抗患者中西医结合治疗的临床研究

Clinical Study of Integrated Traditional Chinese and Western Medicine in Patients with COPD Chronic Respiratory Failure and Type 2 Diabetes Mellitus with Insulin Resistance

目的探究中西医结合治疗手段应用于慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)慢性呼吸衰竭合并2型糖尿病(type 2 diabetes mellitus,T2DM)胰岛素抵抗患者治疗中的价值。方法选取2022年8月—2023年8月东平县中医院收治的60例COPD慢性呼吸衰竭合并T2DM胰岛素抵抗的患者为研究对象,以治疗方法的不同分为观察组、对照组,各30例,对照组采取呼吸内科常规西药治疗,观察组在对照组基础上采取中药代胰降糖方治疗。比较两组血糖水平[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial plasma glucose,2 hPG)、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)]、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、血脂水平[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)]、不良反应(胃肠道反应、头晕、心悸)发生情况。结果治疗前,两组FPG、2 hPG、HbA1c、HOMA-IR、TG、TC、HDL-C水平比较,差异无统计学意义(P均>0.05);治疗后,观察组HDL-C高于对照组,FPG、2 hPG、HbA1c、HOMA-IR、TG、TC均低于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在COPD慢性呼吸衰竭合并T2DM胰岛素抵抗患者的临床治疗中,采取中西医结合治疗对血糖控制及血脂水平改善的作用明显,安全性较高。

Objective To explore the value of integrated traditional Chinese and Western medicine in the treatment of chronic obstructive pulmonary disease(COPD)with chronic respiratory failure and type 2 diabetes mellitus(T2DM)with insulin resistance.Methods Sixty patients with COPD chronic respiratory failure complicated with T2DM insulin resistance admitted to Dongping County Hospital of Traditional Chinese Medicine from August 2022 to August 2023 were selected as the research objects.They were divided into observation group and control group by different treat-ment methods,with 30 cases in each group.The control group was treated with conventional Western medicine in re-spiratory medicine,and the observation group was treated with traditional Chinese medicine on the basis of the control group.The blood glucose levels[fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 hPG),glycated hemoglobin A1c(HbA1c)],homeostatic model assessment of insulin resistance(HOMA-IR),blood lipid levels[triglyc-eride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)],incidence of adverse reactions(gastro-intestinal reactions,dizziness,palpitations)were compared between the two groups.Results Before treatment,the FPG,2 hPG,HbA1c,HOMA-IR,TG,TC,HDL-C were compared between the two groups,the differences were not statistically significant(all P>0.05).After treatment,HDL-C in the observation group was higher than that in the con-trol group,FPG,2 hPG,HbA1c,HOMA-IR,TG and TC were lower than those in the control group,and the differ-ences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reac-tions between the two groups(P>0.05).Conclusion In the clinical treatment of COPD patients with chronic respira-tory failure and T2DM insulin resistance,the combination of traditional Chinese and Western medicine has obvious ef-fect on blood glucose control and blood lipid level improvement,and the safety is high.