加味桃核承气汤联合二甲双胍治疗阴虚热盛型2型糖尿病患者的效果

Effects of modified Taohe Chengqi decoction combined with Metformin in treatment of type 2 diabetes mellitus patients of extreme heat with yin asthenia type

目的:观察加味桃核承气汤联合二甲双胍治疗阴虚热盛型2型糖尿病(T2DM)患者的效果。方法:选取2021年1月至2023年3月北京中医药大学东直门医院洛阳医院收治的80例阴虚热盛型T2DM患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各40例。对照组采用二甲双胍治疗,观察组在对照组基础上联合加味桃核承气汤治疗。比较两组临床疗效,治疗前后中医证候积分,空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平,炎性因子[白细胞介素-6(IL-6)、脂联素、可溶性细胞间黏附分子-1(sICAM-1)]水平,以及不良反应发生率。结果:观察组治疗总有效率为90.00%(36/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05);治疗后,观察组口舌干燥、五心烦热、潮热盗汗、眩晕耳鸣等中医证候积分,FPG、FINS、HbA1c水平及血清IL-6、脂联素、sICAM-1水平均低于对照组,差异有统计学意义(P<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:加味桃核承气汤联合二甲双胍治疗阴虚热盛型T2DM患者效果确切,能加快症状缓解,降低中医证候积分和炎性因子水平,效果优于单用二甲双胍治疗。

Objective:To observe effects of modified Taohe Chengqi decoction combined with Metformin in treatment of type 2 diabetes mellitus(T2DM)patients of extreme heat with yin asthenia type.Methods:From January 2021 to March 2023,80 patients with T2DM of extreme heat with yin asthenia type admitted to Luoyang hospital of Dongzhimen hospital of Beijing university of Chinese medicine were selected for the prospective study.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was treated with Metformin,while the observation group was treated with modified Taohe Chengqi decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome scores,the levels of fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS)and inflammatory factors[interleukin-6(IL-6),adiponectin,soluble intercellular adhesion molecule-1(sICAM-1)]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 90.00%(36/40),which was higher than 72.50%(29/40)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as dry mouth and tongue,feverish sensation over the five centers,tidal fever and night sweating,vertigo and tinnitus as well as the levels of FPG,FINS,HbA1c and serum IL-6,ADPN,sICAM-1 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Modified Taohe Chengqi decoction combined with Metformin is effective in the treatment of the T2DM patients with extreme heat with yin asthenia type,which can accelerate the symptom relief and reduce the TCM syndrome scores and the inflammatory factor levels.Moreover,it is superior to simple Metformin treatment.