桑枝颗粒联合达格列净片治疗2型糖尿病的临床研究

Clinical study on Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus

目的探讨桑枝颗粒联合达格列净片治疗2型糖尿病的临床疗效。方法选取2017年4月—2018年4月在驻马店市中心医院治疗的2型糖尿病患者94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服达格列净片,起始剂量5 mg/次,1次/d,根据血糖可调整剂量至10 mg/次,1次/d;治疗组在对照组基础上口服桑枝颗粒,3 g/次,3次/d。两组均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血糖相关指标、HOMA-β和HOMA-IR及血清学指标。结果治疗后,对照组和治疗组临床有效率分别为82.98%和97.87%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)和胰岛素(FINS)水平均显著降低(P<0.05),且治疗后治疗组这些血糖相关指标明显低于对照组(P<0.05)。治疗后,两组HOMA-β均显著增高(P<0.05),HOMA-IR显著降低(P<0.05),且治疗组HOMA-β和HOMA-IR水平明显好于对照组(P<0.05)。治疗后,两组γ-谷氨酰转肽酶(γ-GT)、血管细胞黏附分子-1(VCAM-1)、单核细胞趋化蛋白-1(MCP-1)水平均显著降低(P<0.05),分泌型卷曲相关蛋白-5(SFRP5)水平显著增加(P<0.05),且治疗组这些血清学指标水平明显优于对照组(P<0.05)。结论桑枝颗粒联合达格列净片治疗2型糖尿病可有效控制患者血糖水平,改善胰岛素抵抗及提高胰岛素敏感性,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus. Methods Patients(94 cases) with type 2 diabetes mellitus in Zhumadian Central Hospital from April 2017 to April 2018 were divided into control(47 cases) and treatment(47 cases) groups according to different treatments. Patients in the control group were po administered with Dapagliflozin Tablets, and the initial dose was 5 mg/time, once daily, then adjusted to 10 mg/time of maximum dose according to blood glucose, once daily. Patients in the treatment group were po administered with Sangzhi Granules on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose related indicators, HOMA-β, HOMA-IR and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.98% and 97.87%, respectively, and there were differences between two groups(P < 0.05). After treatment, the FPG, 2 h PG, HbAlc, and FINS levels in two groups were significantly decreased(P < 0.05), and these blood glucose related indicators in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the HOMA-β in two groups was significantly increased(P < 0.05), but HOMA-IR was significantly decreased(P < 0.05), and the HOMA-β and HOMA-IR levels in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the MCP-1, VCAM-1 and γ-GT levels in two groups were significantly decreased(P < 0.05), but SFRP5 levels was significantly increased(P < 0.05), and these serological indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus can effectively control the blood glucose level, improve the insulin resistance and the insulin sensitivity, which has a certain clinical application value.