中西医结合治疗高龄2型糖尿病患者30例临床观察  

Clinical Observation on Combined Chinese and Western Medication for 30 Elderly Patients with Type 2 Diabetes Mellitus

作　　者：张晓君[1] 王青平[1] 聂晶[1] 吴志平[2] 

机构地区：[1]杭州市红十字会医院 [2]浙江省杭州市第三人民医院

出　　处：《中医杂志》2012年第19期1651-1654,共4页Journal of Traditional Chinese Medicine

基　　金：杭州市医药卫生科技计划项目(2007B0043)

摘　　要：目的探讨甘精胰岛素和那格列奈联合阶段性中药辨证论治治疗高龄2型糖尿病的可行性及优势。方法将60例高龄2型糖尿病患者随机分为治疗组和对照组各30例。对照组予甘精胰岛素睡前皮下注射联合那格列奈口服,治疗组在对照组治疗基础上结合中医辨证分型,分别给予阴虚热盛、气阴两虚和阴阳两虚基本方治疗。两组疗程均为6个月。观察两组治疗前后血糖及血清C肽水平、中医证候评分和生活质量评分,并观察安全性。结果治疗组治疗3个月、6个月常见中医证候积分均明显改善(P<0.05或P<0.01),与对照组治疗后同时间比较,差异有统计学意义(P<0.05或P<0.01)。治疗组治疗3个月、6个月生活质量评分与治疗前比较,差异有统计学意义(P<0.05);与对照组治疗后同时间比较,差异有统计学意义(P<0.05)。两组治疗后血糖和C肽水平比较差异无统计学意义(P>0.05)。治疗组胰岛素日用量和低血糖发生率均明显低于对照组,差异有统计学意义(P<0.05)。结论高龄2型糖尿病患者应用甘精胰岛素和那格列奈联合阶段性中药辨证论治可有效控制血糖,提高生活质量,安全性高,优于单纯西药治疗。Objective To observe the feasibility and advantage of insulin glargine （IG） and nateglinide combined with Chi- nese medication for elderly patients with type 2 diabetes mellitus （T2DM）. Methods Sixty elderly patients with T2DM were randomized into treatment group and control group, with 30 in each. The control group was given subcutaneous injection of IG before bedtime and oral administration of nateglinide before meals. The treatment group was given fundamental formulas ac- cording to different TCM syndromes of yin deficiency exuberant heat, qi-yin dual deficiency and yin yang dual deficiency on the basis of therapy in the control group. The treatment lasted for 6 months. The glycemic control, level of C peptide, TCM syn- drome scores and quality of life （QOL） scores were observed. Results The scores of TCM syndrome were significantly im- proved in the treatment group after treatment （P〈0.01）, with significant differences with the control group after treatment （P〈0.05 or P〈0.01）. After 3 and 6 months of treatment, the QO1. scores improved significantly in the treatment group （P〈0.05）, with significant difference as compared with the control group （P〈0.05）. After treatment, there was no signifi cant difference between groups in fasting blood glucose （FBG） and level of C peptide （P〉0.05） . The differences between groups in daily dosage of insulin and hypoglycemia were statistically significant （P〈0.05）. Conclusion Glargine insulin and nateglinide combined with Chinese medication is effective in controlling blood sugar and improving quality of life for elderly patients with T2DM, with a better efficacy and safety as compared with single western medication.

关 键 词：老年2型糖尿病 辨证治疗 甘精胰岛素 那格列奈 

分 类 号：R587.1[医药卫生—内分泌]