基于持续葡萄糖监测观察润燥益肾方对肾阴亏虚型2型糖尿病患者血糖波动的影响  

Effects of Runzao Yishen Decoction on blood glucose fluctuation in patients of type 2 diabetes mellitus with syndrome of kidney yin deficiency based on continuous glucose monitoring

作　　者：曹惠红 李昀昊[2] 赵晓龙 金丹凤 宋丽 刘莹 于志颖 杨进花 何一然 CAO Huihong;LI Yunhao;ZHAO Xiaolong;JIN Danfeng;SONG Li;LIU Ying;YU Zhiying;YANG Jinhua;HE Yiran(Department of Endocrinology,Shanghai Minhang District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200241,China;Department of Endocrinology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Endocrinology,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]上海市闵行区中西医结合医院内分泌科,上海200241 [2]上海中医药大学附属岳阳中西医结合医院内分泌科,上海200437 [3]复旦大学附属华山医院内分泌科,上海200040

出　　处：《上海中医药大学学报》2021年第5期20-25,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划资助项目[ZY(2018-2020)-ZYBZ-50];上海市闵行区医学特色专科建设项目(2020MWTZB09)。

摘　　要：目的:基于持续葡萄糖监测观察润燥益肾方对肾阴亏虚型2型糖尿病患者糖代谢、血糖波动及中医证候评分的影响。方法:将98例肾阴亏虚型2型糖尿病患者随机分为治疗组49例和对照组49例。对照组使用胰岛素治疗,治疗组在对照组的基础上给予润燥益肾方治疗,两组疗程均为12周。治疗前后比较两组糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、血清肌酐(Scr)、丙氨酸氨基转移酶(ALT)、空腹C肽(FCP)、餐后2 h C肽(2hCP)、糖化白蛋白(GA)、持续葡萄糖监测参数、中医证候评分及胰岛素用量的变化。结果:①治疗后,两组Hb A1c、FPG、2hPG水平均显著下降(P<0.05),且治疗组降幅更明显(P<0.05);②治疗后,两组依据动态血糖计算的血糖标准差(SD)、平均血糖波动幅度(MAGE)、平均血糖(MBG)均显著下降(P<0.05),葡萄糖在目标范围内时间(TIR)显著升高(P<0.05),且治疗组TIR增加水平显著优于对照组(P<0.05),以TIR>70%为达标切点,治疗组TIR达标率为75.51%,高于对照组的55.10%(P<0.05);③治疗后,两组中医证候总积分均下降,且治疗组积分低于对照组(P<0.05);④治疗组治疗前后胰岛素日用量的差值低于对照组(P<0.05)。结论:润燥益肾方能降低2型糖尿病患者血糖水平,减少血糖波动,显著提高TIR,并改善中医证候。Objective:To observe the effects of Runzao Yishen Decoction on glucose metabolism,blood glucose excursion and Chinese medical syndrome score in patients of type 2 diabetes mellitus(T2DM)with syndrome of kidney yin deficiency based on continuous glucose monitoring.Methods:A total of ninety-eight T2DM patients with syndrome of kidney yin deficiency were randomly divided into the treatment group and control group,49 cases in each group.The control group was treated with insulin,and the treatment group was treated with Runzao Yishen Decoction on the basis of the control group,with a course of 12 weeks.The glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),serum creatinine(Scr),alanine aminotransferase(ALT),fasting C-peptide(FCP),2-hour postprandial C-peptide(2hCP),glycosylated albumin(GA),continuous glucose monitoring parameters,Chinese medical syndrome score and insulin dosage were compared between the two groups before and after treatment.Results:①After treatment,the levels of HbA1c,FPG and 2hPG were decreased significantly in both groups(P<0.05),and the decrease in the treatment group was more obvious than that in the control group(P<0.05).②After treatment,calculated by continuous glucose monitoring system,the standard deviations(SD)of blood glucose,mean amplitude of glycemic excursion(MAGE)and mean blood glucose(MBG)were significantly decreased in both groups(P<0.05),and the time in range(TIR)was significantly increased(P<0.05),and the increase of TIR in the treatment group was significantly higher than that in the control group(P<0.05).Taken TIR>70%as the standard point,the rate of TIR compliance in the treatment group was 75.51%,which was significantly higher than that in the control group(55.10%)(P<0.05).③After treatment,the total score of Chinese medical syndrome in both groups was decreased,and the score in the treatment group was lower than that in the control group(P<0.05).④The difference of daily insulin dosage between pre-and post-therapy in the treatment

关 键 词：2型糖尿病 润燥益肾方 肾阴亏虚 持续葡萄糖监测 血糖波动 

分 类 号：R587.1[医药卫生—内分泌]