七味白术散加减结合西医常规疗法治疗2型糖尿病伴脂代谢异常临床研究  

Clinical study on modified Qiwei Baizhu Powder combined with conventional therapy in the treatment of type 2 diabetes mellitus with abnormal lipid metabolism

作　　者：孟海雷 刘怀珍[2] 江鹏 谈佳佳 王瑛瑛 Meng Hailei;Liu Huaizhen;Jiang Peng;Tan Jiajia;Wang Yingying(Department of Endocrinology,Anhui Integrated Traditional Chinese and Western Medicine Hospital,Hefei 230031,China;Department of Endocrinology,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽省中西医结合医院内分泌科,合肥230031 [2]安徽中医药大学第一附属医院内分泌科,合肥230031

出　　处：《国际中医中药杂志》2022年第10期1117-1121,共5页International Journal of Traditional Chinese Medicine

基　　金：安徽省中医药领军人才项目(中医药发展秘〔2018〕23号)。

摘　　要：目的评价七味白术散加减结合西医常规疗法治疗T2DM伴脂代谢异常的临床疗效。方法将符合入选标准的2018年3月-2021年3月安徽省中西医结合医院96例T2DM伴脂代谢异常患者,按随机数字表法分为2组,每组48例。对照组予以西医常规疗法治疗,观察组在对照组基础上结合七味白术散加减治疗。2组均治疗3个月。分别于治疗前后进行中医证候评分,采用葡萄糖氧化酶法检测空腹血糖(FPG)、2 hPG,HPLC法检测HbA1c,胆固醇过氧化酶法、甘油磷酸氧化酶法、直接法-抑制法、直接法-表面活性剂清除法检测TC、TG、HDL-C、LDL-C含量,记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为93.8%(45/48)、对照组为79.2%(38/48),2组比较差异有统计学意义(χ^(2)=4.36,P=0.037)。治疗后,观察组口干、乏力、纳呆、头昏、舌象、脉象评分及总分均低于对照组(t值分别为3.58、3.17、3.24、3.59、3.58、2.76、8.44,P值均<0.05);FPG、2 hPG、HbA1c水平低于对照组(t值分别为3.37、2.05、3.73,P值均<0.05);TC[(4.30±0.85)mmol/L比(4.78±0.94)mmol/L,t=2.62]、TG[(3.00±0.37)mmol/L比(3.19±0.54)mmol/L,t=2.01]、LDL-C[(2.60±0.71)mmol/L比(2.95±0.44)mmol/L,t=2.90]水平低于对照组(P<0.05);HDL-C[(2.07±0.63)mmol/L比(1.82±0.55)mmol/L,t=2.01]水平高于对照组(P<0.05)。结论七味白术散加减结合西医常规疗法可有效改善T2DM伴脂代谢异常患者血糖、血脂水平,减轻患者临床症状,提高疗效。Objective To evaluate the clinical efficacy of modified Qiwei Baizhu Powder combined with conventional therapy in the treatment of type 2 diabetes mellitus(T2DM)with abnormal lipid metabolism.Methods A total of 96 patients with T2DM and abnormal lipid metabolism from March 2018 to March 2021 in Anhui Integrated Traditional Chinese and Western Medicine Hospital who met the inclusion criteria were divided into 2 groups according to the random number table method,with 48 in each group.The control group was treated with conventional western medicine,while the observation group was treated with modified Qiwei Baizhu Powder and treatment of the control group.Both groups were treated for 3 months.TCM syndrome scores were performed before and after treatment.Fasting blood glucose(FPG)and 2 hPG were detected by glucose oxidase method,HbA1c was detected by HPLC,TC,TG,HDL-C and LDL-C were detected by cholesterol peroxidase method,glycerophosphate oxidase method,direct inhibition method and direct surfactant clearance method.Adverse events during treatment were recorded and clinical efficacy was evaluated.Results The total effective rate was 93.8%(45/48)in the observation group and 79.2%(38/48)in the control group,with a statistically significant difference between the two groups(χ^(2)=4.36,P=0.037).After treatment,the scores of dry mouth,fatigue,anorexia,dizziness,tongue,pulse and total scores in the observation group were significantly lower than those in the control group(t values were 3.58,3.17,3.24,3.59,3.58,2.76 and 8.44,respectively,all Ps<0.05);the levels of FPG,2 hPG and HbA1c in the observation group were significantly lower than those in the control group(t values were 3.37,2.05 and 3.73 respectively,all Ps<0.05).After treatment,the levels of TC[(4.30±0.85)mmol/L vs.(4.78±0.94)mmol/L,t=2.62],TG[(3.00±0.37)mmol/L vs.(3.19±0.54)mmol/L,t=2.01],LDL-C[(2.60±0.71)mmol/L vs.(2.95±0.44)mmol/L,t=2.90]were significantly lower than those in the control group(P<0.05).After treatment,the HDL-C[(2.07±0.63)mmol/L vs.(1.8

关 键 词：糖尿病 2型 糖尿病并发症 血脂障碍 血糖 七味白术散 中西医结合疗法 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]