消渴方加减结合西医常规疗法治疗2型糖尿病阴虚热盛证的临床研究  

Effect of modified Xiaoke Prescription on the patients with Yin deficiency and heat excessivetype 2 diabetes mellitus

作　　者：马丹军 周菁荣 孙宁宁 韩振格 王征 唐菁 Ma Danjun;Zhou Jingrong;Sun Ningning;Han Zhenge;Wang Zheng;Tang Jing(Department of Endocrine,Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China;Clinical Laboratory,Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China)

机构地区：[1]上海市光华中西医结合医院内分泌科,上海200052 [2]上海市光华中西医结合医院检验科,上海200052

出　　处：《国际中医中药杂志》2023年第4期410-414,共5页International Journal of Traditional Chinese Medicine

基　　金：上海市长宁区科学技术委员会项目(CNKW2020Y21)。

摘　　要：目的评价消渴方加减结合西医常规疗法治疗T2DM阴虚热盛证患者的临床疗效。方法随机对照试验设计。选择2021年1-7月本院T2DM阴虚热盛证型患者79例,采用随机数字表法分为观察组41例和对照组39例。对照组采用西医常规疗法治疗,观察组在对照组基础上服用消渴方加减治疗。2组均治疗1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,ELISA法检测血清HbA1c、MDA、8-羟基脱氧鸟苷(8-OHdG)水平及SOD活性,比色法检测LDL-C、HDL-C、TC水平,评价临床疗效。结果观察组总有效率为92.68%(38/41)、对照组为76.92%(30/39),2组比较差异有统计学意义(χ2=3.89,P=0.048)。观察组治疗后倦怠乏力、口渴喜饮、多食易饥、舌红少津评分及总分均低于对照组(t值分别为4.46、16.89、13.37、8.58、8.38,P<0.01)。治疗后,观察组血清FPG[(7.31±0.90)mmol/L比(8.72±1.50)mmol/L,t=5.13]、2 hPG[(9.64±2.05)mmol/L比(12.85±1.20)mmol/L,t=8.49]、HbA1c[(7.64±0.58)%比(8.11±1.35)%,t=2.04]水平低于对照组(P<0.05);MDA[(3.96±1.00)mmol/L比(5.04±0.73)mmol/L,t=5.49]、8-OHdG[(203.41±30.70)ng/L比(234.50±59.00)ng/L,t=2.98]水平低于对照组(P<0.05);SOD[(48.64±5.05)mU/L比(41.75±3.58)mU/L,t=7.01]活性高于对照组(P<0.01);LDL-C[(2.01±0.11)mmol/L比(2.56±0.25)mmol/L,t=12.84]、TC[(4.75±0.20)mmol/L比(5.12±0.07)mmol/L,t=10.93]水平低于对照组(P<0.01);HDL-C[(1.62±0.18)mmol/L比(1.24±0.42)mmol/L,t=5.31]水平高于对照组(P<0.01)。结论消渴方加减结合西医常规疗法可有效改善T2DM阴虚热盛证患者临床症状及胰岛功能,缓解氧化应激水平,提高临床疗效。Objective The purpose of this study was to explore the therapeutic effect of modified Xiaoke prescription on patients with Yin deficiency and heat excessive type 2 diabetes mellitus(T2DM),and its influence on TCM syndrome scores,pancreatic islet function and oxidative stress.Methods Randomized controlled trial.Eighty patients with Yin deficiency and heat excessive T2DM treated in the hospital between January and July 2021 were selected,and divided into observation group (41 cases) and control group (39 cases) by random number table method.Patients in the control group were treated with conventional western medicine, and patients in theobservation group were treated with modified Xiaoke Prescription on the basis of the control group.Both groups were treated for 1 month. TCM syndrome scores were performed before and aftertreatment. Fasting plasma glucose (FPG) and 2 hPG were measured by glucose oxidase method.Serum HbA1c, malondialdehyde (MDA), 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels and SODactivity were measured by ELISA. The levels of low density lipoprotein cholesterol (LDL-C), highdensity lipoprotein cholesterol (HDL-C) and total cholesterol (TC) were detected by colorimetry.Results The total effective rate of the observation group was 92.68% (38/41), and that of thecontrol group was 76.92% (30/39). The difference between the two groups was statisticallysignificant (χ2=3.89, P=0.048). After treatment, the scores of tiredness and fatigue, thirst andappetite, overeating and hunger, redness of tongue and lack of saliva and total scores in theobservation group were significantly lower than those in the control group (t=4.46, 16.89, 13.37, 8.58,8.38, P<0.01). After treatment, the levels of serum FPG [(7.31±0.90) mmol/L vs. (8.72±1.50) mmol/L,t=5.13], 2 hPG [(9.64±2.05) mmol/L vs. (12.85±1.20) mmol/L, t=8.49], HbA1c [(7.64±0.58)% vs.(8.11±1.35)%, t=2.04] in the observation group were significantly lower than those in the controlgroup (P<0.05);MDA [(3.96±1.00) mmol/L vs. (5.04±0.73) mmol/L, t=5.49], 8-OHd

关 键 词：糖尿病 2型 阴虚热盛证 消渴方加减 胰岛功能 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]