抵当汤联合盐酸二甲双胍缓释片治疗2型糖尿病临床研究  

Clinical Study on Didang Decoction Combined with Metformin Hydrochloride Sus⁃ tained-Release Tablets for Type 2 Diabetes Mellitus

作　　者：王英 陈青 谢欢欢 WANG Ying;CHEN Qing;XIE Huanhuan(Department of Endocrinology,Changxing County Hospital of Chinese Medicine,Changxing Zhejiang 313100,China)

机构地区：[1]长兴县中医院内分泌科,浙江长兴313100

出　　处：《新中医》2023年第21期18-23,共6页New Chinese Medicine

基　　金：公益性应用研究项目(2020GY60)。

摘　　要：目的:观察抵当汤联合盐酸二甲双胍缓释片治疗2型糖尿病的疗效及对肠道微生态、糖脂代谢的影响。方法:选取60例2型糖尿病患者作为研究对象,按随机数字表法分为对照组及观察组各30例。对照组给予盐酸二甲双胍缓释片治疗,观察组在对照组基础上联合抵当汤治疗,2组均治疗8周。比较2组临床疗效,比较2组治疗前后中医证候积分、糖脂代谢[空腹血糖(FBG)、餐后2 h血糖(P2hBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素]指标值、氧化应激[超氧化物歧化酶(SOD)、活性氧(ROS)、丙二醛(MDA)]指标值、肠道微生态指标值的变化。结果:观察组临床疗效总有效率为93.33%,对照组为73.33%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组神疲乏力、烦躁易怒、口苦咽干、舌红苔黄中医证候积分均较治疗前下降(P<0.05),观察组上述4项中医证候积分均低于对照组(P<0.05)。治疗后,2组血清FBG、P2hBG、HOMA-IR、TG水平均较治疗前下降(P<0.05),血清HDL-C水平均较治疗前升高(P<0.05);观察组FBG、P2hBG、HOMA-IR、TG水平均低于对照组(P<0.05),血清HDL-C水平高于对照组(P<0.05)。2组TC治疗前后比较,差异均无统计学意义(P>0.05)。治疗后,2组血清SOD水平均较治疗前升高(P<0.05),血清ROS、MDA水平均较治疗前下降(P<0.05);观察组SOD水平高于对照组(P<0.05),血清ROS、MDA水平均低于对照组(P<0.05)。治疗后,2组拟杆菌、双歧杆菌、柔嫩梭菌、乳酸杆菌菌落数均较治疗前升高(P<0.05),肠球菌、肠杆菌菌落数均较治疗前下降(P<0.05);观察组拟杆菌、双歧杆菌、柔嫩梭菌、乳酸杆菌菌落数均高于对照组(P<0.05),肠球菌、肠杆菌菌落数均低于对照组(P<0.05)。结论:抵当汤联合盐酸二甲双胍缓释片可有效缓解2型糖尿病患者临床症状,改善糖脂代谢及肠道微生态情况,降低机体氧化应激反应。Objective:To observe the curative effect of Didang Decoction combined with Metformin Hydrochloride Sustained-Release Tablets for type 2 diabetes mellitus(T2DM),and its effect on intestinal microecology and glucose and lipid metabolism.Methods:A total of 60 patients with T2DM were selected as the research objects and divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with Metformin Hydrochloride Sustained-Release Tablets,and the observation group was treated with Didang Decoction on the treatment of the control group.Both groups were treated for 8 weeks.The clinical effects were compared between the two groups.The changes in traditional Chinese medicine(TCM)syndrome scores,glucose and lipid metabolism indicators[fasting blood glucose(FBG),2-hour postprandial blood glucose(P2hBG),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and fasting insulin],oxidative stress indicators[superoxide dismutase(SOD),reactive oxygen species(ROS),and malondialdehyde(MDA)],and intestinal microecology indicators were compared in the two groups before and after treatment.Results:The total effective rate of clinical effect was 93.33%in the observation group,and 73.33%in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores of fatigue,irritability,bitter mouth and dry throat,and red tongue and yellow coating in the two groups were decreased when compared with those before treatment(P<0.05).The TCM syndrome scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of FBG,P2hBG,HOMA-IR,and TG in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of HDL-C in serum were increased when compared with those before treatment(P<0.05);the levels of FBG,P2hBG,HOMA-IR,and TG in serum in the observation group were lower than those in the control group(P<0.05),an

关 键 词：2型糖尿病 抵当汤 盐酸二甲双胍缓释片 肠道微生态 糖脂代谢 

分 类 号：R587.1[医药卫生—内分泌]