参芪地黄汤化裁联合胰岛素治疗二甲双胍控制血糖不佳气阴两虚证糖尿病的效果  

Effect of Shenqi Dihuang Decoction Combined with Insulin in the Treatment of Diabetes Mellitus of Qi-yin Deficiency Syndrome Due to Poor Control by Metformin

作　　者：瞿庆宏 吴亮亮 王义元 何镔[1] QU Qinghong;WU Liangliang;WANG Yiyuan;HE Bin(Department of Traditional Chinese Medicine,Tianchang Hospital of Traditional Chinese Medicine,Tianchang,Anhui 239300,China)

机构地区：[1]天长市中医院中医内科,安徽天长239300

出　　处：《临床误诊误治》2024年第1期112-117,共6页Clinical Misdiagnosis & Mistherapy

基　　金：第一批安徽省中医药学术流派传承工作室建设项目[皖中医药发展秘(2021)30号]。

摘　　要：目的探讨参芪地黄汤化裁联合胰岛素治疗在二甲双胍控制血糖不佳气阴两虚证糖尿病患者中的应用价值。方法选取2019年3月—2022年6月就诊的100例二甲双胍控制血糖不佳气阴两虚证糖尿病开展回顾性研究,均为2型糖尿病。根据治疗方法不同分为研究组和常规组,每组50例。研究组采用参芪地黄汤化裁联合胰岛素治疗,常规组采用胰岛素治疗。比较2组疗效、中医证候积分、血糖相关指标[糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR)、餐后2 h血糖(2 h PBG)、空腹血糖(FBG)、胰岛β细胞功能指数(HOMA-β)]、炎性指标[C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、白血病抑制因子(LIF)、高迁移率族蛋白B1(HMGB1)]、预后指标[脂蛋白相关磷脂酶A2(Lp-PLA2)、血尿酸(SUA)、甲状腺球蛋白(TG)]及安全性。结果研究组临床总有效率94.00%(47/50)高于常规组80.00%(40/50)(P<0.05)。治疗后研究组各中医证候积分及总积分低于常规组(P<0.05)。治疗后研究组HbA1c、2 h PBG、FBG、HOMA-IR低于常规组,HOMA-β高于常规组(P<0.05)。治疗后研究组CRP、MCP-1、LIF、HMGB1、Lp-PLA2、SUA、TG低于常规组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论参芪地黄汤化裁联合胰岛素治疗二甲双胍控制血糖不佳气阴两虚证糖尿病患者效果显著,可有效降低血糖水平,改善临床症状,减轻炎症反应,且安全性高。Objective To investigate the application value of Shenqi Dihuang decoction combined with insulin in the treatment of patients with diabetes mellitus(DM)and poor control of Qi-yin deficiency syndrome by metformin.Methods A retrospective study was conducted on 100 DM patients with poor control of with Qi-yin deficiency syndrome by metformin from March 2019 to June 2022,all of whom had type 2 diabetes mellitus(T2DM).According to different treatment methods,the patients were divided into research group and conventional group,with 50 cases in each group.The research group was treated with Shenqi Dihuang decoction combined with insulin,and the conventional group was treated with insulin.The therapeutic effect,traditional Chinese medicine(TCM)syndrome score,blood glucose-related indexes[glycated hemoglobin A1c(HbA1c),homeostasis model assessment-insulin resistance index(HOMA-IR),2 h postprandial blood glucose(2 h PBG),fasting blood glucose(FBG),islet beta cell function index(HOMA-β)],inflammatory indicators[C reactive protein(CRP),monocyte chemotactic protein-1(MCP-1),leukemia inhibitory factor(LIF),high mobility group protein B1(HMGB1)],prognostic indicators[lipoprotein-associated phospholipase A2(Lp-PLA2),serum uric acid(SUA),thyroglobulin(TG)]and safety were compared between the two groups.Results The total clinical effective rate of the research group was 94.00%(47/50),which was higher than that of the conventional group[80.00%(40/50)](P<0.05).After treatment,the TCM syndrome scores and total scores of the research group were lower than those of the conventional group(P<0.05).After treatment,HbA1c,2 h PBG,FBG and HOMA-IR in the research group were lower than those in the conventional group,while HOMA-βwas higher than that in the conventional group(P<0.05).After treatment,CRP,MCP-1,LIF,HMGB1,Lp-PLA2,SUA and TG in the research group were lower than those in the conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Shenqi Dihuang

关 键 词：糖尿病 气阴两虚 二甲双胍 参芪地黄汤 胰岛素 血糖 白血病抑制因子 甲状腺球蛋白 

分 类 号：R587.1[医药卫生—内分泌]