健脾化湿方联合司美格鲁肽治疗超重/肥胖2型糖尿病的疗效及对脂质蓄积指数的影响  

Efficacy of decoction for fortifying spleen and resolving dampness combined with simethicone on overweight/obese type 2 diabetes mellitus and its effect on lipid accumulation index

作　　者：何瑞雪 张贺芳 张庚良 臧钰荣 李硕 HE Ruixue;ZHANG Hefang;ZHANG Gengliang;ZANG Yurong;LI Shuo(The First Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北中医药大学第一附属医院,河北石家庄050011

出　　处：《现代中西医结合杂志》2024年第16期2238-2243,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：政府资助临床医学优秀人才培养项目(ZF2023169);河北省中医药防治重大疑难疾病研究项目(2018125580)。

摘　　要：目的探讨健脾化湿方联合司美格鲁肽治疗脾虚湿盛型超重/肥胖2型糖尿病(T2DM)患者的临床疗效及对脂质蓄积指数(LAP)的影响。方法收集2022年9月—2023年9月于河北省中医院内分泌科接受治疗的68例脾虚湿盛型超重/肥胖T2DM患者,根据就诊顺序,将患者随机分为对照组和观察组,每组34例。对照组给予糖尿病生活方式干预及司美格鲁肽注射液皮下注射治疗,观察组在对照组治疗基础上联合健脾化湿方汤剂口服,2组治疗周期均为12周。比较2组患者治疗前后脾虚湿盛型主症和次症评分及证候总积分、体重、体质指数(BMI)、腰围、LAP、血糖指标[空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],统计2组总体治疗效果及治疗期间不良反应发生情况。结果治疗后,2组患者的中医证候主症和次症评分及总积分、体重、BMI、腰围、LAP及FPG、2hPG、HbAlc、HOMA-IR、TC、TG、LDL-C水平均较治疗前明显降低(P均<0.05),且治疗后观察组各指标均明显低于对照组(P均<0.05);2组患者的HDL-C水平均较治疗前明显升高(P均<0.05),且治疗后观察组明显高于对照组(P<0.05)。治疗后,观察组总有效率明显高于对照组[90.62%(29/32)比64.51%(20/31),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),且不良反应均轻微。结论健脾化湿方能有效改善脾虚湿盛型超重/肥胖T2DM患者的临床症状,有助于降脂、减重、减少体内脂肪蓄积、控制血糖及改善胰岛素抵抗。Objective It is to explore the clinical efficacy of decoction for fortifying spleen and resolving dampness combined with simethicone in the treatment of patients with overweight/obese type 2 diabetes mellitus(T2DM)and its effect on lipid accumulation product(LAP).Methods Sixty-eight cases of T2DM patients with syndrome of spleen deficiency and exuberant dampness treated in the Department of Endocrinology of Hebei Provincial Hospital of Traditional Chinese Medicine from September 2022 to September 2023 were collected,and were randomly divided into control group and observation group according to their order of medical consultation,with 34 cases in each group.The control group was treated with diabetic lifestyle intervention and subcutaneous injection of simethicone,and the observation group was treated with decoction for fortifying spleen and resolving dampness orally based on the treatment of the control group,both groups were treated for 12 weeks.The primary and secondary symptom scores and total scores of syndrome,body weight,body mass index(BMI),waist circumference,LAP,blood glucose indexes[fasting plasma(FPG),2 h postprandial glucose(2hPG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)],lipid indexes[total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]of patients in the two groups before and after treatment were compared,the overall treatment effects were assessed and the occurrence of adverse effects during the treatment period were counted in the two groups.Results After 12 weeks of treatment,the primary and secondary symptom scores and total scores of syndrome,weight,WC,BMI,the levels of FPG,HOMA-IR,2hPG,HbAlc,TC,TG,LDL-c and LAP of patients in both groups were significantly lower than those before treatment(all P<0.05),and the these indexes in the observation group were significantly lower than those in the control group(all P<0.05);the HDL-C levels of patients in the two groups were higher than those before tre

关 键 词：2型糖尿病 自拟健脾化湿方 减重 脂质蓄积指数 

分 类 号：R587.1[医药卫生—内分泌]