健脾补肾活血方联合“双C”方案治疗脆性糖尿病的临床研究  

Efficacy of decoction for fortifying spleen,tonifying kidney and activating blood combined with“Double C”regimen on brittle diabetes mellitus

作　　者：魏杰 戎士玲 赵雅茹 袁国栋 张庚良 WEI Jie;RONG Shiling;ZHAO Yaru;YUAN Guodong;ZHANG Gengliang(The First Affiliated Hospital of Hebei University of 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23期3244-3249,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020055);河北中医药防治重大疑难疾病研究项目(2018125580)。

摘　　要：目的观察健脾补肾活血方联合“双C”方案治疗脆性糖尿病患者的临床疗效。方法按随机数字表法,将2022年2月—2024年2月在河北中医药大学第一附属医院内分泌科住院治疗的70例脆性糖尿病患者分为西药组和中西医结合组,每组35例。西药组给予“双C”方案治疗,即在连续动态血糖监测系统(CGMS)下进行胰岛素持续皮下输注(CSII),中西医结合组在西药组治疗基础上给予健脾补肾活血方治疗,2组均治疗2周。比较2组治疗前后中医证候积分、血糖水平[空腹血糖(FPG)、餐后2 h血糖(2hPG)]、血糖波动指标[平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、血糖水平的标准差(SDBG)、血糖的目标范围时间(TIR)、高于目标范围的时间(TAR)、低于目标范围的时间(TBR)]及治疗2周后的临床疗效、治疗期间低血糖发生情况和安全性。结果西药组34例、中西医结合组33例患者完成研究。治疗后2组中医证候积分及FPG、2hPG、MAGE、LAGE、SDBG、TAR、TBR均明显低于治疗前(P均<0.05),且中西医结合组上述指标均明显低于西药组(P均<0.05);治疗后2组TIR均明显高于治疗前(P均<0.05),且中西医结合组明显高于西药组(P<0.05)。中西医结合组治疗总有效率高于西药组[84.8%(28/33)比67.6%(23/34),P<0.05];中西医结合组低血糖发生率明显低于西药组[12.1%(4/33)比29.4%(10/34),P<0.05];2组治疗前后血尿常规、肝肾功能、心电图均未见明显异常。结论健脾补肾活血方联合“双C”方案能明显缓解脆性糖尿病患者的症状,改善血糖波动,降低低血糖发生率,且安全性好。Objective It is to observe the clinical efficacy of decoction for fortifying spleen,tonifying kidney and activating blood combined with“Double C”regimen in the treatment of patients with brittle diabetes mellitus.Methods Seventy patients with brittle diabetes mellitus hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Hebei University of Chinese Medicine from February 2022 to February 2024 were divided into the western medicine group and combination of traditional Chinese medicine and western medicine group(combination group)according to the method of randomized numerical table,with 35 patients in each group.The western medicine group was treated with“Double C”regimen which was continuous subcutaneous insulin infusion(CSII)under continuous glucose monitoring system(CGMS),and the combination group was treated with decoction for fortifying spleen,tonifying kidney and activating blood on the basis of treatment in the western medicine group,both groups were treated for 2 weeks.The scores of traditional Chinese medicine syndrome,blood glucose levels[fasting plasma glucose(FPG),2 h postprandial blood glucose(2hPG)],blood glucose fluctuation indexes[mean amplitude of glycemic excursion(MAGE),largest amplitude of glycemic excursion(LAGE),standard deviations of blood glucose(SDBG),time in range(TIR),time above range(TBR),and time below range(TBR)of blood glucose]in the two groups were compared before and after the treatment,and the clinical efficacy,occurrence of hypoglycemia during treatment and safety after 2 weeks of treatment were compared between the two groups.Results Thirty-four patients in the western medicine group and 33 patients in the combination group completed the study.After treatment,the scores of traditional Chinese medicine and FPG,2hPG,MAGE,LAGE,SDBG,TAR,TBR of the two groups were significantly lower than those before treatment(all P<0.05),and the above indexes of the combination group were significantly lower than those of the western medicine group(all P<0.05);

关 键 词：脆性糖尿病 健脾补肾活血方 双C方案 血糖波动 

分 类 号：R587.1[医药卫生—内分泌]