大柴胡汤加减联合甘精胰岛素与阿卡波糖治疗肥胖2型糖尿病患者的效果  

Effects of Modified Dachaihu decoction combined with Insulin glargine and Acarbose in treatment of obese patients with type 2 diabetes mellitus

作　　者：杨世江 YANG Shijiang(Department of Endocrine and Metabolic Diseases of Qiandongnan Traditional Chinese Medicine Hospital,Qiandongnan 556000 Guizhou,China)

机构地区：[1]黔东南州中医医院内分泌与代谢病科,贵州黔东南556000

出　　处：《中国民康医学》2025年第4期85-89,共5页Medical Journal of Chinese People’s Health

摘　　要：目的:观察大柴胡汤加减联合甘精胰岛素与阿卡波糖治疗肥胖2型糖尿病(T2DM)患者的效果。方法:回顾性分析2022年12月至2023年12月该院收治的80例肥胖T2DM患者的临床资料,按照治疗方法不同将其分为对照组与观察组各40例。对照组采用甘精胰岛素与阿卡波糖治疗,观察组在对照组基础上联合大柴胡汤加减治疗。比较两组临床疗效,治疗前后血脂指标[高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]水平、胰岛功能[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]水平、中医证候积分(口渴喜饮、少食易饥、腹部膨隆、气短寡言、疲乏无力),以及不良反应发生率。结果:观察组治疗总有效率为97.50%(39/40),高于对照组的80.00%(32/40),差异有统计学意义(P<0.05);治疗后,两组HDL-C水平均高于治疗前,但组间比较,差异无统计学意义(P>0.05);两组TG、TC、LDL-C水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组FPG、2hPG、HbA1c水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组HOMA-β水平均高于治疗前,且观察组高于对照组,两组HOMA-IR、FINS水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组口渴喜饮、少食易饥、腹部膨隆、气短寡言、疲乏无力等中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:大柴胡汤加减联合甘精胰岛素与阿卡波糖治疗肥胖T2DM患者可提高治疗总有效率,改善胰岛功能水平,以及降低糖代谢指标水平、中医证候积分和TG、TC、LDL-C水平,效果优于甘精胰岛素联合阿卡波糖治疗�Objective:To observe effects of modified Dachaihu decoction combined with Insulin glargine and Acarbose in treatment of obese patients with type 2 diabetes mellitus(T2DM).Methods:The clinical data of 80 obese T2DM patients admitted to the hospital from December 2022 to December 2023 were retrospectively analyzed.According to the different treatment methods,they were divided into control group and observation group,40 cases in each group.The control group was treated with Insulin glargine and Acarbose,while the observation group was treated with modified Dachaihu decoction on the basis of that of the control group.The clinical efficacy,the levels of blood lipid indexes[highdensity lipoprotein cholesterol(HDL-C),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)],glucose metabolism indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)]and islet function[fasting insulin(FINS),isletβcell function index(HOMA-β),insulin resistance index(HOMA-IR)],the TCM syndrome scores(thirsty and drinking,less food and rapid hungering,abdominal bulge,shortness of breath and being reticent,fatigue and weakness)before and after the treatment,and the incidence of adverse reactions were compared between the two groups Results:The total effective rate of the observation group was 97.50%(39/40),which was higher than 80.00%(32/40)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the HDL-C levels in both groups were higher than those before the treatment,but there was no statistically significant difference between the groups(P>0.05).The levels of TG,TC and LDL-C in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of FPG,2hPG and HbA1c in the two groups were lower than those before the treatment,those in the observation group were lower than th

关 键 词：2型糖尿病 肥胖 大柴胡汤加减 中医证候积分 糖代谢 胰岛功能 

分 类 号：R587.1[医药卫生—内分泌]