健脾祛湿方联合盐酸二甲双胍片治疗肥胖型2型糖尿病临床观察
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R587.1

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湖州市科学技术项目(2015GY22)


ClinicalObservation ofJianpiQushiPrescription Combined with Metformin Hydrochloride Tablets for Obese Type 2 Diabetes Mellitus
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    摘要:

    目的:观察健脾祛湿方联合盐酸二甲双胍片治疗肥胖型2型糖尿病(T2DM)的临床疗效,及对患者血脂、血糖、胰岛功能相关指标的影响。方法:将80例肥胖型T2DM患者随机分为对照组和治疗组各40例。对照组予口服盐酸二甲双胍片治疗,治疗组在对照组的用药基础上加服健脾祛湿方。观察2组治疗前后临床症状及血脂、血糖、胰岛功能相关指标的改善情况,比较2组临床疗效。结果:对照组总有效率62.5%,治疗组总有效率87.5%,2组比较,差异有统计学意义(P<0.05)。治疗后,治疗组口渴喜饮、多食易饥、小便频多、倦怠乏力、气短懒言、头身困重、肢体麻木积分均较治疗前降低(P<0.05);且均低于对照组同期(P<0.05)。治疗后,2组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平及体质量指数(BMI)均较治疗前降低(P<0.05),高密度脂蛋白胆固醇(HDL-C) 水平均较治疗前升高(P<0.05);治疗组TC、TG水平及BMI均低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。治疗后,2组糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS) 水平及HOMA-IR值均较治疗前降低(P<0.05);治疗组HbA1c、FBG、P2hBG、FINS水平及HOMA-IR值均低于对照组(P<0.05)。治疗后,2组葡萄糖依赖性促胰岛素分泌多肽(GIP) 和胰升糖素样多肽-1(GLP-1) 水平均较治疗前升高(P<0.05);治疗组GIP、GLP-1水平均高于对照组(P<0.05)。结论:健脾祛湿方联合盐酸二甲双胍片能有效改善肥胖型T2DM患者的临床症状,降低血糖指标,改善血脂情况,促进肠促胰素GIP和GLP-1的生成。

    Abstract:

    Objective:To observe the clinical effect of Jianpi Qushi prescription combined with metformin hydrochloride tablets for obese type 2 diabetes mellitus(T2DM)as well as its effect onserum lipids,blood glucose and islet function of patients.Methods:Divided 80 cases of patients with obese T2DM into the control group and the treatment group randomly,40 cases in each group.Both groups were given metformin hydrochloride tablets for treatment,while the treatment group additionally receivedJianpi Qushi prescription.Observed improvements of clinical symptoms,serum lipids,blood glucose,and islet function before and after treatment.Compared the clinical effect of both groups.Results:The total effective rate was 62.5%in the control group and was 87.5% in the treatment group,the difference being significant(P<0.05).Aftertreatment,scores of thirst,polyorexia,frequent urination and polyuria,languid shortness of breath with a disinclination to talk,heaviness in head and body,and limb numbness in treatment group were all decreased when compared with those before treatment(P<0.05).The above 7 Chinese medicine syndrome scores in the treatment group were lower than those in the control group(P <0.05).After treatment, levels of total cholesterol(TC), triglycerides(TG)and low density lipoprotein cholesterol(LDL-C)as well as body mass index(BMI)were decreased when compared with those before treatment(P<0.05).Levels of high density lipoprotein cholesterol(HDL-C)were increased when compared with those before treatment(P<0.05).Levels of TC and TG as well as BMI in the treatment group were lower than those in the control group(P<0.05).HDL-C levels in the treatment group were higher than those in the control group(P<0.05).After treatment,levels of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FBG),postprandial 2h plasma glucose(P2hBG)and fasting insulin(FINS)as well as Homeostasis model assessment-insulin resistance(HOMA-IR)values in both groups were decreased when compared with those before treatment(P<0.05).Levels of HbA1c,FPG,P2hBG and FINS as well as HOMA-IR values in the treatment group were all lower than those in the control group(P<0.05).After treatment,levels of glucose-dependent insulinotropic poly peptide(GIP)and glucagon-like peptide-1(GLP-1)in both groups were increased when compared with those before treatment(P<0.05).Levels of GIP and GLP-1 in the treatment group were both higher than those in the control group(P<0.05).Conclusion:The therapy of Jianpi Qushi prescription combined with metformin hydrochloride tablets can effectively improve the clinical symptoms of patients with obese T2DM,which has significant effect on decreasing blood glucose indexes,improving serum lipids and promoting the formation of incretin GIP and GLP-1.

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陶静怡,李敏,胡利江,杨颖.健脾祛湿方联合盐酸二甲双胍片治疗肥胖型2型糖尿病临床观察[J].新中医,2018,50(1):53-56

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  • 在线发布日期: 2018-01-05
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