摘要
目的:观察益气养阴消酮方治疗糖尿病酮症酸中毒的临床疗效。方法:将糖尿病酮症酸中毒患者90例按1∶1随机分为对照组与治疗组各45例,2组均采用扩容、抗炎、纠正水电解质紊乱等基础治疗,对照组采用小剂量胰岛素持续静脉滴注治疗,治疗组在对照组基础上联合益气养阴消酮方治疗,2组均治疗72小时,观察2组患者超敏C反应蛋白、二氧化碳结合力水平、血糖恢复正常时间、尿酮体消失时间及酮症酸中毒纠正时间及临床疗效。结果:2组治疗后倦怠乏力、口燥咽干评分及超敏C反应蛋白、二氧化碳结合力水平较治疗前改善(P<0.05),治疗组改善程度优于对照组(P<0.05);治疗组血糖恢复正常时间、尿酮体消失时间及酸中毒纠正时间均短于对照组(P<0.05);治疗组总有效率为93.3%,高于对照组的80.0%(P<0.05)。结论:在内科常规治疗基础上联合益气养阴消酮方能改善糖尿病酮症酸中毒患者临床症状,较好地控制血糖,加快酮体消失,快速纠正酮症酸中毒。
Objective: To observe clinical effects of Yi Qi YangYin XiaoTong prescription in treating diabetic ketoacidosis(DKA). Methods: All 90 patients were allocated to the control group and the treatment group according to random principles of 1:1, both groups adopted basic therapy of dilatation, anti-inflammation and correcting water and electrolyte disorders, the control group were given intravenous dripping of small dose of insulin continuously,while the treatment group took Yi Qi YangYin XiaoTong prescription based on the therapy that the control group accepted, to observe clinical effects, acidosis correction time, extinction time of urine ketone body, the time of blood glucose returning to normal, carbon dioxide combining power and the levels of CRP between both groups after they were treated for 72 hours. Results: After treating, the scores of lassitude and fatigue, dry mouth and throat, the levels of CRP and carbon dioxide combining power of both groups after treating improved compared with before treating(P<0.05), the treatment group was superior to the control group in the improvement(P<0.05); the treatment group was shorter than the control group in the time of blood glucose returning to normal, extinction time of urine ketone body and acidosis correction time(P <0.05); total effective rate of the treatment group was 93.3%, higher than80.0% of the control group(P<0.05). Conclusion: On the foundation of conventional therapy of internal medicine,Yi Qi YangYin XiaoTong prescription could improve clinical symptoms of the patients suffering diabetic ketoacidosis,control blood glucose better, accelerate the disappearing of ketone body and correct the acidosis rapidly.
引文
[1]刘佳,李丽静,崔一民,等.中药辅助治疗糖尿病酮症酸中毒疗效的系统评价[J].世界中医药,2015,10(6):924-927.
[2]王丽君,宋迎香,叶潇,等.2型糖尿病酮症诱因研究[J].预防医学,2017,29(1):20-22.
[3]吴东,李骥.北京协和医院内科住院医师手册[M].北京:人民卫生出版社,2013:748.
[4]陈灏珠,林果为.实用内科学[M].13版.北京:人民卫生出版社,2009:1059-1064.
[5]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[6]朱琳.健脾益气养阴方治疗糖尿病酮症酸中毒的临床观察[J].中国中医急症,2016,25(7):1412-1414.
[7]范丽萍.糖尿病酮症酸中毒诊治概述[J].辽宁中医药大学学报,2014,16(6):239-241.
[8]陈卫香,郭莉婷,郑运江.糖尿病酮症酸中毒患者血清中炎性细胞因子水平增高的临床意义[J].中国医药指南,2014,12(34):51-53.
[9]罗恩斯,唐亮,李湘.3种不同胰岛素给药方式治疗糖尿病酮症酸中毒的临床疗效比较[J].深圳中西医结合杂志,2017,27(2):143-145.
[10]张婧,刘长山,刘阳,等.黄芪对2型糖尿病大鼠胰岛素抵抗及肾脏损伤的影响[J].临床合理用药杂志,2013,6(10):54-55.
[11]刘竹青,张克良,麻风华.葛根煎剂对糖尿病大鼠降血糖机理的研究[J].中医药信息,2006,23(3):56-58.
[12]李化玲,王鑫,刘有平,等.葛根-黄连药对提取物对α-葡萄糖苷酶活性及大鼠餐后高血糖的抑制作用[J].沈阳药科大学学报,2015,32(12):975-979.
[13]孙佳明,杜延佳,宗颖,等.白芍降血糖和抗氧化的有效部位筛选研究[J].时珍国医国药,2014,25(9):2113-2114.
[14]张爽,曲琰,吴莹,等.盐知母降血糖活性部位作用研究[J].中国医院药学杂志,2016,36(10):791-794.
[15]李成军,陈鹏.当归多糖对STZ诱导的糖尿病大鼠的降血糖作用及其机制[J].齐齐哈尔医学院学报,2007,28(10):1158-1161.
[16]姜信正,战春光,池中求,等.川芎提取物对链脲佐菌素诱导糖尿病模型大鼠血糖的影响[J].山东中医杂志,2011,30(3):194-196.