芪蛭降糖胶囊联合西格列汀治疗2型糖尿病的临床研究
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摘要
目的探讨芪蛭降糖胶囊联合西格列汀治疗2型糖尿病的临床效果。方法选取2016年6月—2018年6月廊坊市人民医院收治的2型糖尿病患者126例,随机分成对照组(63例)和治疗组(63例)。对照组口服磷酸西格列汀片,1片/次,1次/d。治疗组在对照组基础上口服芪蛭降糖胶囊,2.5 g/次,3次/d。两组患者均连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者症状积分、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)/高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(Apo)-CⅢ/Apo-CⅡ比值及胰岛功能相关参数。结果治疗后,对照组和治疗组临床有效率分别为81.0%和93.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者症状积分均显著降低(P<0.05),且治疗组患者上述症状积分明显低于对照组(P<0.05)。治疗后,两组血浆FPG、HbA1c水平及血清TG/HDL-C、Apo-CⅢ/Apo-CⅡ比值均显著下降(P<0.05),且治疗组患者这些指标水平明显低于对照组(P<0.05)。治疗后,两组患者血浆空腹胰岛素(FINS)、C肽(C-P)、胰高血糖素(GC)浓度和胰岛素抵抗指数(HOMA-IR)值较治疗前均显著下降(P<0.05),胰岛β细胞功能指数(HOMA-β)值均显著升高(P<0.05),且治疗组患者上述胰岛功能相关参数水平明显好于对照组(P<0.05)。结论芪蛭降糖胶囊联合西格列汀治疗2型糖尿病能有效减轻患者症状,平稳控制血糖,调节血脂,改善胰岛功能,降低胰岛素抵抗。
Objective To investigate the clinical effects of Qizhi Jiangtang Capsules combined with sitagliptin in treatment of type 2 diabetes mellitus. Methods Patients(126 cases) with type 2 diabetes mellitus in the People's Hospital of Langfang City from June2016 to June 2018 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were po administered with Sitagliptin Phosphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Qizhi Jiangtang Capsules on the basis of the control group, 2.5 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the symptom scores, FPG, HbA1c, TG/HDL-C, Apo-CIII/Apo-CII, the related parameters of islet function in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.0% and 93.7% respectively, and there were differences between two groups(P < 0.05). After treatment, the symptom scores in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the plasma levels of FPG and HbA1c,TG/HDL-C and Apo-CⅢ/Apo-CⅡ in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the plasma concentration of FINS, C-P and GC, and HOMA-IR value in two groups were significantly decreased(P < 0.05), but HOMA-β value was significantly increased(P < 0.05), and the related parameters of islet function in the treatment group were significantly better than those in the control group(P < 0.05).Conclusion Qizhi Jiangtang Capsules combined with sitagliptin in treatment of type 2 diabetes mellitus can effectively alleviate the symptoms, control blood sugar smoothly, regulate blood lipids, improve islet function and reduce insulin resistance.
Objective To investigate the clinical effects of Qizhi Jiangtang Capsules combined with sitagliptin in treatment of type 2 diabetes mellitus. Methods Patients(126 cases) with type 2 diabetes mellitus in the People's Hospital of Langfang City from June2016 to June 2018 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were po administered with Sitagliptin Phosphate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Qizhi Jiangtang Capsules on the basis of the control group, 2.5 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the symptom scores, FPG, HbA1c, TG/HDL-C, Apo-CIII/Apo-CII, the related parameters of islet function in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.0% and 93.7% respectively, and there were differences between two groups(P < 0.05). After treatment, the symptom scores in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the plasma levels of FPG and HbA1c,TG/HDL-C and Apo-CⅢ/Apo-CⅡ in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the plasma concentration of FINS, C-P and GC, and HOMA-IR value in two groups were significantly decreased(P < 0.05), but HOMA-β value was significantly increased(P < 0.05), and the related parameters of islet function in the treatment group were significantly better than those in the control group(P < 0.05).Conclusion Qizhi Jiangtang Capsules combined with sitagliptin in treatment of type 2 diabetes mellitus can effectively alleviate the symptoms, control blood sugar smoothly, regulate blood lipids, improve islet function and reduce insulin resistance.
引文
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[14]周玉荣,肖健青.2型糖尿病患者血清胰岛素及C肽水平变化的临床研究[J].检验医学与临床,2013,10(18):2413-2415.
[15]刘艳杰,张丽侠,袁进磊,等.胰高血糖素与2型糖尿病的相关性研究[J].医学研究杂志,2016,45(5):148-151.
[16]王占科,余锟生.2型糖尿病患者和高血脂肥胖人群HOMA模型胰岛素抵抗指数和胰岛素分泌指数变化及临床意义[J].中国临床实验室,2002,1(2):16-17.
[2]潘长玉.2型糖尿病血糖控制的意义及实践[J].国际内分泌代谢杂志,2005,19(1):4-5.
[3]陈鑫,张菁.西格列汀在糖尿病治疗中的药理作用及临床评价[J].中国医药,2018,13(3):467-470.
[4]中国药典[S].一部.2015:925-926.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:233-236.
[7]李雪贝,张良,冷远景,等.当代2型糖尿病临床治疗药物的研究进展[J].中国医院药学杂志,2016,36(20):1824-1828.
[8]李寅辉,李凯利,刘浩.西格列汀治疗2型糖尿病药理作用的Meta分析[J].循证医学,2015,15(3):149-154.
[9]张琪琛,张洪钧,周冬卉,等.2型糖尿病中医病因病机探讨[J].国际中医中药杂志,2016,38(1):9-12.
[10]张晓天,陈禹,于春江,等.芪蛭降糖胶囊对糖尿病大鼠胰岛素抵抗的作用及其机制[J].吉林大学学报:医学版,2014,40(4):805-811.
[11]陈璐,孙伯欣.糖化血红蛋白与血脂检测在2型糖尿病检测中的临床评价[J].中国老年学,2013,33(19):4856-4857.
[12]张琦,马红.血脂及血尿酸在2型糖尿病患者中的临床意义[J].中国药物与临床,2013,13(z1):69-70.
[13]靳瑾,苟静,李晓岚,等.2型糖尿病患者胰高血糖素及胰岛素水平检测及临床意义[J].现代生物医学进展,2016,16(22):4381-4383,4351.
[14]周玉荣,肖健青.2型糖尿病患者血清胰岛素及C肽水平变化的临床研究[J].检验医学与临床,2013,10(18):2413-2415.
[15]刘艳杰,张丽侠,袁进磊,等.胰高血糖素与2型糖尿病的相关性研究[J].医学研究杂志,2016,45(5):148-151.
[16]王占科,余锟生.2型糖尿病患者和高血脂肥胖人群HOMA模型胰岛素抵抗指数和胰岛素分泌指数变化及临床意义[J].中国临床实验室,2002,1(2):16-17.