桑枝颗粒联合达格列净片治疗2型糖尿病的临床研究
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摘要
目的探讨桑枝颗粒联合达格列净片治疗2型糖尿病的临床疗效。方法选取2017年4月—2018年4月在驻马店市中心医院治疗的2型糖尿病患者94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服达格列净片,起始剂量5 mg/次,1次/d,根据血糖可调整剂量至10 mg/次,1次/d;治疗组在对照组基础上口服桑枝颗粒,3 g/次,3次/d。两组均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血糖相关指标、HOMA-β和HOMA-IR及血清学指标。结果治疗后,对照组和治疗组临床有效率分别为82.98%和97.87%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)和胰岛素(FINS)水平均显著降低(P<0.05),且治疗后治疗组这些血糖相关指标明显低于对照组(P<0.05)。治疗后,两组HOMA-β均显著增高(P<0.05),HOMA-IR显著降低(P<0.05),且治疗组HOMA-β和HOMA-IR水平明显好于对照组(P<0.05)。治疗后,两组γ-谷氨酰转肽酶(γ-GT)、血管细胞黏附分子-1(VCAM-1)、单核细胞趋化蛋白-1(MCP-1)水平均显著降低(P<0.05),分泌型卷曲相关蛋白-5(SFRP5)水平显著增加(P<0.05),且治疗组这些血清学指标水平明显优于对照组(P<0.05)。结论桑枝颗粒联合达格列净片治疗2型糖尿病可有效控制患者血糖水平,改善胰岛素抵抗及提高胰岛素敏感性,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus. Methods Patients(94 cases) with type 2 diabetes mellitus in Zhumadian Central Hospital from April 2017 to April 2018 were divided into control(47 cases) and treatment(47 cases) groups according to different treatments. Patients in the control group were po administered with Dapagliflozin Tablets, and the initial dose was 5 mg/time, once daily, then adjusted to 10 mg/time of maximum dose according to blood glucose, once daily. Patients in the treatment group were po administered with Sangzhi Granules on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose related indicators, HOMA-β, HOMA-IR and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.98% and 97.87%, respectively, and there were differences between two groups(P < 0.05). After treatment, the FPG, 2 h PG, HbAlc, and FINS levels in two groups were significantly decreased(P < 0.05), and these blood glucose related indicators in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the HOMA-β in two groups was significantly increased(P < 0.05), but HOMA-IR was significantly decreased(P < 0.05), and the HOMA-β and HOMA-IR levels in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the MCP-1, VCAM-1 and γ-GT levels in two groups were significantly decreased(P < 0.05), but SFRP5 levels was significantly increased(P < 0.05), and these serological indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus can effectively control the blood glucose level, improve the insulin resistance and the insulin sensitivity, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus. Methods Patients(94 cases) with type 2 diabetes mellitus in Zhumadian Central Hospital from April 2017 to April 2018 were divided into control(47 cases) and treatment(47 cases) groups according to different treatments. Patients in the control group were po administered with Dapagliflozin Tablets, and the initial dose was 5 mg/time, once daily, then adjusted to 10 mg/time of maximum dose according to blood glucose, once daily. Patients in the treatment group were po administered with Sangzhi Granules on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose related indicators, HOMA-β, HOMA-IR and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 82.98% and 97.87%, respectively, and there were differences between two groups(P < 0.05). After treatment, the FPG, 2 h PG, HbAlc, and FINS levels in two groups were significantly decreased(P < 0.05), and these blood glucose related indicators in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the HOMA-β in two groups was significantly increased(P < 0.05), but HOMA-IR was significantly decreased(P < 0.05), and the HOMA-β and HOMA-IR levels in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the MCP-1, VCAM-1 and γ-GT levels in two groups were significantly decreased(P < 0.05), but SFRP5 levels was significantly increased(P < 0.05), and these serological indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Sangzhi Granules combined with Dapagliflozin Tablets in treatment of type 2 diabetes mellitus can effectively control the blood glucose level, improve the insulin resistance and the insulin sensitivity, which has a certain clinical application value.
引文
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[10]Lu Y C,Wang C P,Hsu C C,et al.Circulating secreted frizzled-related protein 5(Sfrp5)and wingless-type MMTVintegration site family member5a(Wnt5a)levels in patients with type 2 diabetes mellitus[J].Diabetes Metab Res Rev,2013,29(7):551-556.
[11]隋璐,张锦.VCAM-1在糖尿病患者的动脉粥样硬化动脉上的表达[C].中华医学会第六次全国内分泌学术会议论文汇编.广州:中华医学会,2001.
[2]杨维娜,李冬民,曹三成,等.2型糖尿病各并发症及影响因素的临床分析[J].临床和实验医学杂志,2012,11(8):573-575.
[3]倪倩,封宇飞,裴艺芳,等.达格列净的药理及临床研究概述[J].中国药师,2014,17(11):1947-1949.
[4]张志平.桑枝颗粒联合格列齐特缓释片治疗2型糖尿病的疗效观察[J].中外医学研究,2015,13(11):148-149.
[5]陆再英,钟南山.内科学[M].第7版.北京:人民卫生出版社,2007:652.
[6]乔海平.浅谈2型糖尿病的临床疗效评价标准[J].环球中医药,2012,5(11):825-827.
[7]汪会琴,胡如英,武海滨,等.2型糖尿病报告发病率研究进展[J].浙江预防医学,2016,28(1):37-39,57.
[8]Tone A,Shikata K,Nakagawa K,et al.Renoprotective effects of clarthromycin via reduction of urinary MCP-1levels in type 2 diabetic patients[J].Clin Exp Nephrol,2011,15(1):79-85.
[9]黄景明,徐朝阳,史煜波,等.2型糖尿病肾病患者正五聚蛋白3和超敏C反应蛋白及γ-谷氨酰转移酶的检测及其临床意义[J].中国全科医学,2012,15(33):3845-3847.
[10]Lu Y C,Wang C P,Hsu C C,et al.Circulating secreted frizzled-related protein 5(Sfrp5)and wingless-type MMTVintegration site family member5a(Wnt5a)levels in patients with type 2 diabetes mellitus[J].Diabetes Metab Res Rev,2013,29(7):551-556.
[11]隋璐,张锦.VCAM-1在糖尿病患者的动脉粥样硬化动脉上的表达[C].中华医学会第六次全国内分泌学术会议论文汇编.广州:中华医学会,2001.