生脉散合六味地黄汤治疗气阴两虚型2型糖尿病临床研究
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摘要
目的:研究生脉散合六味地黄汤治疗气阴两虚型2型糖尿病患者的临床疗效。方法:将160例患者按抽签方法随机分为2组各80例,对照组服用西药治疗,观察组在对照组治疗方案的基础上加服生脉散合六味地黄汤治疗,均治疗4周后比较2组临床疗效,治疗前后中医证候积分、体质量指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、餐后2 h胰岛素及糖化血红蛋白(HbA1c)水平、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平及不良反应发生率。结果:临床疗效总有效率观察组90.0%,高于对照组75.0%(P <0.05);治疗后,2组证候积分均较治疗前下降,且观察组明显低于对照组,差异均有统计学意义(P <0.05);治疗后,2组FBG、P2hBG、HbA1c、BMI、HOMA-IR、TG、TC、LDL-C水平均较治疗前降低,2组FINS、餐后2 h胰岛素、HOMA-β、HDL-C水平均较治疗前升高,且观察组与对照组比较,差异均有统计学意义(P <0.05);2组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:生脉散合六味地黄汤治疗气阴两虚型2型糖尿病可显著提高疗效,降低血糖水平,改善胰岛功能及脂质代谢紊乱,从而改善患者的临床症状,且无明显副作用。
Objective: To study the clinical effect of Shengmai powder and Liuwei Dihuang tang for type 2 diabetes of qi-yin deficiency type. Methods:Divided 160 cases of patients into two groups by random draw,90 cases in each group. The control group received the oral administration of western medicine,while the observation group additionally received the oral administration of Shengmai powder and Liuwei Dihuang tang. The treatment of both groups lasted for 4 weeks. Observed the clinical effect in both groups, and compared Chinese medicine syndrome scores, body mass index(BMI), the levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(P2 hBG),fasting insulin(FINS),2-hour postprandial insulin and hemoglobin A1 c(HbA1 c),the levels of homeostatic model assessment for insulin resistance(HOMA-IR),homeostatic model assessment for β cell function(HOMA-β),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C) and the incidence of adverse reactions in both groups before and after treatment. Results: The clinical total effective rate was 90.0% in the observation group, being higher than 75.0% in the control group(P < 0.05). After treatment, Chinese medicine syndrome scores in both groups were lower than those before treatment,and Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group,differences being significant(P < 0.05). After treatment,the levels of FBG,P2 hBG,HbA1 c,BMI,HOMA-IR,TG,TC and LDL-C in both groups were respectively lower than those before treatment,and the levels of FINS,2-hour postprandial insulin,HOMA-β and HOMA-IR in both groups were respectively higher than those before treatment;comparing each index above in-between the two groups, there were significant differences being found(P < 0.05). Comparing the incidence of adverse reactions in-between the two groups, there was no significant difference being found(P > 0.05). Conclusion:Shengmai powder and Liuwei Dihuang tang for type 2 diabetes of qi-yin deficiency type can significantly promote the clinical effect, decrease the level of blood glucose and improve islet function and lipid metabolism disorder, thus to improve the clinical symptoms of patients without obvious side effects.
Objective: To study the clinical effect of Shengmai powder and Liuwei Dihuang tang for type 2 diabetes of qi-yin deficiency type. Methods:Divided 160 cases of patients into two groups by random draw,90 cases in each group. The control group received the oral administration of western medicine,while the observation group additionally received the oral administration of Shengmai powder and Liuwei Dihuang tang. The treatment of both groups lasted for 4 weeks. Observed the clinical effect in both groups, and compared Chinese medicine syndrome scores, body mass index(BMI), the levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(P2 hBG),fasting insulin(FINS),2-hour postprandial insulin and hemoglobin A1 c(HbA1 c),the levels of homeostatic model assessment for insulin resistance(HOMA-IR),homeostatic model assessment for β cell function(HOMA-β),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C) and the incidence of adverse reactions in both groups before and after treatment. Results: The clinical total effective rate was 90.0% in the observation group, being higher than 75.0% in the control group(P < 0.05). After treatment, Chinese medicine syndrome scores in both groups were lower than those before treatment,and Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group,differences being significant(P < 0.05). After treatment,the levels of FBG,P2 hBG,HbA1 c,BMI,HOMA-IR,TG,TC and LDL-C in both groups were respectively lower than those before treatment,and the levels of FINS,2-hour postprandial insulin,HOMA-β and HOMA-IR in both groups were respectively higher than those before treatment;comparing each index above in-between the two groups, there were significant differences being found(P < 0.05). Comparing the incidence of adverse reactions in-between the two groups, there was no significant difference being found(P > 0.05). Conclusion:Shengmai powder and Liuwei Dihuang tang for type 2 diabetes of qi-yin deficiency type can significantly promote the clinical effect, decrease the level of blood glucose and improve islet function and lipid metabolism disorder, thus to improve the clinical symptoms of patients without obvious side effects.
引文
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[9]程雯,刘志丹,王华,等.中西医结合治疗气阴两虚型糖尿病肾病的临床疗效观察[J].中华中医药学刊,2016,34(8):2013-2015.
[10]殷佳,潘晔,王朔,等.基于中医传承辅助平台分析糖尿病气阴两虚证的用药规律[J].天津中医药,2017,34(10):659-663.
[11]姜维娜,马尧.白虎加人参汤加减联合西药治疗对气阴两虚型糖尿病患者生命质量与心理健康的影响[J].世界中医药,2018,13(2):374-377.
[12]王辉.参芪地黄汤联合厄贝沙坦片治疗气阴两虚型糖尿病肾病患者的临床观察[J].中国中西医结合肾病杂志,2016,17(9):794-796.
[2]张颖.中西医结合治疗气阴两虚血瘀型2型糖尿病60例疗效观察[J].世界中西医结合杂志,2016,11(3):392-394.
[3]刘树林,朱章志,万晓刚,等.中西医结合治疗2型糖尿病气阴两虚证临床观察[J].中医学报,2016,31(12):1897-1899.
[4]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].中国糖尿病杂志,2014,30(8):893-942.
[5]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,2002:156-162.
[6]周玉刚,田大虎,门超.干姜黄芩黄连人参汤治疗气阴两虚2型糖尿病临床观察[J].陕西中医,2017,38(5):568-569.
[7]任蕾.早期胰岛素治疗2型糖尿病疗效分析[J].中国煤炭工业医学杂志,2014,17(2):270-271.
[8]郑少林,李红.2型糖尿病的中医辨证论治现状[J].四川中医,2014,32(2):171-172.
[9]程雯,刘志丹,王华,等.中西医结合治疗气阴两虚型糖尿病肾病的临床疗效观察[J].中华中医药学刊,2016,34(8):2013-2015.
[10]殷佳,潘晔,王朔,等.基于中医传承辅助平台分析糖尿病气阴两虚证的用药规律[J].天津中医药,2017,34(10):659-663.
[11]姜维娜,马尧.白虎加人参汤加减联合西药治疗对气阴两虚型糖尿病患者生命质量与心理健康的影响[J].世界中医药,2018,13(2):374-377.
[12]王辉.参芪地黄汤联合厄贝沙坦片治疗气阴两虚型糖尿病肾病患者的临床观察[J].中国中西医结合肾病杂志,2016,17(9):794-796.