通腑润燥方治疗口服降糖药物控制不佳的胃肠实热型2型糖尿病60例

Tongfu Runzao Decoction in the Treatment of Oral Hypoglycemic Drugs in Uncontrolled Stomach-intestine Excessive Heat Type 2 Diabetes 60 Cases

摘要:

目的: 探讨通腑润燥方治疗口服降糖药物控制不佳的胃肠实热型2型糖尿病(T2 DM)的临床疗效。方法: 将120例口服降糖药物控制不佳的胃肠实热型T2 DM随机分为对照组和观察组各60例。两组均采用重组甘精胰岛素治疗,观察组加服通腑润燥方,疗程为8周。监测治疗后空腹血糖(FBG)、餐后2 h血糖(2 hPG);检测治疗前后糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)及血脂;记录血糖达标时间,记录每周重组甘精胰岛素使用量,记录低血糖发生人次及记录胃肠实热证评分。结果: 观察组2 hPG、HbA1c及FINS水平低于对照组(P<0.05);两组胰岛素敏感指数(ISI)均升高,观察组上升更为显著(P<0.01);观察组BMI、体重及腰围改善均明显优于对照组(P<0.05);治疗后第4、6、8周,观察组重组甘精胰岛素使用量均低于对照组(P<0.01);观察组平均血糖达标时间(14.2±2.48) d少于对照组的(17.8±2.79) d (P<0.01);观察组低血糖发生率及平均发生人次均少于对照组(P<0.01);治疗后观察组TG,TC,LDL-C水平低于对照组,HDL-C高于对照组(P<0.05);治疗后观察组口渴喜冷饮、脘腹痞满及大便硬结等主要症状评分均低于对照组(P<0.01)。结论: 通腑润燥方能降低口服降糖药物控制不佳的T2 DM的2 hPG,HbA1c,促使患者血糖达标,能减少胰岛素的使用量,降低胰岛素所致低血糖发生率,还能有效改善患者临床症状,提高生活质量。

Abstract:

Objective: Discuss the clinical efficacy of Tongfu Runzao decoction of oral antidiabetic drugs in poorly controlled gastrointestinal-heat type 2 diabetes(T2 DM). Method: Divide the 120 cases of oral hypoglycemic drugs poorly controlled type gastrointestinal excess heat T2 DM into control group and observation group randomly,each group has 60 cases. Both groups were treated with recombinant insulin glargine,observation group took Relaxing moistening party additionally,therapy for eight weeks.Monitor fasting blood glucose after treatment.2 h postprandial blood glucose(2 hPG);test glycosylated hemoglobin before and after treatment,fasting insulin (FINS) and blood lipids;record the time of blood glucose,record usage of recombinant insulin glargine per week,record hypoglycemia occurred and gastrointestinal excess heat syndrome score. Result: The 2 hPG,HbA1c and FINS of the observation group is lower than the control group (P<0.05). The ISI of two groups both increased, while the significant increasing occurred in the observation group (P<0.01). Compared to the control group, the improvements of weight and waist circumference were all more obvious (P<0.05). During the 4, 6, 8 weeks after the treatment, the dose of recombinant insulin glargine of the observation group was all inferior to that of the control group (P<0.01). The average time (14.2±2.48) d of recovering blood glucose of the observation group was less than the time (17.8±2.79) d of the control group (P<0.01). The incidence of hypoglycemia and average people-time were both lower than the control group (P<0.01). Besides, after the treatment, the TG, TC and LDL-C level were lower than the control group excepting the HDL-C level higher than that of control group (P<0.05). The scores of the main symptoms (such as thirsty, like of cold drinks, distention and fullness and stool induration) were lower than control group (P<0.01). Conclusion: The Tongfu Runzao decoction can reduce the 2 hPG, HbA1c in the T2 DM, which could be controlled well by oral antidiabetic drugs, prompting the blood glucose of patients reaching the standard level. It can also decrease the usage of insulin, reducing the incidence of hypoglycemia caused by insulin. Can effectively improve the clinical symptoms, improve patient quality of life.