摘要
目的观察大柴胡汤加减治疗肝胃郁热型2型糖尿病(T2DM)合并高尿酸血症(HUA)的临床疗效。方法前瞻性纳入2019年1月至2020年7月期间中国中医科学院广安门医院南区内分泌科收治的100例肝胃郁热型T2DM合并HUA患者。按照随机数字表法,将其分为2组。治疗组50例在常规西药治疗的基础上加服大柴胡汤,对照组50例予常规西药治疗,2组疗程均为12周。比较2组患者中医证候疗效。比较2组患者治疗前、治疗后12周血尿酸(UA)、血糖[空腹血糖(FBG)、餐后2 h血糖(2 hPG)]、糖化血红蛋白(HbA1c)、血脂谱[甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)]、体重指数(BMI)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)变化。结果治疗组证候改善总有效率为89.6%,明显高于对照组的50.0%,差异有统计学意义(P<0.001)。2组患者治疗前UA、FBG、2 hPG、HbA1c、FINS、HOMA-IR、BMI、TG、TC及LDL-C水平比较,差异无统计学意义(P>0.05)。治疗组患者治疗后12周UA、FBG、2 hPG、HbA1c、FINS、HOMA-IR、TG、TC及LDL-C水平分别为(287.62±46.06)μmol/L、(7.13±0.78)mmol/L、(9.67±0.79)mmol/L、(7.10±0.64)%、(10.74±3.38)mU/L、6.04±1.32、(1.54±0.51)mmol/L、(4.13±0.64)mmol/L、(2.32±0.58)mmol/L,显著低于对照组[(343.51±40.58)μmol/L、(7.86±1.08)mmol/L、(10.49±1.50)mmol/L、(7.83±0.68)%、(12.60±5.39)mU/L、7.84±2.12、(1.89±0.53)mmol/L、(4.68±0.98)mmol/L、(2.89±0.97)mmol/L],差异均有统计学意义(P<0.05)。治疗后12周治疗组BMI较对照组有所下降[(27.34±2.46)kg/m2vs.(28.56±3.39)kg/m2],但差异无计学意义(P>0.05)。结论大柴胡汤加减能有效纠正肝胃郁热型T2DM合并HUA患者的血糖、尿酸、脂代谢紊乱及减轻胰岛素抵抗,明显改善本病患者的临床症状。
Objective To observe the clinical efficacy of modified Dachaihu Decoction in the treatment of type 2 diabetes mellitus(T2DM) with hyperuricemia(HUA). Methods From January 2019 to July 2020,100 patients with T2DM combined with HUA in the Department of Endocrinology,Guanganmen Hospital,China Academy of Chinese Medical Sciences,were prospectively included. According to the random number table method,they were divided into two groups. The treatment group 50 cases were treated with Dachaihu Decoction on the basis of conventional western medicine treatment,and the control group 50 cases were treated with conventional western medicine. Both groups were treated for 12 weeks. The curative effect of TCM syndromes was compared between the two groups. Two groups of patients before treatment,12 weeks after treatment,blood uric acid(UA),blood glucose [fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG) ],glycosylated hemoglobin(HbA1c),blood lipid profile [total cholesterol(TC),Changes in triglycerides(TG) and low-density lipoprotein cholesterol(LDL-C) ],body mass index(BMI),fasting insulin(FINS) and insulin resistance index(HOMA-IR) were compared. Results The total effective rate of syndrome improvement in the treatment group was 89. 6%,which was significantly higher than the 50. 0% in the control group,and the difference was statistically significant(P < 0. 05). There was no significant difference in the levels of UA,FBG,2 hPG,HbA1 c,FINS,HOMA-IR,BMI,TG,TC and LDL-C between the two groups before treatment(P > 0. 05). The levels of UA,FBG,2 hPG,HbA1 c,FINS,HOMA-IR,TG,TC and LDL-C in the treatment group were(287. 62 ± 46. 06) μmol/L,(7. 13 ± 0. 78) mmol/L,(9. 67 ± 0. 79) mmol/L,(7. 10 ±0. 64) %,(10. 74 ± 3. 38) mU/L,6. 04 ± 1. 32,(1. 54 ± 0. 51) mmol/L,(4. 13 ± 0. 64) mmol/L,(2. 32 ± 0. 58) mmol/L,which were significantly lower than those of the control group [(343. 51 ± 40. 58) μmol/L,(7. 86 ± 1. 08) mmol/L,(10. 49 ± 1. 50) mmol/L,(7. 83 ±0. 68) %,(12. 60 ± 5. 39) mU/L,7. 84 ± 2. 12,(1. 89 ± 0. 5
作者
张秋菊
吴瑞
王竹风
秦莉
郭丰年
安然
石白
ZHANG Qiu-ju;WU Rui;WANG Zhu-feng(Department of Endocrinology,South District of Guang'anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 102600,China)
出处
《临床和实验医学杂志》
2021年第5期478-482,共5页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金项目(编号:82004345)
中国中医科学院广安门医院南区院级科研基金(编号:Y2018-07)。
