芩连降糖方联合胰岛素治疗2型糖尿病湿热证的临床观察

发布时间：2018-04-22 21:04

本文选题：2 + 型糖尿病　；参考：《华北理工大学》2015年硕士论文

【摘要】：目的观察芩连降糖方联合胰岛素治疗2型糖尿病湿热证患者的疗效,通过比较患者用药前后的症状体征的改变、胰岛素用量的调整、各化验指标的差异,证实芩连降糖方的临床疗效。方法1研究对象本次试验病例选自2013年6月至2014年10月之间华北理工大学附属唐山市中医医院内二门诊的2型糖尿病患者98例,治疗组50例,对照组48例。2研究方法挑选符合纳入标准的湿热证型的2型糖尿病患者,将其随机分为两组,均给予胰岛素诺和灵30R治疗(早晚餐前半小时注射),治疗组在此基础上加用芩连降糖方(早晚餐后半小时,每次200ml),4周为一个疗程,观察3个疗程。3观察指标统计患者年龄、性别、病程、体重指数、空腹血糖、餐后两小时血糖、糖化血红蛋白、血脂四项、血压、胰岛素用量、低血糖次、血糖达标时间、胰岛素达标用量等指标以及中医症状情况,记录不同化验指标的变化,将上述资料应用SPSS 17.0进行统计分析,以获得两组治疗前后的疗效差异。结果1糖化血红蛋白:两组治疗后值低于治疗前,疗后治疗组糖化血红蛋白值低于对照组(P0.05)差异有统计学意义。2空腹血糖:两组治疗后值均低于治疗前值,组间比较疗后第8、12周治疗组空腹血糖值低于对照组(P0.05);餐后两小时血糖:两组治疗后值均低于治疗前值(P0.05),组间比较治疗后第12周治疗组餐后两小时血糖低于对照组(P0.05)。3血脂四项:治疗组疗后血脂四项值均低于治疗前(P0.05);疗后组间比较:治疗组总胆固醇及高密度胆固醇值低于对照组(P0.05)。4体重指数:治疗组疗后体重指数值低于治疗前数值(P0.05),对照组无明显改变;疗后组间比较治疗组体重指数低于对照组(P0.05)。5胰岛素用量:两组治疗后均较治疗前胰岛素用量减少(P0.05);疗后组间比较,在第8及12周治疗组胰岛素用量低于对照组(P0.05)。应用胰岛素达标时间:治疗组时间短于对照组(P0.05);胰岛素达标时用量:治疗组用量低于对照组(P0.05)差异有统计学意义。6低血糖发生次数:治疗组低血糖发生次数低于对照组(P0.05)。7疗后中医疗效比较:治疗组共50人,总有效44人,有效率为88.00%,对照组48人,总有效33人,有效率为68.75%(P0.05)差异有统计学意义。中医单项症候积分比较:疗后治疗组在多食易饥、胸脘腹胀、乏力倦怠、气短懒言、小便黄赤、舌红苔腻、形体肥胖方面优于对照组(P0.05)。8安全性指标检查:两组治疗前后患者在血压、肝功、肾功、血常规方面未见明显异常,未出现不良反应事件发生。结论芩连降糖方联合胰岛素应用,能降低2型糖尿病湿热证患者的糖化血红蛋白、血糖、血脂四项、体重指数的数值,能够改善中医症状;且能够减少低血糖次数的发生、减少胰岛素用量及达标时间,疗效肯定。
[Abstract]:Objective to observe the curative effect of Qinlianjiangtang decoction combined with insulin in treating type 2 diabetes mellitus with damp-heat syndrome, and to compare the changes of symptoms and signs before and after treatment, the adjustment of insulin dosage, and the differences of test indexes. To confirm the clinical effect of Qinlianjiangtang prescription. Methods 1 from June 2013 to October 2014, 98 patients with type 2 diabetes mellitus were selected from Tangshan Hospital of traditional Chinese Medicine affiliated to North China University of Technology. In the control group, 48 cases of type 2 diabetes with damp-heat syndrome were selected and randomly divided into two groups. All of them were treated with insulin novolin 30R (half an hour before breakfast and half an hour before meal). The treatment group was treated with Qilianjiangtang recipe (200ml / min for 4 weeks after half a meal in the morning and evening). Three courses of treatment were observed and the age of the patients was counted. Gender, course of disease, body mass index, fasting blood glucose, two hours postprandial blood glucose, glycosylated hemoglobin, four items of blood lipid, blood pressure, insulin dosage, hypoglycemia, blood glucose standard time, insulin standard dosage, and TCM symptoms, etc. The changes of different test indexes were recorded and the above data were statistically analyzed with SPSS 17.0 in order to obtain the difference of curative effect between the two groups before and after treatment. Results (1) glycosylated hemoglobin: the value of glycosylated hemoglobin in the treatment group was lower than that in the control group (P 0.05). The fasting blood glucose level in the treatment group was lower than that in the control group at week 8 and 12 after treatment, and the two hours postprandial blood glucose in the treatment group was lower than that in the control group (P 0.05). The blood glucose in the treatment group was lower than that in the control group at the 12th week after treatment, and that in the treatment group was lower than that in the control group at the 12th week after treatment. Four items of blood lipids: after treatment, the blood lipid levels in the treatment group were lower than those in the pre-treatment group, and the comparison between the treatment groups: the total cholesterol and high density cholesterol values in the treatment group were lower than those in the control group (P 0.050.4. body mass index): the body weight index value of the treatment group was lower than that of the treatment group after treatment. There was no significant change in the former value of P0.05A in the control group. Body mass index (BMI) of the treatment group was lower than that of the control group (P 0.05). The insulin dosage of the treatment group was lower than that of the control group (P 0.05) after treatment, and that of the treatment group was lower than that of the control group (P 0.05) at the 8th and 12th week after treatment. The time of using insulin to reach the standard: the time of treatment group was shorter than that of control group (P 0.05); the dosage of insulin in treatment group was lower than that of control group (P 0.05). There was significant difference in the frequency of hypoglycemia: the frequency of hypoglycemia in treatment group was lower than that in control group. Comparison of the efficacy of traditional Chinese Medicine (TCM) after treatment in the control group P0.057.The treatment group consisted of 50 patients, The total effective rate was 88.00, the control group was 48, the total effective rate was 33, and the effective rate was 68.75 (P 0.05). Comparison of TCM single symptom score: after treatment, the treatment group is prone to hunger, abdominal distension, fatigue, shortness of breath, yellow red urination, red tongue fur and greasy tongue, The safety index of body obesity was better than that of control group (P 0.05.8): there was no obvious abnormality in blood pressure, liver function, renal function and blood routine before and after treatment, and no adverse events occurred in the two groups. Conclusion Qinlianjiangtang prescription combined with insulin can reduce the levels of glycosylated hemoglobin, blood glucose, blood lipid, body mass index, and reduce the frequency of hypoglycemia in patients with type 2 diabetes mellitus. Reducing the dosage of insulin and meeting the standard time, the curative effect is positive.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R259

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