清热利湿健脾降糖方联合穴位...病湿热困脾证患者的疗效观察_张娟.pdf

世界中西医结合杂志 2023 年第 18 卷第 1 期World Journal of Integrated Traditional and Western Medicine2023，Vol.18，No.1临床研究DOI:10 13935/j cnki sjzx 230115基金项目:陕西省社会发展科技项目(2017SF157)作者单位:空军军医大学第一附属医院综合诊疗科，陕西 西安 710032通信作者:潘静，Email:canna651269388163 com清热利湿健脾降糖方联合穴位埋线治疗肥胖型 2 型糖尿病湿热困脾证患者的疗效观察张娟杨丽平潘静【摘要】目的探讨清热利湿健脾降糖方联合穴位埋线治疗肥胖型 2 型糖尿病(Type 2 diabetes，T2DM)湿热困脾证的临床价值。方法选取 2020 年 1 月2021 年 10 月期间空军军医大学第一附属医院收治的肥胖型T2DM 湿热困脾证患者 88 例，采用随机数字表法分为对照组与试验组，每组各 44 例。两组患者均开展 T2DM 基础治疗，在此基础上，对照组给予盐酸二甲双胍治疗，试验组给予盐酸二甲双胍+中医特色疗法(清热利湿健脾降糖方、穴位埋线)。治疗 12 周后，观察比较两组患者治疗前后中医证候积分、血糖指标空腹血糖(Fasting plasmaglucose，FPG)、餐后 2 h 血糖(Blood glucose 2 h after meal，2 h PG)、糖化血红蛋白(Glycosylated hemoglobin，HbAlc)、血脂指标 高密度脂蛋白(High density lipoprotein，HDL)、低密度脂蛋白(Low density lipoprotein，LDL)、甘油三酯(Triglyceride，TG)、总胆固醇(Total cholesterol，TC)、肥胖指数 体质量指数(Body mass index，BMI)、腰臀比(Waist hip ratio，WH)、生活质量评分(Adjusted diabetes specific quality of life scale，A DQOL)变化及中医证候疗效、治疗安全性。结果(1)中医证候积分:治疗后两组患者中医证候积分均较治疗前降低，差异有统计学意义(P 0 05);且试验组中医证候积分均低于对照组，差异有统计学意义(P 0 05);(2)中医证候疗效:治疗后试验组中医证候总有效率92 86%(39/42)高于对照组64 29%(27/42)，差异有统计学意义(P 0 05);(3)血糖水平:治疗后两组患者血糖 FPG、2 h PG、HbAlc 水平均较治疗前降低，差异有统计学意义(P 0 05);且试验组血糖FPG、2 h PG、HbAlc 水平均低于对照组，差异有统计学意义(P 0 05);(4)血脂水平:治疗后两组患者血脂 HDL C、LDL C、TG、TC 水平均较治疗前改善，差异有统计学意义(P 0 05);且试验组血脂 HDL C、LDL C、TG、TC水平改善均优于对照组，差异有统计学意义(P 0 05);(5)肥胖指数:治疗后两组患者肥胖指数 BMI、WH 均较治疗前降低，差异有统计学意义(P 0 05);且试验组肥胖指数 BMI、WH 均低于对照组，差异有统计学意义(P 0 05);(6)生活质量:治疗后两组患者生活质量 A DQOL 评分均较治疗前降低，差异有统计学意义(P 0 05);且试验组生活质量 A DQOL 评分均低于对照组，差异有统计学意义(P 0 05);(7)安全性:试验组不良反应发生率 11 90%(5/42)与对照组 9 52%(4/42)比较，差异无统计学意义(P 0 05)。结论清热利湿健脾降糖方联合穴位埋线治疗肥胖型 T2DM 湿热困脾证安全、有效，有利于控制血糖、血脂水平，改善患者肥胖指数及生活质量。【关键词】肥胖型 2 型糖尿病;湿热困脾证;清热利湿健脾降糖方;穴位埋线;血糖控制;肥胖指数;生活质量【中图分类号】781 6+4;245 9+1【文献标识码】AClinical Observation of Qingre Lishi Jianpi Jiangtang ecipe Combined with Acu-point Catgut Embedding in the Treatment of Obese Type 2 Diabetes with DampnessHeat Disturbing SpleenZHANG Juan，YANG Li ping，PAN Jing(Department of Comprehensive Diagnosis and Treatment of the First Affiliated Hospital of Air Force Military Medical Uni-versity，Xian Shaanxi 710032)【Abstract】ObjectiveTo investigate the clinical value of Qingre Lishi Jianpi Jiangtang ecipe combined withacupoint catgut embedding in the treatment of obese type 2 diabetes with dampness heat disturbing spleen MethodsA89世界中西医结合杂志 2023 年第 18 卷第 1 期World Journal of Integrated Traditional and Western Medicine2023，Vol.18，No.1total of 88 patients with obese type 2 diabetes(dampness heat disturbing spleen)treated in the First Affiliated Hospital ofAir Force Military Medical University from January 2020 to October 2021 were selected and divided into a control groupand an experimental group by random number table，with 44 in each group Both groups were given basic treatmentfortype 2diabetes On this basis，the control group received metformin hydrochloride，while the experimental group received metform-in hydrochloride+traditional Chinese medicine(TCM)therapy(Qingre Lishi Jianpi Jiangtang ecipe combined with acu-point catgut embedding)After 12 weeks of treatment，the changes in theTCM syndrome score，blood glucose indexes fast-ing plasma glucose(FPG)，2 h postprandial glucose(2 h PG)，glycated hemoglobin(HbAlc)，blood lipid indexes high density lipoprotein cholesterol(HDL C)，low density lipoprotein cholesterol(LDL C)，triglyceride(TG)，total choles-terol(TC)，obesity indexes body mass index(BMI)，waist to hip ratio(WH)，adjusted diabetes specific qualityof life scale(A DQOLS)score in the two groups before and after treatment as well as the TCM syndrome efficacy andtreatment safety were observed and compared esultsAfter treatment，the TCM syndrome scores，blood glucose levels(FPG，2h PG and HbAlc)，obesity indexes(BMI and WH)，and A DQOLS scorein both groups were decreased com-pared with those before treatment(all P 0 05)，and the experimental group had more decrease than the control group(P0 05)The total effective rate of TCM syndromes in the experimental group was 92 86%(39/42)higher than 64 29%(27/42)in the control group(P 0 05)The blood lipid levels(HDL C，LDL C，TG，TC)in the two groups after treat-ment were improved compared with those before treatment(P 0 05)，and the experimental group had more improvementthan the control group(P 0 05)In terms of treatment safety，there was no significant difference in the incidence of ad-verse reactions between the experimental group 11 90%，(5/42)and the control group 9 52%，(4/42)during treat-ment(P 0 05)ConclusionQingre Lishi Jianpi Jiangtang ecipe combined with acupoint catgut embedding is safe andeffective in the treatment of obese type 2 diabetes with dampness heat disturbing spleen It is beneficial to control bloodsugar and blood lipid and improves the obesity index and quality of life of patients【Keywords】Obese type 2 diabetes;Dampness heat disturbing spleen;Qingre Lishi Jianpi Jiangtang ecipe;Acu-point catgut embedding;Glycemic control;Obesity index;Quality of life2 型糖尿病(Type 2 diabetes mellitus，T2DM)是一种较为常见的代谢性疾病，近年发病率随生活方式、饮食习惯改变及人口老龄化加剧等因素呈明显上升趋势1。数据显示，超过 80%的 T2