目的 探討津力達(dá)顆粒聯(lián)合達(dá)格列凈片治療老年2型糖尿病的臨床效果。方法 選取2017年9月-2019年5月內(nèi)蒙古自治區(qū)人民醫(yī)院收治的84例2型糖尿病老年患者，隨機(jī)分成對(duì)照組（42）和治療組（42例）。對(duì)照組晨服達(dá)格列凈片，10 mg/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服津力達(dá)顆粒，1袋/次，3次/d。兩組均連續(xù)治療12周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者體質(zhì)量指數(shù)（BMI）值、外周血中性粒細(xì)胞與淋巴細(xì)胞比值（NLR）、胰島素抵抗（HOMA-IR）值、胰島β細(xì)胞功能（HOMA-β）值及血清糖化血紅蛋白（HbA1c）、空腹血糖（FPG）、餐后2 h血糖（2 h PG）、C反應(yīng)蛋白（CRP）、淀粉樣蛋白A（AA）、丙二醛（MDA）、超氧化物歧化酶（SOD）水平。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為81.0%、95.2%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清HbA1c、FPG和2 h PG水平及BMI值均顯著低于治療前（P<0.05），且治療組下降程度比對(duì)照組更顯著（P<0.05）。治療后，兩組患者外周血NLR值和血清CRP、AA水平均顯著降低（P<0.05），且治療組上述微炎癥標(biāo)志物均顯著低于對(duì)照組（P<0.05）。治療后，兩組患者HOMA-IR值及血清MDA水平較治療前均顯著降低（P<0.05），而HOMA-β值和血清SOD水平均顯著增加（P<0.05），且治療組以上指標(biāo)的改善效果更明顯（P<0.05）。結(jié)論 津力達(dá)顆粒聯(lián)合達(dá)格列凈片治療老年2型糖尿病的整體療效確切，有助于控制血糖，改善機(jī)體微炎癥狀態(tài)，糾正體內(nèi)氧化應(yīng)激，保護(hù)胰島功能。

Objective To investigate the clinical effect of Jinlida Granules combined with dapagliflozin in treatment of elderly type 2 diabetes mellitus. Methods Patients (84 cases) with type 2 diabetes mellitus in Inner Mongolia People's Hospital from September 2017 to May 2019 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Dapagliflozin Tablets in the morning, 10 mg/time, once daily. Patients in the treatment group were po administered with Jinlida Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the living ability, the BMI, NLR of peripheral blood, the value of HOMA-IR and HOMA-β, the serum level of HbA1c, FPG, 2 h PG, CRP, AA, MDA and SOD in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.0% and 95.2%, respectively, and there were differences between two groups (P<0.05). After treatment, the serum level of HbA1c, FPG and 2 h PG, and BMI in two groups were significantly decreased (P<0.05), and the glucose metabolism index and BMI value in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the NLR of peripheral blood, and the serum level of CRP and AA in two groups were significantly decreased (P<0.05), and the micro-inflammatory indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the value of HOMA-IR and the serum level of MDA in two groups were significantly decreased (P<0.05), but the value of HOMA-β and the serum level of SOD were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Jinlida Granules combined with dapagliflozin in treatment of elderly type 2 diabetes mellitus have overall curative effect, which is helpful for controlling the blood glucose, improving micro-inflammatory state, correcting oxidative stress, and protecting of islet function.

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