目的 探討消渴清顆粒聯(lián)合恩格列凈治療2型糖尿病的臨床療效。方法 選取2019年7月-2020年7月商丘市第三人民醫(yī)院收治的150例2型糖尿病患者為研究對象，根據(jù)用入院號的奇偶數(shù)分成對照組（75例）和治療組（75例）。對照組口服恩格列凈片，10 mg/次，1次/d；治療組在對照組治療基礎上口服消渴清顆粒，6 g/次，3次/d。兩組均經(jīng)8周治療后進行效果評價。觀察兩組的臨床療效，比較兩組治療前后血糖相關指標、血糖波動指標和血清學因子的變化情況。結(jié)果 經(jīng)治療，治療組的總有效率為98.67%，明顯高于對照組（82.67%，P<0.05）。經(jīng)治療，治療組空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbAlc）、胰島素（FINS）水平均較治療前顯著降低（P<0.05）；治療后，治療組血糖相關指標低于對照組（P<0.05）。經(jīng)治療，兩組HOMA-β均增高，而HOMA-IR均降低（P<0.05）；治療后，治療組HOMA-β高于對照組，而HOMA-IR低于對照組（P<0.05）。經(jīng)治療，兩組患者血糖標準差（SDBG）、平均血糖波動幅度（MAGE）、24 h血糖波動次數(shù)（NGE）及24 h血糖平均絕對差（MODD）均較治療前顯著降低（P<0.05）；且治療后，治療組血糖波動指標顯著低于對照組（P<0.05）。經(jīng)治療，兩組血清趨化素、生長分化因子-15（GDF-15）、單核細胞趨化蛋白-1（MCP-1）、淀粉樣蛋白A（SAA）水平均顯著降低，但1-磷酸鞘氨醇（SIP）顯著升高（P<0.05）；治療后，治療組趨化素、GDF-15、MCP-1、SAA水平低于對照組，而SIP高于對照組（P<0.05）。結(jié)論 消渴清顆粒聯(lián)合恩格列凈治療2型糖尿病患者具有較好的臨床療效，可有效降低患者血糖水平，改善機體趨化素、GDF-15、MCP-1、SAA、SIP水平，并有效保護胰島β細胞功能，有著良好的臨床應用價值。

Objective To investigate the clinical efficacy of Xiaokeqing Granules combined with empagliflozin in treatment of type 2 diabetes. Methods A total of 150 patients with type 2 diabetes who were admitted to Shangqiu Third People's Hospital from July 2019 to July 2020 were selected as the research objects, and they were divided into control group (75 cases) and treatment group (75 cases) according to the odd-even number of admission number. Patients in the control group were po administered with Empagliflozin Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Xiaokeqing Granules on the basis of the control group, 6 g/time, three times daily. Both groups were evaluated after 8 weeks of treatment. The clinical efficacy of the two groups was observed, and the changes of blood glucose related indexes, blood glucose fluctuation indexes and serological factors before and after treatment were compared between the two groups. Results After treatment, the total effective rate of treatment group was 98.67%, which was significantly higher than that of control group (82.67%, P<0.05). After treatment, the levels of FPG, 2 h PG, HbAlc, and FINS in treatment group were significantly decreased compared with before treatment (P<0.05). After treatment, the blood glucose related indexes in treatment group were lower than those in control group (P<0.05). After treatment, HOMA-β increased and HOMA-IR decreased in both groups (P<0.05). After treatment, HOMA-β in the treatment group was higher than that in the control group, while HOMA-IR was lower than that in the control group (P<0.05). After treatment, SDBG, MAGE, NGE and MODD in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the blood glucose fluctuation indexes of treatment group were significantly lower than those of control group (P<0.05). After treatment, the levels of serum chemokine, GDF-15, MCP-1, and SAA in both groups were significantly decreased, but the level of SIP was significantly increased (P<0.05). After treatment, the levels of chemokine, GDF-15, MCP-1, and SAA in the treatment group were lower than those in the control group, while SIP was higher than that in the control group (P<0.05). Conclusion Xiaokeqing Granules combined with empagliflozin has a good clinical effect in treatment of type 2 diabetes, and can effectively reduce the patient's blood glucose levels, and also can improve the body chemokine, GDF-15, MCP-1, SAA, SIP levels, and effectively protect the function of pancreatic beta cells, which has a good clinical application value.

R977

河南省醫(yī)學科技攻關計劃項目（LHGJ20191500）