目的 觀察參芪降糖顆粒聯(lián)合艾塞那肽注射液治療2型糖尿病的臨床療效。方法 選取2018年10月—2020年8月鄭州大學(xué)第一附屬醫(yī)院接收的120例2型糖尿病患者，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各60例。對(duì)照組患者早、晚餐前60 min皮下注射艾塞那肽注射液，5 μg/次，2次/d。治療組在對(duì)照組的治療基礎(chǔ)上口服參芪降糖顆粒，1袋/次，3次/d。兩組患者連續(xù)治療4周。觀察兩組臨床療效，比較兩組治療前后的血糖波動(dòng)指標(biāo)、血糖、胰島素抵抗指標(biāo)。結(jié)果 治療后，治療組的總有效率為88.33%，高于對(duì)照組的70.00%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血糖標(biāo)準(zhǔn)差（SDBG）、全天平均血糖波動(dòng)幅度（MAGE）、全天有效血糖波動(dòng)次數(shù)（NGE）水平均降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組SDBG、MAGE、NGE水平低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbAlc）水平均降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組FPG、2 h PG、HbAlc水平低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組胰島素（FINS）、胰島素抵抗指數(shù)（HOMA-IR）較治療前下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組FINS、HOMA-IR低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 參芪降糖顆粒聯(lián)合艾塞那肽注射液治療2型糖尿病患者的效果顯著，能夠降低患者血糖，減輕胰島素抵抗及改善血糖波動(dòng)指數(shù)，安全性較高。

Objective To observe the clinical effect of Shenqi Jiangtang Granules combined with Exenatide Injectio in treatment of type 2 diabetes mellitus. Methods Patients (120 cases) with type 2 diabetes mellitus in the First Affiliated Hospital of Zhengzhou University from October 2018 to August 2020 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were sc injection administered with Exenatide Injection at 60 min before breakfast and dinner, 5 μg/time, twice daily. Patients in the treatment group were po administered with Shenqi Jiangtang Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and blood glucose fluctuation indexes, blood glucose and insulin resistance in two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 88.33%, which was higher than that of the control group (70%), and the difference was statistically significant (P<0.05). After treatment, the levels of SDBG, MAGE, and NGE in two groups were decreased, and the difference was statistically significant (P<0.05). The levels of SDBG, MAGE, and NGE in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of FPG, 2 h PG, and HbAlc in two groups were decreased, and the difference was statistically significant (P<0.05). The level of blood glucose related indicators FPG, 2 h PG, and HbAlc in the treatment group was lower than that in the control group, and the difference was statistically significant (P<0.05). After treatment, the FINS and HOMA-IR of two groups were decreased, and the difference was statistically significant (P<0.05). Insulin related indexes FINS and HOMA-IR of the treatment group were lower than those of the control group, and the difference was statistically significant (P<0.05). Conclusion Shenqi Jiangtang Granules combined with Exenatide Injection has clinical effect in treatment of type 2 diabetes mellitus, can reduce blood glucose, reduce insulin resistance, and improve blood glucose fluctuation index, with high safety.

R977

國(guó)家自然科學(xué)基金資助項(xiàng)目（81400800）