目的 探討?zhàn)B陰降糖片聯(lián)合格列美脲片治療2型糖尿病的臨床療效。方法 選取2021年3月—2022年3月在山西運(yùn)城同德醫(yī)院治療的106例2型糖尿病患者，根據(jù)住院號(hào)的奇偶性分為對(duì)照組和治療組，每組各53例。對(duì)照組早餐時(shí)口服格列美脲片，初始2 mg/次，1次/d，對(duì)降糖藥敏感者1 mg/次，1次/d，維持劑量1～4 mg/次，1次/d，最大維持量不超過6 mg/次，1次/d；在此基礎(chǔ)上治療組口服養(yǎng)陰降糖片，4片/次，3次/d。兩組患者均連續(xù)治療4周進(jìn)行效果對(duì)比。觀察兩組患者臨床療效，比較治療前后兩組患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbAlc）、血胰島素（FINS）和胰島素抵抗指數(shù)（HOMA-IR）水平，HFS-II評(píng)分、DDS評(píng)分、中醫(yī)證候積分、DSC評(píng)分和CDES-SF評(píng)分，血清視黃醇結(jié)合蛋白4（RBP4）、攝食抑制因子-1（Nesfatin-1）、抑瘤素M（OSM）、鳶尾素和血清網(wǎng)膜素-1（Omentin-1）水平。結(jié)果 治療后，對(duì)照組臨床有效率為81.13%，明顯低于治療組98.11%（P＜0.05）。治療后，兩組FPG、2 h PG、HbAlc、FINS、HOMA-IR水平均明顯降低（P＜0.05），并以治療組下降的最為明顯（P＜0.05）。治療后，兩組HFS-II評(píng)分、DDS評(píng)分、中醫(yī)證候積分明顯下降，而DSC評(píng)分和CDES-SF評(píng)分明顯升高（P＜0.05），且治療組相關(guān)量表積分改善最為明顯（P＜0.05）。經(jīng)治療，兩組血清RBP4和OSM水平明顯降低，而Nesfatin-1、鳶尾素和Omentin-1水平明顯升高（P＜0.05），且治療組這些細(xì)胞因子水平明顯好于對(duì)照組（P＜0.05）。結(jié)論 養(yǎng)陰降糖片聯(lián)合格列美脲片治療2型糖尿病可促進(jìn)機(jī)體血糖下降，提高患者自我效能和自我照顧能力，降低痛苦和低血糖恐懼情緒。

Objective To explore the clinical efficacy of Yangyin Jiangtang Tablets combined with glimepiride in treatment of type 2 diabetes. Methods Patients (106 cases) with type 2 diabetes in Shanxi Yuncheng Tongde Hospital from March 2021 to March 2022 were randomly divided into control and treatment group according to the parity of the hospitalization number, and each group had 53 cases. Patients in the control group were po administered with Glimepiride Tablets at breakfast, the initial dose was 2 mg/time, 1 mg/time for those sensitive to hypoglycemic drugs, the maintenance dose was 1-4 mg, and the maximum maintenance dose was not more than 6 mg, once daily. Patients in the treatment group were po administered with Yangyin Jiangtang Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the levels of FPG, 2 h PG, HbAlc, FINS, and HOMA-IR, HFS-Ⅱ scores, DDS scores, TCM symptom scores, DSC scores and CDES-SF scores, the levels of RBP4, OSM, Nesfatin-1, irisin and Omentin-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 81.13%, which was significantly lower than that of the treatment group (98.11%) (P < 0.05). After treatment, the levels of FPG, 2 h PG, HbAlc, FINS and HOMA-IR were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, HFS-Ⅱ score, DDS score and TCM syndrome score were significantly decreased, while DSC score and CDES-SF score were significantly increased in two groups (P < 0.05), and the score of related scale in the treatment group improved most significantly (P < 0.05). After treatment, the levels of serum RBP4 and OSM were significantly decreased, while the levels of Nesfatin-1, irisin and Omentin-1 were significantly increased in two groups (P < 0.05), and the levels of these cytokines in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Yangyin Jiangtang Tablets combined with glimepiride tablets in the treatment of type 2 diabetes can promote the decrease of blood sugar, provide high self-efficacy and self-care ability, and reduce pain and hypoglycemia fear.

R977

山西省衛(wèi)生健康委科研課題(2019165)