目的 探討六味地黃丸聯(lián)合恩格列凈治療2型糖尿病的臨床效果。方法 選取2020年3月—2023年2月首都醫(yī)科大學附屬北京友誼醫(yī)院（平谷醫(yī)院）收治的102例2型糖尿病患者作為研究對象，將所有的研究對象按治療方法不同分為對照組和治療組，每組各51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六味地黃丸，1丸/次，2次/d。兩組療程均為12周。觀察兩組的臨床療效，比較兩組治療前后血糖指標、胰島功能相關指標、2型糖尿病患者生存質(zhì)量量表（DMQLS）評分及全血中性粒細胞與淋巴細胞比值（NLR）和血清三酰甘油（TG）、總膽固醇（TC）、載脂蛋白A1（ApoA1）、攝食抑制因子-1（Nesfatin-1）水平。結(jié)果 治療后，治療組總有效率是96.08%，較之對照組的82.35%顯著提高（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（HbA1c）較同組治療前均明顯下降（P＜0.05）；且治療后治療組FPG、2 h PG、HbA1c低于對照組（P＜0.05）。治療后，兩組HOMA-IR和DMQLS評分較同組治療前均明顯下降，而QUICKI較同組治療前均明顯上升（P＜0.05）；且治療后，治療組HOMA-IR和DMQLS評分均低于對照組，QUICKI高于對照組，差異有統(tǒng)計學意義（P＜0.05）。治療后，兩組全血NLR和血清TG、TC、Nesfatin-1水平較同組治療前均顯著下降，血清ApoA1水平均顯著升高（P＜0.05）；且治療后，治療組全血NLR和血清TG、TC、Nesfatin-1水平均低于對照組，血清ApoA1水平高于對照組（P＜0.05）。結(jié)論 六味地黃丸聯(lián)合恩格列凈治療2型糖尿病可取得較為滿意的效果，能有效降低機體炎癥狀態(tài)，糾正脂質(zhì)代謝紊亂，對患者血糖的控制作用及胰島功能、生活質(zhì)量的改善效果突出。

Objective To explore the clinical effect of Liuwei Dihuang Pills combined with empagliflozin in treatment of type 2 diabetes. Methods A total of 102 patients with type 2 diabetes admitted to Beijing Friendship Hospital (Pinggu Hospital), Affiliated to Capital Medical University from March 2020 to February 2023 were selected as the study objects. All patients were divided into control group and treatment group according to different treatment methods, with 51 cases in each group. 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 Liuwei Dihuang Pills on the basis of the control group, 1 pill/time, twice daily. The treatment course of both groups was 12 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose indexes, islet function related indexes, quality of life scale (DMQLS) score, neutrophil lymphocyte ratio (NLR), serum triglyceride (TG), total cholesterol (TC), apoA1, and feeding inhibitory factor-1 (Nesfatin-1) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 96.08%, which was significantly higher than that of the control group (82.35%) (P < 0.05). After treatment, fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG) and glycosylated hemoglobin (HbA1c) in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, FPG, 2 h PG and HbA1c in the treatment group were lower than those in the control group (P < 0.05). After treatment, HOMA-IR and DMQLS scores in both groups were significantly decreased compared with before treatment, while QUICKI scores were significantly increased compared with before treatment (P < 0.05). After treatment, HOMA-IR and DMQLS scores in the treatment group were lower than those in the control group, and QUICKI scores were higher than those in the control group, with statistical significance (P < 0.05). After treatment, whole blood NLR, serum TG, TC and Nesfatin-1 levels in 2 groups were significantly decreased compared with before treatment, and serum ApoA1 levels were significantly increased (P < 0.05). After treatment, whole blood NLR, serum TG, TC and Nesfatin-1 levels in the treatment group were lower than those in the control group, and serum ApoA1 level was higher than that in the control group (P < 0.05). Conclusion Liuwei Dihuang Pills combined with empagliflozin has achieve satisfactory effect in treatment of type 2 diabetes, and can effectively reduce the inflammatory state of the body, correct the disorder of lipid metabolism, which can improve the blood sugar control, islet function and quality of life of patients.

R977

吳階平醫(yī)學基金會臨床科研專項資助基金（320.6750.18528）