目的 探討降糖寧膠囊聯(lián)合羅格列酮治療2型糖尿病的臨床效果。方法 選取2018年6月—2021年6月在商洛市中心醫(yī)院接受治療的98例2型糖尿病患者，按隨機數(shù)字表法將患者分為對照組和治療組，每組各49例。對照組口服鹽酸羅格列酮膠囊，4 mg/d，頓服。治療組在對照組治療基礎上口服降糖寧膠囊，2 g/次，3次/d。兩組療程12周。評估兩組降糖療效，對比治療前后兩組餐后2 h血糖（2 h PG）等糖代謝指標、胰島功能指標[胰島β細胞功能指數(shù)（HOMA-β）、胰島素抵抗指數(shù)（HOMA-IR）]、血小板最大聚集率（MAR）、血液流變學參數(shù)[血漿黏度（PV）、全血高切黏度（HBV）、全血低切黏度（LBV）]及血清視黃醇結合蛋白4（RBP4）、可溶性細胞間黏附分子1（sICAM-1）、脂聯(lián)素（APN）、生長分化因子-15（GDF-15）水平。結果 治療后，治療組總有效率是95.9%，顯著高于對照組的83.7%（P＜0.05）。治療后，兩組患者FPG、2 h PG、HbA1c均顯著降低（P＜0.05）；治療后，治療組糖代謝指標低于對照組（P＜0.05）。治療后，兩組HOMA-β顯著升高，而HOMA-IR顯著降低（P＜0.05）；治療后，治療組胰島功能指標改善優(yōu)于對照組（P＜0.05）。與治療前比較，兩組治療后MAR和血液流變學參數(shù)（PV、HBV、LBV）均顯著降低（P＜0.05）；且均以治療組下降更顯著（P＜0.05）。治療后，兩組血清RBP4、sICAM-1和GDF-15濃度均較治療前顯著下降，而血清APN水平均較治療前顯著升高（P＜0.05）；且治療后，治療組血清RBP4、sICAM-1、APN和GDF-15水平改善較對照組更顯著（P＜0.05）。結論 降糖寧膠囊聯(lián)合羅格列酮治療2型糖尿病能獲得較為理想的血糖控制效果，并可進一步改善胰島功能及機體微循環(huán)，增強內(nèi)源性保護作用，保護血管內(nèi)皮功能，且安全性好，值得臨床推廣應用。

Objective To explore the clinical effect of Jiangtangning Capsules combined with rosiglitazone in treatment of type 2 diabetes. Methods 98 Patients with type 2 diabetes who received treatment in Shangluo Central Hospital from June 2018 to June 2021 were selected and divided into control group and treatment group according to random number table method, with 49 cases in each group. Patients in the control group were po administered with Rosiglitazone Hydrochloride Capsules, 4 mg/d, and was given daily. Patients in the treatment group were po administered with Jiangtangning Capsules on the basis of the control group, 2 g/time, 3 times daily. Both groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, 2 h PG and other glucose metabolism indicators, HOMA-β, HOMA-IR, MAR, PV, HBV, LBV, RBP4, sICAM-1, APN, GDF-15 in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 95.9%, which was significantly higher than that of the control group (83.7%, P < 0.05). After treatment, FPG, 2 h PG, and HbA1c were significantly decreased in both groups (P < 0.05). After treatment, the glucose metabolism index of the treatment group was lower than that of the control group (P <0.05). After treatment, HOMA-β was significantly increased, while HOMA-IR was significantly decreased in both groups (P < 0.05). After treatment, the improvement of islet function indexes in treatment group was better than that in control group (P < 0.05). Compared with before treatment, MAR and hemorheological parameters (PV, HBV, LBV) were significantly decreased in both groups after treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, serum concentrations of RBP4, sICAM-1, and GDF-15 in both groups were significantly decreased compared with before treatment, but serum APN levels were significantly increased compared with those before treatment (P < 0.05). After treatment, the serum levels of RBP4, sICAM-1, APN, and GDF-15 in treatment group were significantly improved compared with those in the control group (P < 0.05). Conclusion Jiangtangning Capsules combined with rosiglitazone can obtain ideal blood glucose control effect in treatment of type 2 diabetes, and can further improve islet function and microcirculation, enhance endogenous protective effect, and protect vascular endothelial function, which is safe and worthy of clinical application.

R977