目的 探討消渴清顆粒聯(lián)合利格列汀治療血糖控制不佳的2型糖尿病的臨床療效。方法 選擇唐山市第八醫(yī)院2018年4月-2019年11月收治的血糖控制不佳的2型糖尿病患者84例作為本實(shí)驗(yàn)對(duì)象，根據(jù)隨機(jī)數(shù)字表法將患者分成對(duì)照組和觀察組，每組各42例。對(duì)照組口服利格列汀片，5 mg/次，1次/d。觀察組在對(duì)照組基礎(chǔ)上溫水沖服消渴清顆粒，6 g/次，3次/d。兩組患者連續(xù)治療16周。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的血糖指標(biāo)、體質(zhì)量指數(shù)（BMI）、胰島β細(xì)胞功能、細(xì)胞因子水平，錄兩組患者血糖達(dá)標(biāo)時(shí)間。結(jié)果 觀察組患者在治療后的總有效率為95.24%，顯著高于對(duì)照組的80.95%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血紅蛋白（HbA1c）、BMI均明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組的BMI比對(duì)照組低（P<0.05）。治療后，兩組的胰島素（INS）、胰島素β細(xì)胞功能指數(shù)（HOMA-β）明顯升高，胰島素抵抗指數(shù)（HOMA-IR）明顯降低（P<0.05）；治療后，觀察組的INS、HOMA-β比對(duì)照組高，HOMA-IR比對(duì)照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的白細(xì)胞介素-1β（IL-1β）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）顯著降低，脂聯(lián)素（APN）顯著升高（P<0.05）；治療后，觀察組的IL-1β、IL-6、TNF-α比對(duì)照組低，APN比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組患者的血糖達(dá)標(biāo)時(shí)間比對(duì)照組短，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 消渴清顆粒聯(lián)合利格列汀可提高血糖控制不佳的2型糖尿病的療效，提高血糖控制效率，可能與調(diào)節(jié)炎癥因子分泌，改善胰島β細(xì)胞功能有關(guān)。

Objective To investigate the clinical effect of Xiaokeqing Granules combined with linagliptin in treatment of type 2 diabetes mellitus with poor blood glucose control. Methods A total of 84 patients with type 2 diabetes mellitus with poor blood glucose control in Tangshan Eighth Hospital from April 2018 to November 2019 were divided into control group and observation group, each group had 42 cases. Patients in the control group were po administered with Linagliptin Tablets, 5 mg/time, once daily. Patients in the observation group were treated with Xiaokeqing Granules on the basis of control group, 6 g/time, three times daily. Patients were treated for 16 weeks. The clinical efficacy in two groups were observed, the blood glucose index, BMI, β-cell function of insulin, and cytokine levels before and after treatment in two groups were compared, and the blood glucose standard time were recorded. Results The total effective rate of the observation group after treatment was 95.24%, which was significantly higher than 80.95% of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of FBG, 2 h PG, HbA1c, and BMI were significantly decreased in two groups, and the difference was statistically significant (P<0.05). After treatment, BMI in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the INS and HOMA-β in two groups were significantly increased, but HOMA-IR were significantly decreased (P<0.05). After treatment, INS and HOMA-β in the observation group was significantly higher than those in the control group, but HOMA-IR was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of IL-1β, IL-6, and TNF-α in two groups were significantly decreased, but APN was increased (P<0.05). After treatment, the levels of IL-1β, IL-6, and TNF-α in the observation group were lower than those in the control group, but APN was higher than that in the control group, the difference was statistically significant (P<0.05). After treatment, the standard time of blood glucose in the observation group was shorter than that in the control group (P<0.05). Conclusion Xiaokeqing Granules combined with linagliptin can improve the efficacy of type 2 diabetes with poor blood glucose control, and improve the efficiency of blood glucose control, which may be related to regulating the secretion of inflammatory factors and improving the function of pancreatic islet cells.

R977

河北省衛(wèi)生和計(jì)劃生育委員會(huì)科研基金項(xiàng)目（20160873）