摘要
目的基于真实世界评价中药"序贯三法"治疗2型糖尿病的临床疗效和安全性。方法收集2018年8月至2020年8月在全国5家医院就诊的2型糖尿病患者共255例,并给予基础治疗结合中药"序贯三法"[根据患者空腹血糖(FBG)、餐后血糖(2hPG)水平给予专证专方、不同阶段的专病专药、专病专茶的单用或联用的动态循环的治疗方法]共治疗12周。治疗前后检测患者FBG、2hPG、果糖胺(FMN)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、胰岛素抵抗指数(IRI)、胰岛素敏感指数(ISI),并监测安全性指标。结果观察期间共脱落3例,最终252例完成治疗。与治疗前比较,患者治疗后FBG、2hPG、FMN、HbA1c、TC、TG、IRI显著下降(P<0.05或P<0.01),而HDL-C、ISI显著上升(P<0.05)。治疗过程中共出现轻度胃肠道反应8例,减少药量后上述症状缓解。结论中药"序贯三法"治疗2型糖尿病可能通过改善胰岛素抵抗,升高胰岛素敏感指数,发挥血糖、血脂同调的作用,且安全性较好。
Objective To evaluate the clinical effectiveness and safety of sequential triple therapy of Chinese herbal medicine for type 2 diabetes(T2D)based on real-world data.Methods Totally 255 patients admitted to the five hospitals from August 2018 to August 2020 were included,who met the diagnostic criteria of T2D and were given 12-week"sequential triple therapy"of Chinese herbal medicine,i.e.specific formula to specific syndrome based on fasting blood glucose(FBG)and 2-hour postprandial glucose(2 hPG);specific medicine to specific disease for different stages;specific medicated tea to specific disease used alone or in combination as a circle and in a dynamic treatment way.FBG,2 hPG,fructosamine(FMN),glycosidated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),insulin resistance index(IRI),insulin sensitivity index(IRI),and safety indicators were assessed before and after treatment.ResultsThere were three drop-outs,and finally 252 patients finished.The levels of FBG,2 hPG,FMN,HbA1c TC,TG and IRI decreased significantly(P<0.05,P<0.01),while the levels of HDL-C and ISI increased significantly after treatment(P<0.05).Eight mild gastrointestinal reactions occurred during treatment and were improved when the medication dose was reduced.Conclusion Sequential triple therapy of Chinese herbal medicine can regulate the blood glucose and lipid simultaneously by improving insulin resistance and increasing insulin sensitivity,and it has good safety.
作者
庞国明
张芳
王凯锋
武楠
朱璞
付永祥
李方旭
王银姗
南凤尾
娄静
高言歌
陈丹丹
孔丽丽
叶乃菁
马宇鹏
许强
甘洪桥
章津铭
李鹏辉
PANG Guoming;ZHANG Fang;WANG Kaifeng;WU Nan;ZHU Pu;FU Yongxiang;LI Fangxu;WANG Yinshan;NAN Fengwei;LOU Jing;GAO Yange;CHEN Dandan;KONG Lili;YE Naijing;MA Yupeng;XU Qiang;GAN Hongqiao;ZHANG Jinming;LI Penghui(Institute of Traditional Chinese Medicine,Henan University,Kaifeng,475001;Kaifeng Hospital of Traditional Chinese Medicine,Henan Province;Sichuan Second Hospital of Traditional Chinese Medicine;Shenzhen Hospital of Beijing University of Chinese Medicine;Chengdu University of Traditional Chinese Medicine)
出处
《中医杂志》
CSCD
北大核心
2021年第18期1612-1616,1621,共6页
Journal of Traditional Chinese Medicine
基金
河南省中医药科学研究专项(2018ZY3024)
开封市科技发展计划(2103050)。
关键词
2型糖尿病
中医药疗法
血糖
血脂
胰岛素抵抗
序贯三法
type 2 diabetes
Chinese medicine therapy
blood glucose
blood lipids
insulin resistance
sequential triple therapy
