目的 探討消渴清顆粒聯(lián)合門冬胰島素30注射液治療2型糖尿病的臨床療效。方法 選取2018年1月-2019年9月天津市北辰醫(yī)院收治的86例糖尿病患者作為實(shí)驗(yàn)對(duì)象，將全部患者按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各43例。對(duì)照組皮下注射門冬胰島素30注射液，初始劑量12 U，每周至少血糖監(jiān)測(cè)3 d根據(jù)餐前血糖水平調(diào)整胰島素劑量，每3~5天調(diào)整1次，調(diào)整劑量為-2~6 U，直至血糖水平達(dá)標(biāo)后保持，1次/d。治療組在對(duì)照組治療的基礎(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3個(gè)月。觀察兩組的臨床療效，比較兩組的糖化血紅蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h血糖（2 hBG）、空腹胰島素（INS）、胰島β細(xì)胞功能（HOMA-β）、胰島素抵抗指數(shù)（HOMA-IR）、細(xì)胞間黏附分子-1（ICAM-1）、腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）水平。結(jié)果 治療后，治療組患者的總有效率95.35%比對(duì)照組（81.40%）高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的HbA1c、FBG、2 hBG明顯降低（P<0.05），且治療組血糖相關(guān)指標(biāo)降低的更明顯（P<0.05）。治療后，兩組的INS、HOMA-β顯著升高，HOMA-IR顯著降低（P<0.05）；治療后治療組的INS、HOMA-β比對(duì)照組高，HOMA-IR比對(duì)照組低（P<0.05）。治療后，兩組的ICAM-1、TNF-α、IL-6水平明顯低于治療前（P<0.05）；治療后治療組的ICAM-1、TNF-α、IL-6水平比對(duì)照組低（P<0.05）。結(jié)論 消渴清顆粒聯(lián)合門冬胰島素30注射液治療2型糖尿病有較好的療效，可降低血糖水平，改善胰島β細(xì)胞功能，降低炎癥因子的水平，具有一定的臨床研究?jī)r(jià)值。

Objective To explore the effect of Xiaokeqing Granules combined with Insulin Aspart 30 Injection in treatment of type 2 diabetes mellitus. Methods Patients (86 cases) with type 2 diabetes mellitus in Tianjin Beichen Hospital from January 2018 to September 2019 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were sc administered with Insulin Aspart 30 Injection, starting dosage 12 U, the insulin dose was adjusted according to the level of blood glucose before meals at least 3 d weekly, adjust once every 3-5 days, adjust the dose to -2-6 U until the blood glucose level reached the standard, once daily. Patients in the treatment group were po administered with Xiaokeqing Granules on the basis of the control group, 6 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the levels of HbA1c, FBG, 2 hBG, INS, HOMA-β, HOMA-IR, ICAM-1, TNF-α, and IL-6 in two groups were compared. Results After treatment, the total effective rate in the treatment group was 95.35% higher than that in the control group (81.40%), and the difference was statistically significant (P<0.05). After treatment, the levels of HbA1c, FBG and 2 hBG in the two groups were significantly decreased (P<0.05), and the related indexes of blood glucose in the treatment group were significantly reduced (P<0.05). After treatment, the INS and the HOMA-β in two groups were significantly increased, but the HOMA-IR in two groups were significantly decreased (P<0.05). The INS and the HOMA-β in the treatment group were higher than those in the control group, and the HOMA-IR was lower than that in the control group (P<0.05). After treatment, the levels of ICAM-1, TNF-α, and IL-6 in two groups were significantly decreased (P<0.05). And the levels of ICAM-1, TNF-α, and IL-6 in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xiaokeqing Granules combined with Insulin Aspart 30 Injection has clinical curative effect in treatment of type 2 diabetes mellitus, can reduce the level of blood glucose, improve the function of islet β cells, and reduce the level of inflammatory factors, which has a certain clinical research value.

R977

天津市中醫(yī)藥重點(diǎn)領(lǐng)域科技項(xiàng)目（A0203）