目的 探討金糖寧膠囊聯(lián)合度拉糖肽注射液治療2型糖尿病的臨床療效。方法 選取2020年4月—2023年3月在衡水市人民醫(yī)院就診的136例2型糖尿病患者，根據(jù)隨機(jī)數(shù)字表法將136例患者分為對照組和治療組，每組各68例。對照組皮下注射度拉糖肽注射液，初始1支/次，1次/周，然后維持劑量2支/次，1次/周。治療組在對照組基礎(chǔ)上口服金糖寧膠囊，4粒/次，3次/d。兩組治療6個(gè)月。觀察兩組的臨床療效，比較兩組治療前后主要血糖指標(biāo)、血糖波動指標(biāo)以及丙二醛（MDA）、谷胱甘肽過氧化物酶1（GPX-1）、過氧化物酶（LPO）、內(nèi)皮素-1（ET-1）、FMD水平。結(jié)果 治療組的總有效率為94.12%，對照組總有效率為82.35%，組間差異顯著（P＜0.05）。治療后，兩組的空腹血糖（FBG）、糖化血紅蛋白（HbA1c）、餐后2 h血糖（2 hPG）均顯著降低（P＜0.05）。治療后，兩組的平均血糖波動幅度（MAGE）、平均血糖（MBG）、血糖變異系數(shù)（CV）均低于治療前（P＜0.05）；治療后，治療組的MAGE、MBG、CV低于對照組（P＜0.05）。治療后，兩組的血清GPX-1水平高于治療前，血清MDA、LPO水平低于治療前（P＜0.05）；治療后，治療組的血清GPX-1水平高于對照組，血清MDA、LPO水平低于對照組（P＜0.05）。治療后，兩組的血清ET-1水平明顯降低，F(xiàn)MD明顯升高（P＜0.05）；治療組的血清ET-1水平低于對照組，F(xiàn)MD高于對照組（P＜0.05）。結(jié)論 金糖寧膠囊聯(lián)合度拉糖肽注射液可顯著提高2型糖尿病的療效，降低血糖和血糖波動，減輕氧化應(yīng)激反應(yīng)，改善血管內(nèi)皮功能。

Objective To investigate the clinical efficacy of Jintangning Capsules combined with Dulaglutide Injection in treatment of type 2 diabetes mellitus. Methods Patients (136 cases) with type 2 diabetes mellitus in Hengshui People’s Hospital from April 2020 to March 2023 were divided into control and treatment groups according to the random number table method, and each group had 68 cases. Patients in the control group was sc administered with Dulaglutide Injection, the initial dose was 1 dose/time, once weekly, and then the maintenance dose was 2 doses/time, once weekly. Patients in the treatment group were po administered with Jintangning Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the blood glucose indicators, blood glucose fluctuation indicators, the levels of MDA, GPX-1, LPO, ET-1, and FMD in two groups were compared. Results The total effective rate of the treatment group was 94.12%, while the control group was 82.35%, with a significant difference between the groups (P< 0.05). After treatment, FBG, HbA1c, and 2 hPG in two groups were significantly decreased (P < 0.05). After treatment, MAGE, MBG, and CV in two groups were lower than before treatment (P < 0.05). After treatment, MAGE, MBG, and CV in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum level of GPX-1 was higher than before treatment, while the serum levels of MDA and LPO were lower than before treatment (P < 0.05). After treatment, the serum level of GPX-1 in the treatment group was higher than that in the control group, but the serum levels of MDA and LPO were lower than those in the control group (P< 0.05). After treatment, the serum level of ET-1 in two groups was significantly decreased, but FMD in two groups was significantly increased (P< 0.05). The serum level of ET-1 in the treatment group was lower than that in the control group, but FMD in the treatment group was higher than that in the control group (P < 0.05). Conclusion Jintangning Capsules combined with Dulaglutide Injection can significantly improve the therapeutic effect of type 2 diabetes mellitus, reduce blood glucose and blood glucose fluctuation, alleviate oxidative stress reaction, improve vascular endothelial function.

R977

河北省醫(yī)學(xué)科學(xué)研究課題計(jì)劃項(xiàng)目（20232188）