目的 探究參苓白術(shù)散聯(lián)合吡格列酮治療脾虛濕困型2型糖尿病的治療效果與安全性。方法 選取2021年12月—2023年12月在武漢市中醫(yī)醫(yī)院治療的脾虛濕困型2型糖尿病患者113例，根據(jù)治療方案的差異將患者分成對照組（56例）和治療組（57例）。對照組患者早餐前口服鹽酸吡格列酮片，30 mg/d，1次/d；治療組在對照組基礎(chǔ)上口服參苓白術(shù)散，6 g/次，3次/d。兩組患者均進(jìn)行8周治療。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候評分和糖尿病生存質(zhì)量特異性量表（DSQL）評分，及空腹血糖（FBG）、餐后2 h血糖（2 h PG）和糖化血紅蛋白（HbA1c）、生長分化因子-15（GDF-15）、游離脂肪酸（FFA）和趨化素（chemerin）水平。結(jié)果 治療后，對照組和治療組臨床總有效率分別為78.57%和94.74%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組患者中醫(yī)證候評分和DSQL評分均顯著下降（P＜0.05），且治療組評分較對照組下降更顯著（P＜0.05）。治療后，兩組患者FBG、2 h PG、HbA1c、GDF-15、FFA和chemerin水平均顯著降低（P＜0.05），且治療組這些指標(biāo)水平較對照組下降更顯著（P＜0.05）。結(jié)論 參苓白術(shù)散聯(lián)合吡格列酮治療脾虛濕困型2型糖尿病效果顯著，不僅能夠改善患者臨床證候和生存質(zhì)量，同時(shí)還能夠促進(jìn)血清學(xué)指標(biāo)的恢復(fù)。

Objective To explore the therapeutic effect and safety of Shenling Baizhu Powder combined with pioglitazone in treatment of type 2 diabetes with spleen deficiency and dampness stagnation. Methods Patients (113 cases) with type 2 diabetes of spleen deficiency and dampness stagnation in Wuhan Hospital of Traditional Chinese Medicine from December 2021 to December 2023 were divided into control (56 cases) and treatment (57 cases) group based on different treatments. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets before breakfast, 30 mg/d, once daily. Patients in the treatment group were po administered with Shenling Baizhu Powder on the basis of the control group, 6 g/time, three time daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the traditional Chinese medicine syndrome score and DSQL score, the levels of FBG, 2 h PG, HbA1c, GDF-15, FFA and chemerin in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 78.57% and 94.74%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores and DSQL scores of patients in two groups were decreased significantly (P < 0.05), and the score in the treatment group decreased more significantly than that in the control group (P < 0.05). After treatment, the levels of FBG, 2 h PG, HbA1c, GDF-15, FFA and chemerin were significantly reduced in two groups (P < 0.05), and the levels of these indicators in the treatment group decreased more significantly than in the control group (P < 0.05). Conclusion Shenling Baizhu Powder combined with pioglitazone produced notably effective results in treating spleen deficiency and dampness accumulation type 2 diabetes mellitus, improving patient symptoms and quality of life while promoting serum marker recovery.

R977

湖北省科學(xué)技術(shù)廳資助項(xiàng)目(2018CFB707)