目的: 通过回顾性病例分析,系统评估清热止渴膏联合阿卡波糖治疗2型糖尿病（type 2 diabetes mellitus, T2DM）的临床疗效及安全性,重点探讨其对患者胰岛功能、糖代谢水平、脂质代谢相关参数的影响。方法: 回顾性分析2021年2月—2022年12月在我院就诊的88例T2DM患者临床资料,按照标准筛选后根据治疗药物不同分成阿卡组（46例）、联合组（42例）。阿卡组予以阿卡波糖治疗,联合组予以清热止渴膏联合阿卡波糖治疗。比较两组糖代谢水平[空腹血糖（fasting blood glucose,FBG）、2 h血糖（2 h Blood glucose,PBG）、糖化血红蛋白（glycosylated hemoglobin,HbA1c）]、胰岛功能[空腹胰岛素（fasting insulin,INS）、胰岛素抵抗指数（HOMA-IR）、C-肽（CP）]、脂质代谢相关参数[总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（insulin resistance index,HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）]、临床疗效;并采用Pearson相关性分析糖代谢水平与胰岛功能、脂质代谢相关参数的相关性。结果: 治疗后,两组患者FBG、PBG、HbA1c水平明显低于治疗前,且联合组患者FBG、PBG、HbA1c水平低于阿卡组;两组患者CP较治疗前升高,INS、HOMA-IR较治疗前降低,联合组患者CP高于阿卡组,INS、HOMA-IR低于阿卡组;两组患者HDL-C较治疗前升高,TC、TG、LDL-C较治疗前降低,联合组HDL-C高于阿卡组,TC、TG、LDL-C低于阿卡组。联合组患者治疗总有效率高于阿卡组。Pearson相关性分析结果显示,FBG与INS、HOMA-IR、TG、LDL-C呈正相关,与HDL-C呈负相关;PBG与INS、HOMA-IR、TG、LDL-C呈正相关,与HDL-C呈负相关;HbA1c与HOMA-IR、TG呈正相关,与CP呈负相关。结论: 清热止渴膏联合阿卡波糖治疗T2DM临床效果较好,尤其在改善糖代谢、恢复胰岛功能、调节脂质代谢方面效果突出,值得临床推广应用。
Abstract
Objective To systematically evaluate the clinical efficacy and safety of Qingrezhike paste combined with acarbose in the treatment of type 2 diabetes mellitus (T2DM) by retrospective case analysis, focusing on its effects on islet function, glucose metabolism level and related parameters of lipid metabolism in patients. Methods The clinical data of 88 T2DM patients treated in our hospital from February 2021 to December 2022 were retrospectively analyzed, and they were divided into Acca group (46 cases) and combined group (42 cases) according to different therapeutic drugs after standard screening. The acca group was treated with acarbose, and the combined group was treated with Qingrezhike ointment combined with acarbose. The levels of glucose metabolism [fasting blood glucose (FBG), 2 h Blood glucose (PBG), glycosylated hemoglobin (HbA1c)], islet function [fasting insulin (INS), insulin resistance index (HOMA-IR), C-peptide (CP)], lipid metabolism-related parameters [total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) LDL-C)], clinical efficacy; Pearson correlation was used to analyze the correlation between glucose metabolism and islet function and lipid metabolism. Results After treatment, the levels of FBG, PBG, and HbA1c in both groups of patients were significantly lower than before treatment, and the levels of FBG, PBG, and HbA1c in the combination group of glucose patients were lower than those in the Acao group. CP in two groups was higher than before treatment, INS and HOMA-IR were lower than before treatment, CP in combination group was higher than that in Acao group, INS and HOMA-IR were lower than that in Acao group. HDL-C in both groups was higher than before treatment, TC, TG and LDL-C were lower than before treatment, HDL-C in combination group was higher than Acca group, TC, TG and LDL-C were lower than Acca group. The total effective rate of combination group was higher than that of acca group. Pearson correlation analysis showed that FBG was positively correlated with INS, HOMA-IR, TG, LDL-C, and negatively correlated with HDL-C. PBG was positively correlated with INS, HOMA-IR, TG, LDL-C, and negatively correlated with HDL-C. HbA1c was positively correlated with HOMA-IR and TG, and negatively correlated with CP. Conclusion Qingrezhike paste combined with acarbose has good clinical effect in the treatment of T2DM, especially in improving glucose metabolism, restoring islet function and regulating lipid metabolism, which is worthy of clinical application.
关键词
清热止渴膏 /
阿卡波糖 /
2型糖尿病 /
胰岛功能 /
疗效
Key words
qingrezhike ointment /
acarbose /
type 2 diabetes /
curative effect
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参考文献
[1] SCHERBAK NN, KRUSE R, NYSTRÖM T, et al. Glimepiride Compared to Liraglutide Increases Plasma Levels of miR-206, miR-182-5p, and miR-766-3p in Type 2 Diabetes Mellitus: A Randomized Controlled Trial[J]. Diabetes Metab J, 2023, 47(5): 668-681.
[2] KRISHNA STR, BAHURUPI Y, et al.Prevalence of metabolic syndrome and its risk factors among newly diagnosed type 2 diabetes mellitus patients-A hospital-based cross-sectional study[J]. J Family Med Prim Care, 2024, 13(8): 3325-3331.
[3] VASQUEZ MS, MERTENS E, BERETE F, et al.Comparing self-reported health interview survey and pharmacy billing data in determining the prevalence of diabetes, hypertension, and hypercholesterolemia in Belgium[J]. Arch Public Health, 2023, 81(1): 121.
[4] NAIK BN, RAO R, VERMA M, et al.Prevalence of diabetes distress and its correlates among adults with type 2 diabetes mellitus in a primary health center of Bihar A cross-sectional study[J]. J Family Med Prim Care, 2024, 13(8): 3275-3281.
[5] DEHKORDI SR, PAHLAVANI N, NIKBAF-SHANDIZ M, et al.A systematic review, meta-analysis, dose-response, and meta-regression of the effects of acarbose intake on glycemic markers in adults[J]. J Diabetes Metab Disord, 2023, 23(1): 135-172.
[6] OBAID QA, KHUDAIR KK, AL-SHAMMARI AM.Glucose deprivation using 2-deoxyglucose and acarbose induce metabolic oxidative stress and apoptosis in female mice bearing breast cancer[J]. Biochimie, 2022, 195: 59-66.
[7] 苏菲, 张媛媛, 关晓文, 等. 葛根芩连汤对2型糖尿病模型小鼠肝组织NLRP3炎症小体信号通路的影响[J]. 国际中医中药杂志, 2023, 45(7): 834-839.
[8] 孟智睿, 李丽, 邵紫萱, 等. 参竹降糖方对糖尿病气阴两虚证大鼠模型血糖, 血脂及神经内分泌免疫功能的影响[J]. 环球中医药, 2022, 15(8): 1322-1328.
[9] 中国老年2型糖尿病防治临床指南编写组, 中国老年医学学会老年内分泌代谢分会, 中国老年保健医学研究会老年内分泌与代谢分会, 等. 中国老年2型糖尿病防治临床指南 (2022年版)[J]. 中华内科杂志, 2022, 61(1): 12-50.
[10] 吴慧娟, 赵桂芝, 张明丽. 中医诊断学[M]. 北京: 中国医药科技出版社, 2022: 109-112.
[11] 翁建平. 基层糖尿病规范化诊疗手册[M]. 北京: 人民军医出版社, 2014: 118-119.
[12] SONMEZ A, SABBOUR H, ECHTAY A, et al.Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations[J]. J Diabetes, 2022, 14(5): 315-333.
[13] NOUHI Y, ABOUBAKR FZ, EL BRINI O, et al.Association of combined 344T/C and K173R polymorphisms in aldosterone synthase gene with type 2 diabetes mellitus in the Moroccan population[J]. Rom J Intern Med, 2024, 62(3): 323-330.
[14] LI Y, TENG D, SHI X, et al.Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study[J]. BMJ, 2020, 369: m997-1007.
[15] TANOEYADI S, TSUNODA T, ITO T, et al.Acarbose May Function as a Competitive Exclusion Agent for the Producing Bacteria[J]. ACS Chem Biol, 2023, 18(2): 367-376.
[16] ABIOYE RO, NWAMBA OC, OKAGU O, et al.Synergistic Effect of Acarbose-Chlorogenic Acid on α-Glucosidase Inhibition: Kinetics and Interaction Studies Reveal Mixed-Type Inhibition and Denaturant Effect of Chlorogenic Acid[J]. ACS Food Sci Technol, 2023, 3(7): 1255-1268.
[17] 王祺, 蒋磊. 加味桃核承气汤治疗2型糖尿病血瘀脉络证疗效及对血管内皮功能, 血清炎症因子的影响[J]. 西部中医药, 2022, 35(7): 6-10.
[18] 关晓文, 梁永林, 朱向东, 等. 葛根芩连汤对2型糖尿病db/db小鼠胰腺组织PERK/ATF4/CHOP信号通路的影响[J]. 中国中医药信息杂志, 2024, 31(1): 97-103.
[19] 张宏信, 宗耀华, 许冬舒, 等. 滋肾止渴方对肾阴亏虚型2型糖尿病患者血糖代谢及胰岛素抵抗的影响[J]. 四川中医, 2021, 39(6): 131-134.
[20] 甘小双, 张红梅. 白虎汤在温病气分证中的辨证应用[J]. 湖北中医药大学学报, 2022, 24(4): 52-54.
[21] 帅丽霞, 陈旺, 袁袁, 等. 基于指纹图谱和网络药理学对经典名方二冬汤质量标志物 (Q-Marker) 预测分析[J]. 中草药, 2022, 53(18): 5682-5691.
[22] 孙孝仁, 庄松华, 陈钦. 二甲双胍+阿卡波糖+复方黄柏液治疗糖尿病合并肛周脓肿效果分析[J]. 糖尿病新世界, 2023, 26(22): 81-84.
[23] 闫炜, 郭丹, 孙晓婷.2型糖尿病合并非酒精性脂肪肝患者血清小而密低密度脂蛋白变化及与胰岛素抵抗脂肪衰减指数的关系分析[J]. 河北医学, 2023, 29(11): 1868-1872.
基金
江苏省中医院科技项目“清热止咳膏对糖尿病前期疾病转归及胰岛素β细胞功能的临床评价”（Y2021CX15）
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