罗明玉

【摘 要】 目的：观察中西医结合治疗肝肾阴虚型2型糖尿病的临床疗效。方法：选取符合纳入标准的160例2型糖尿病患者为研究对象，随机分为对照组和研究组各80例。两组均予精蛋白锌胰岛素合磷酸西格列汀片治疗，研究组在此基础上予中药汤剂六味地黄丸并随证予活血、行气、化湿等中药治疗。治疗后对比两组空腹血糖、糖化血红蛋白水平，二肽基肽酶-4抑制剂磷酸西格列汀不良反应发生情况及疗效水平。结果：研究组有效率为95.5%高于对照组的74%；治疗后两组空腹血糖较治疗前均降低，且研究组降低更为明显（P<0.05）；糖化血红蛋白降低不明显，两组比较差异无统计学意义（P>0.05）；研究组不良反应发生率明显低于对照组（P<0.05）。结论：西药联合六味地黄丸治疗肝肾阴虚型2型糖尿病临床疗效较好，同时可以降低不良反应发生率，值得临床推广应用。

【关键词】 2型糖尿病；肝肾阴虚；六味地黄丸；磷酸西格列汀片

【中图分类号】R587.1 【文献标志码】 A【文章编号】1007-8517（2018）04-0094-04

Abstract：Objective To investigate the clinical efficacy observation of combination of TCM and western medicine treatment for the 2 type diabetes mellitus belonging to kidney and liver Yin weakness type. Methods Chooded 160 patients in the hospital internal department complying with the absorbing standards， randomly divided into the study and control group， 80cases in each group. The two groups were treated with the regular curing-diabetes mellitus drug with the phosphate Gliclazide tables. On the basis the study was treated with liuweidihuang detection added with the activating Blood channeling Qi Eliminating wetness herbs according to the symptoms. After treatment compared the levels of free food glucose （FBG） Glycosylated Hemoglobin （HbAlc） and the side effects of phosphate Gliclazide tables of the two groups as well as the efficacy level. Results The efficacy level of study group（95.5%） was higher than the control group（74%）； compared with the FBG levels of the two groups before treatment after the treatment the FBG levels of the two groups all decreased the study was more preeminent（P<0.05）；the HbAlc levels of two groups also decreased however the differences of the groups had no statistical sense（P>0.05）； the side effect level of study group was lower outstandingly than the control group（P<0.05）， especially in the aspect of bone fracture. Conclusion Compared with the regular treatment for the 2 type diabetes mellitus belonging to kidney and liver Yin weakness typeliuweidihuang pill accompanying phosphate Gliclazide may have better efficacy at the same time may decrease the side effect happenings of phosphate Gliclazide tables.

Keywords：2 type diabetes mellitus； kidney and liver Yin weakness type； liuweidihuang pill； phosphate Gliclazide tables

2型糖尿病（type-2 Diabetes Mellitus）是臨床常见的老年内分泌性疾病，多表现为胰岛素相对或绝对不足，其发病与自身免疫功能障碍以及遗传等因素相关[1]。据统计2型糖尿病患者中伴发糖尿病肾病、糖尿病视网膜病变、糖尿病脑血管病变的患者比例远远大于I型糖尿，且往往与血清中糖化血红蛋白（Glycosylated Hemoglobin）水平持续升高相关[2]。因此预防2型糖尿病相关并发症及降低糖化血红蛋白在临床治疗中尤为重要。向先玉等[3]通过临床调查发现2型糖尿病中肝肾阴虚型较为普遍，发生率约为20%。而磷酸西格列汀（DDP-4抑制剂）是目前常被临床广泛用于治疗2型糖尿病的一种二肽基肽酶4抑制剂，具有增加细胞胰岛素敏感性，显著降低血糖及糖化血红蛋白的作用[4]。……