葛根芩连汤联合利拉鲁肽对肥胖2型糖尿病湿热困脾证的临床疗效

Efficacy of Gegen Qinlian Decoction combined with liraglutide in the treatment of obese type 2 diabetes(T2DM) of dampness accumulation in spleen syndrome

关键词:  利拉鲁肽  葛根芩连汤  肥胖  2型糖尿病  湿热困脾证

Key words:  liraglutide  Gegen Qinlian Decoction  obesity  type 2 diabetes  dampness accumulation in spleen syndrome

摘要:

[目的] 探讨葛根芩连汤联合利拉鲁肽治疗肥胖2型糖尿病（T2DM）湿热困脾证的临床疗效。[方法] 选取90例肥胖型T2DM证属湿热困脾的患者，随机分为对照组和联合组，各45例，对照组给予利拉鲁肽治疗，联合组在此基础上给予葛根芩连汤，治疗12周后比较两组患者治疗前后体质量（W）、体重指数（BMI）、血糖、糖化血红蛋白（HbA1c）、血脂、肝功能、胰岛素抵抗指数（HOMA-IR）、中医症状积分。[结果] 治疗前两组患者各项指标无明显统计学差异（P>0.05），治疗后两组指标均较治疗前改善，联合组改善血糖、HbA1c、血脂、HOMA-IR及中医证候评分较对照组更显著（P<0.05），而对W、BMI及肝功能的改善与对照组无显著差异（P>0.05）。对照组有3例恶心伴腹泻，5例厌食，2周后好转，均可耐受并在治疗4周后缓解，联合组出现2例厌食，2周后好转，组间不良反应有统计学差异（P<0.05）。[结论] 葛根芩连汤联合利拉鲁肽对肥胖T2DM湿热困脾证患者降低W、BMI、改善肝功能作用与利拉鲁肽相当，但对于血糖、血脂、胰岛素抵抗和中医证候评分的改善优于单用利拉鲁肽，而且联合用药组不良反应显著低于对照组，使患者依从性更佳，值得临床推广。

Abstract:

[Objective] To investigate the efficacy of Gegen Qinlian Decoction combined with liraglutide in the treatment of obese type 2 diabetes(T2DM) of dampness accumulation in spleen syndrome.[Methods] A total of 90 obese T2DM patients of damp accumulation in spleen syndrome were selected and divided into 2 groups and each group has 45 patients randomly. Then control group received liraglutide,while the combination group received Gegen Qinlian Decoction combined with liraglutide.Both groups were treated for 12 weeks. Before and after the treatment,the body weight(W),body mass index(BMI),blood glucose(FPG,2 h PG),glycosylated hemoglobin(HbA1c),blood lipid(TC,TG,LDL-c),liver function(ALT,AST,GGT),homeostasis model assessment of insulin resistance(HOMA-IR) and the traditional Chinese medicine (TCM) symptom scores were monitored and compared.[Results] Before the treatment,there were no significant differences between groups of the indexes above,after the treatment of 12 weeks,all the indexes were superior than before,while the blood glucose,HbA1c,blood lipid,HOMA-IR and TCM symptom scores of the combination group were better than those of the control group.Meanwhile the differences of the W,BMI,liver function between the groups were not significant (P>0.05). There were three patients suffered from nausea accompanied with diarrhea and five with anorexia in the control group,while only two patients with anorexia were discovered in the combination group,the difference was significant(P<0.05).[Conclusion] Gegen Qinlian Decoction combined with liraglutide has equivalent effect with liraglutide single use in the amelioration of the W,BMI,liver function in obese T2DM of dampness accumulation in spleen syndrome,while the blood glucose,HbA1c,blood lipid,insulin resistance and TCM symptom scores of the combination group were superior to the control group. Furthermore,the combination group had less side effects than the control group. therefore,it is worthy of clinical recommendation.