滋阴清热法联合胰岛素泵强化治疗初诊2型糖尿病的临床观察

目的 观察中医滋阴清热法改善初诊2型糖尿病胰岛素抵抗状态的疗效.方法 将40例新诊断2型糖尿病患者随机分成两组,其中治疗组20例,对照组20例.治疗组给予胰岛素泵强化治疗加服滋阴清热方(由生地、玄参、麦冬、生石膏、知母、葛根、天花粉、黄连、枳实等组成),对照组单纯采用胰岛素泵强化治疗；血糖控制目标:空腹血糖( FBG)＜6.1 mmol/L,餐后血糖(PBG)＜8.0 mmol/L,维持2周.观察两组中医证候、空腹血糖及胰岛素、餐后2h血糖、血脂、血流变、胰岛素抵抗指数等变化,记录胰岛素用量、血糖达标时间.结果 治疗组中医证候疗效明显优于对照组(P＜ 0.05).治疗组Ins平均用量比对照组少,血糖达标时间比对照组快(P＜0.05).治疗过程中除了少数患者出现低血糖反应,均未出现其他明显不良反应.结论中西医结合治疗初诊2型糖尿病有效,在改善胰岛素抵抗方面中药具有一定的优势,同时胰岛素的用量更少,血糖达标更快、更平稳.

Chinese therapy with nourishing yin and clearing heat combined with insulin pump for newly diagnosed patients with type 2 diabetes mellitus

Objective To observe the efficacy of Chinese therapy with nourishing yin and clearing heat treatment combined with insulin pump in the treatment of newly diagnosed patients with type 2 diabetes mellitus. Methods 40 patients were ramdomly assigned to receive Chinese therapy with nourishing yin and clearing heat （ formula with rehmannia, figwort root, ophiopogon japonicus, gypsum, rhizoma anemarrhenae, radix puerariae, radix trichosanthis, coptis chinensis franch, and immature bitter orange ） combined with insulin pump （ 20 patients, study group ）, or insulin pump alone （ 20 patients, control group ）. The target of blood glucose control was FBG 〈 6.1mmol/L and PBG 〈 8.0 mmol/L for 2 weeks. Syndromes, FBG, FINS, 2hPG, TC, TG, Blood rheology, and HOMA-IR were compared between the two groups. The dosage of insulin use and time to standard glucose level were noted. Results The study group was superior to the control group in improvement of syndromes, with a significant difference （ P 〈 0.05 ）. FBG, 2hPG, FINS, and HOMA-IR were reduced significantly after combination therapy （ P〈 0.05 ）, and HOMA-IR was significantly reduced in the study group, as compared to the control group （ P〈 0.05 ）. Both dosage of insulin use was smaller and time to standard glucose level were shorter in the study group than in the control group. No obvious adverse reactions occurred except hypoglycemia in few patients. Conclusions Combination therapy with TCM and Western medicine for newly diagnosed type 2 diabetes mellitus is effective. There are some advantages in reducing insulin resistance with less use of insulin.