1.上海市闵行区中西医结合医院内分泌科(上海 200241)
2.上海中医药大学附属岳阳中西医结合医院内分泌科(上海 200437)
3.复旦大学附属华山医院内分泌科(上海 200040)
曹惠红,女,硕士,副主任医师,主要从事糖尿病及其并发症的中西医结合治疗临床研究
李昀昊,副主任医师;E-mail:1678831862@qq.com
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曹惠红, 李昀昊, 赵晓龙, 等. 基于持续葡萄糖监测观察润燥益肾方对肾阴亏虚型2型糖尿病患者血糖波动的影响[J]. 上海中医药大学学报, 2021,35(5):20-25.
CAO Huihong, LI Yunhao, ZHAO Xiaolong, et al. Effects of Runzao Yishen Decoction on blood glucose fluctuation in patients of type 2 diabetes mellitus with syndrome of kidney yin deficiency based on continuous glucose monitoring[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(5):20-25.
曹惠红, 李昀昊, 赵晓龙, 等. 基于持续葡萄糖监测观察润燥益肾方对肾阴亏虚型2型糖尿病患者血糖波动的影响[J]. 上海中医药大学学报, 2021,35(5):20-25. DOI: 10.16306/j.1008-861x.2021.05.004.
CAO Huihong, LI Yunhao, ZHAO Xiaolong, et al. Effects of Runzao Yishen Decoction on blood glucose fluctuation in patients of type 2 diabetes mellitus with syndrome of kidney yin deficiency based on continuous glucose monitoring[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(5):20-25. DOI: 10.16306/j.1008-861x.2021.05.004.
目的:,2,基于持续葡萄糖监测观察润燥益肾方对肾阴亏虚型2型糖尿病患者糖代谢、血糖波动及中医证候评分的影响。,方法:,2,将98例肾阴亏虚型2型糖尿病患者随机分为治疗组49例和对照组49例。对照组使用胰岛素治疗,治疗组在对照组的基础上给予润燥益肾方治疗,两组疗程均为12周。治疗前后比较两组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、血清肌酐(Scr)、丙氨酸氨基转移酶(ALT)、空腹C肽(FCP)、餐后2 h C肽(2hCP)、糖化白蛋白(GA)、持续葡萄糖监测参数、中医证候评分及胰岛素用量的变化。,结果:,2,①治疗后,两组HbA1c、FPG、2hPG水平均显著下降(,P,<,0.05),且治疗组降幅更明显(,P,<,0.05);②治疗后,两组依据动态血糖计算的血糖标准差(SD)、平均血糖波动幅度(MAGE)、平均血糖(MBG)均显著下降(,P,<,0.05),葡萄糖在目标范围内时间(TIR)显著升高(,P,<,0.05),且治疗组TIR增加水平显著优于对照组(,P,<,0.05),以TIR,>,70%为达标切点,治疗组TIR达标率为75.51%,高于对照组的55.10%(,P,<,0.05);③治疗后,两组中医证候总积分均下降,且治疗组积分低于对照组(,P,<,0.05);④治疗组治疗前后胰岛素日用量的差值低于对照组(,P,<,0.05)。,结论:,2,润燥益肾方能降低2型糖尿病患者血糖水平,减少血糖波动,显著提高TIR,并改善中医证候。
Objective:,2,To observe the effects of Runzao Yishen Decoction on glucose metabolism, blood glucose excursion and Chinese medical syndrome score in patients of type 2 diabetes mellitus(T2DM) with syndrome of kidney yin deficiency based on continuous glucose monitoring.,Methods:,2,A total of ninety-eight T2DM patients with syndrome of kidney yin deficiency were randomly divided into the treatment group and control group, 49 cases in each group.The control group was treated with insulin, and the treatment group was treated with Runzao Yishen Decoction on the basis of the control group, with a course of 12 weeks.The glycosylated hemoglobin(HbA1c), fasting plasma glucose(FPG), 2-hour postprandial glucose(2hPG), serum creatinine(Scr), alanine aminotransferase(ALT), fasting C-peptide(FCP), 2-hour postprandial C-peptide(2hCP), glycosylated albumin(GA), continuous glucose monitoring parameters, Chinese medical syndrome score and insulin dosage were compared between the two groups before and after treatment.,Results:,2,①After treatment, the levels of HbA1c, FPG and 2hPG were decreased significantly in both groups(,P,<,0.05), and the decrease in the treatment group was more obvious than that in the control group(,P,<,0.05) .②After treatment, calculated by continuous glucose monitoring system, the standard deviations(SD) of blood glucose, mean amplitude of glycemic excursion(MAGE) and mean blood glucose(MBG) were significantly decreased in both groups(,P,<,0.05), and the time in range(TIR) was significantly increased(,P,<,0.05), and the increase of TIR in the treatment group was significantly higher than that in the control group(,P,<,0.05) .Taken TIR,>,70% as the standard point, the rate of TIR compliance in the treatment group was 75.51%, which was significantly higher than that in the control group(55.10%) (,P,<,0.05) .③After treatment, the total score of Chinese medical syndrome in both groups was decreased, and the score in the treatment group was lower than that in the control group(,P,<,0.05) .④The difference of daily insulin dosage between pre- and post-therapy in the treatment group was lower than that in the control group(,P,<,0.05) .,Conclusion:,2,Runzao Yishen Decoction can reduce the blood glucose level and glucose excursion, significantly increase TIR and improve Chinese medical syndrome in T2DM patients.
2型糖尿病润燥益肾方肾阴亏虚持续葡萄糖监测血糖波动
type 2 diabetes mellitusRunzao Yishen Decoctionkidney yin deficiencycontinuous glucose monitoringglucose fluctuation
申晶,窦京涛. 糖尿病大血管并发症管理的思考: 历史与未来[J]. 中华糖尿病杂志,2020,12(11): 857-860.
刘玉华,高玲. 糖尿病视网膜病变治疗研究现状、问题与展望[J]. 中华眼底病杂志,2016,32(2): 206-210.
杨丹,鲍海萍,黄山. 糖尿病周围神经病变患者的电生理检查结果及患病危险因素分析[J]. 中国糖尿病杂志,2016,24(6): 540-542.
曾龙驿,江玮. 重视糖尿病肾病发生机制的研究[J]. 中华医学杂志,2016,96(17): 1313-1314.
BRERETON M F,ROHM M,ASHCROFT F M. β-Cell dysfunction in diabetes:a crisis of identity?[J]. Diabetes Obes Metab,2016,18(Suppl 1): 102-109.
翟迎九,郭美姿,吕清,等. 血糖波动对老年糖尿病患者氧化应激指标及胰岛β细胞功能的影响[J]. 中华临床医师杂志(电子版),2018,12(9): 500-503.
WEIR G C,BONNER-WEIR S. Islet β cell mass in diabetes and how it relates to function,birth,and death[J]. Ann N Y Acad Sci,2013,1281(1): 92-105.
包玉倩. 管理糖尿病,血糖波动不容轻视[J]. 中华糖尿病杂志,2016,8(12): 713-716.
AMERICAN DIABETES ASSOCIATION. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021[J]. Diabetes Care,2021,44(Suppl 1): S15-S33.
庞国明,孙扶. 2型糖尿病中医证型与动态血糖变化相关性的临床研究[J]. 中华中医药杂志,2017,32(3): 1384-1386.
李嘉蕾,苏明. 栗锦迁降糖方对2型糖尿病患者中医临床症状的影响[J]. 天津中医药,2017,34(11): 742-744.
张海生,刘晓奇,韩昕,等. 大柴胡汤对胰岛素强化治疗的初发肝胃郁热型2型糖尿病患者降糖疗效及血糖波动性的影响[J]. 湖北中医杂志,2019,41(11): 7-9.
杨志新,刘燕凤,曹翼,等. 三黄祛瘀汤联合西药治疗2型糖尿病气阴两虚、脉络瘀阻证的临床疗效及对患者血尿酸水平和颈动脉内中膜厚度的影响[J]. 河北中医,2020,42(6): 882-887.
黎海冰. 中西医结合治疗对2型糖尿病患者血糖波动的影响[J]. 湖北中医杂志,2014,36(4): 4-5.
庞博,赵进喜,王世东,等. 施今墨诊疗糖尿病学术思想与临证经验[J]. 世界中医药,2013,8(1): 60-63.
ALBERTI K G,ZIMMER P Z. Definition,diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med,1998,15(7): 539-553.
郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社,2002: 233-237.
陈湘君. 中医内科学[M]. 上海: 上海科学技术出版社,2004: 335-340.
BATTELINO T,DANNE T,BERGENSTAL R M,et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range[J]. Diabetes Care,2019,42(8): 1593-1603.
戴冬君,陆静毅,张磊,等. 应用葡萄糖在目标范围内时间评价2型糖尿病血糖控制情况的适宜切点分析[J]. 中华医学杂志,2020,100(38): 2990-2996.
施吉祥,朱菁,徐希明,等. 麦冬多糖多囊脂质体的制备及其抗2型糖尿病活性的研究[J]. 中医药信息,2018,35(5): 54-60.
刘印,陈兆杰. 知母多糖治疗糖尿病大鼠[J]. 中成药,2017,39(9): 1761-1765.
张伟云,刘华欣,王青,等. 23-乙酰泽泻醇B对2型糖尿病小鼠血糖的影响[J]. 中国药理学通报,2019,35(5): 639-643.
徐志猛,朱晶晶,江振洲,等. 山茱萸总萜对db/db糖尿病小鼠的降血糖作用[J]. 中国药科大学学报,2016,47(3): 337-341.
周迎春,张廉洁,张燕丽. 山茱萸化学成分及药理作用研究新进展[J]. 中医药信息,2020,37(1): 114-120.
石永芳. 黄芪多糖对Ⅱ-型糖尿病小鼠血糖的影响[J]. 安徽农业科学,2015,43(29): 29-30,37.
魏祥燕,王国娟,王桦影,等. 女贞子药理作用研究进展[J]. 上海中医药杂志,2017,51(8): 106-108.
吴英萍,张永杰,杨文奎. 黄芪多糖联用胰岛素对糖尿病大鼠胰岛素抵抗的作用机制研究[J]. 中国临床药理学杂志,2020,36(13): 1830-1832,1841.
BECK R W,BERGENSTAL R M,RIDDLESWORTH T D,et al. Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials[J]. Diabetes Care,2019,42(3): 400-405.
戴冬君,陆静毅,周健. 持续葡萄糖监测新指标:葡萄糖在目标范围内时间的临床意义解析[J]. 中华糖尿病杂志,2019,11(2): 139-142.
居悦俊,张琳琪,王冠怡,等. 糖尿病肾病Ⅲ期患者的目标血糖范围与糖化血红蛋白、1,5-脱水葡萄糖醇和糖化血清白蛋白的相关性研究[J]. 海南医学院学报,2020,26(3): 199-203,208.
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