目的 探讨养阴降糖片联合格列美脲片治疗2型糖尿病的临床疗效。方法 选取2021年3月—2022年3月在山西运城同德医院治疗的106例2型糖尿病患者，根据住院号的奇偶性分为对照组和治疗组，每组各53例。对照组早餐时口服格列美脲片，初始2 mg/次，1次/d，对降糖药敏感者1 mg/次，1次/d，维持剂量1～4 mg/次，1次/d，最大维持量不超过6 mg/次，1次/d；在此基础上治疗组口服养阴降糖片，4片/次，3次/d。两组患者均连续治疗4周进行效果对比。观察两组患者临床疗效，比较治疗前后两组患者空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbAlc）、血胰岛素（FINS）和胰岛素抵抗指数（HOMA-IR）水平，HFS-II评分、DDS评分、中医证候积分、DSC评分和CDES-SF评分，血清视黄醇结合蛋白4（RBP4）、摄食抑制因子-1（Nesfatin-1）、抑瘤素M（OSM）、鸢尾素和血清网膜素-1（Omentin-1）水平。结果 治疗后，对照组临床有效率为81.13%，明显低于治疗组98.11%（P＜0.05）。治疗后，两组FPG、2 h PG、HbAlc、FINS、HOMA-IR水平均明显降低（P＜0.05），并以治疗组下降的最为明显（P＜0.05）。治疗后，两组HFS-II评分、DDS评分、中医证候积分明显下降，而DSC评分和CDES-SF评分明显升高（P＜0.05），且治疗组相关量表积分改善最为明显（P＜0.05）。经治疗，两组血清RBP4和OSM水平明显降低，而Nesfatin-1、鸢尾素和Omentin-1水平明显升高（P＜0.05），且治疗组这些细胞因子水平明显好于对照组（P＜0.05）。结论 养阴降糖片联合格列美脲片治疗2型糖尿病可促进机体血糖下降，提高患者自我效能和自我照顾能力，降低痛苦和低血糖恐惧情绪。

Objective To explore the clinical efficacy of Yangyin Jiangtang Tablets combined with glimepiride in treatment of type 2 diabetes. Methods Patients (106 cases) with type 2 diabetes in Shanxi Yuncheng Tongde Hospital from March 2021 to March 2022 were randomly divided into control and treatment group according to the parity of the hospitalization number, and each group had 53 cases. Patients in the control group were po administered with Glimepiride Tablets at breakfast, the initial dose was 2 mg/time, 1 mg/time for those sensitive to hypoglycemic drugs, the maintenance dose was 1-4 mg, and the maximum maintenance dose was not more than 6 mg, once daily. Patients in the treatment group were po administered with Yangyin Jiangtang Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the levels of FPG, 2 h PG, HbAlc, FINS, and HOMA-IR, HFS-Ⅱ scores, DDS scores, TCM symptom scores, DSC scores and CDES-SF scores, the levels of RBP4, OSM, Nesfatin-1, irisin and Omentin-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 81.13%, which was significantly lower than that of the treatment group (98.11%) (P < 0.05). After treatment, the levels of FPG, 2 h PG, HbAlc, FINS and HOMA-IR were significantly decreased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, HFS-Ⅱ score, DDS score and TCM syndrome score were significantly decreased, while DSC score and CDES-SF score were significantly increased in two groups (P < 0.05), and the score of related scale in the treatment group improved most significantly (P < 0.05). After treatment, the levels of serum RBP4 and OSM were significantly decreased, while the levels of Nesfatin-1, irisin and Omentin-1 were significantly increased in two groups (P < 0.05), and the levels of these cytokines in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Yangyin Jiangtang Tablets combined with glimepiride tablets in the treatment of type 2 diabetes can promote the decrease of blood sugar, provide high self-efficacy and self-care ability, and reduce pain and hypoglycemia fear.

R977

山西省卫生健康委科研课题(2019165)