目的 探讨金糖宁胶囊联合度拉糖肽注射液治疗2型糖尿病的临床疗效。方法 选取2020年4月—2023年3月在衡水市人民医院就诊的136例2型糖尿病患者，根据随机数字表法将136例患者分为对照组和治疗组，每组各68例。对照组皮下注射度拉糖肽注射液，初始1支/次，1次/周，然后维持剂量2支/次，1次/周。治疗组在对照组基础上口服金糖宁胶囊，4粒/次，3次/d。两组治疗6个月。观察两组的临床疗效，比较两组治疗前后主要血糖指标、血糖波动指标以及丙二醛（MDA）、谷胱甘肽过氧化物酶1（GPX-1）、过氧化物酶（LPO）、内皮素-1（ET-1）、FMD水平。结果 治疗组的总有效率为94.12%，对照组总有效率为82.35%，组间差异显著（P＜0.05）。治疗后，两组的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、餐后2 h血糖（2 hPG）均显著降低（P＜0.05）。治疗后，两组的平均血糖波动幅度（MAGE）、平均血糖（MBG）、血糖变异系数（CV）均低于治疗前（P＜0.05）；治疗后，治疗组的MAGE、MBG、CV低于对照组（P＜0.05）。治疗后，两组的血清GPX-1水平高于治疗前，血清MDA、LPO水平低于治疗前（P＜0.05）；治疗后，治疗组的血清GPX-1水平高于对照组，血清MDA、LPO水平低于对照组（P＜0.05）。治疗后，两组的血清ET-1水平明显降低，FMD明显升高（P＜0.05）；治疗组的血清ET-1水平低于对照组，FMD高于对照组（P＜0.05）。结论 金糖宁胶囊联合度拉糖肽注射液可显著提高2型糖尿病的疗效，降低血糖和血糖波动，减轻氧化应激反应，改善血管内皮功能。

Objective To investigate the clinical efficacy of Jintangning Capsules combined with Dulaglutide Injection in treatment of type 2 diabetes mellitus. Methods Patients (136 cases) with type 2 diabetes mellitus in Hengshui People’s Hospital from April 2020 to March 2023 were divided into control and treatment groups according to the random number table method, and each group had 68 cases. Patients in the control group was sc administered with Dulaglutide Injection, the initial dose was 1 dose/time, once weekly, and then the maintenance dose was 2 doses/time, once weekly. Patients in the treatment group were po administered with Jintangning Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the blood glucose indicators, blood glucose fluctuation indicators, the levels of MDA, GPX-1, LPO, ET-1, and FMD in two groups were compared. Results The total effective rate of the treatment group was 94.12%, while the control group was 82.35%, with a significant difference between the groups (P< 0.05). After treatment, FBG, HbA1c, and 2 hPG in two groups were significantly decreased (P < 0.05). After treatment, MAGE, MBG, and CV in two groups were lower than before treatment (P < 0.05). After treatment, MAGE, MBG, and CV in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum level of GPX-1 was higher than before treatment, while the serum levels of MDA and LPO were lower than before treatment (P < 0.05). After treatment, the serum level of GPX-1 in the treatment group was higher than that in the control group, but the serum levels of MDA and LPO were lower than those in the control group (P< 0.05). After treatment, the serum level of ET-1 in two groups was significantly decreased, but FMD in two groups was significantly increased (P< 0.05). The serum level of ET-1 in the treatment group was lower than that in the control group, but FMD in the treatment group was higher than that in the control group (P < 0.05). Conclusion Jintangning Capsules combined with Dulaglutide Injection can significantly improve the therapeutic effect of type 2 diabetes mellitus, reduce blood glucose and blood glucose fluctuation, alleviate oxidative stress reaction, improve vascular endothelial function.

R977

河北省医学科学研究课题计划项目（20232188）