目的 探讨六味地黄丸联合恩格列净治疗2型糖尿病的临床效果。方法 选取2020年3月—2023年2月首都医科大学附属北京友谊医院（平谷医院）收治的102例2型糖尿病患者作为研究对象，将所有的研究对象按治疗方法不同分为对照组和治疗组，每组各51例。对照组口服恩格列净片，10 mg/次，1次/d。治疗组在对照组治疗基础上口服六味地黄丸，1丸/次，2次/d。两组疗程均为12周。观察两组的临床疗效，比较两组治疗前后血糖指标、胰岛功能相关指标、2型糖尿病患者生存质量量表（DMQLS）评分及全血中性粒细胞与淋巴细胞比值（NLR）和血清三酰甘油（TG）、总胆固醇（TC）、载脂蛋白A1（ApoA1）、摄食抑制因子-1（Nesfatin-1）水平。结果 治疗后，治疗组总有效率是96.08%，较之对照组的82.35%显著提高（P＜0.05）。治疗后，两组空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）较同组治疗前均明显下降（P＜0.05）；且治疗后治疗组FPG、2 h PG、HbA1c低于对照组（P＜0.05）。治疗后，两组HOMA-IR和DMQLS评分较同组治疗前均明显下降，而QUICKI较同组治疗前均明显上升（P＜0.05）；且治疗后，治疗组HOMA-IR和DMQLS评分均低于对照组，QUICKI高于对照组，差异有统计学意义（P＜0.05）。治疗后，两组全血NLR和血清TG、TC、Nesfatin-1水平较同组治疗前均显著下降，血清ApoA1水平均显著升高（P＜0.05）；且治疗后，治疗组全血NLR和血清TG、TC、Nesfatin-1水平均低于对照组，血清ApoA1水平高于对照组（P＜0.05）。结论 六味地黄丸联合恩格列净治疗2型糖尿病可取得较为满意的效果，能有效降低机体炎症状态，纠正脂质代谢紊乱，对患者血糖的控制作用及胰岛功能、生活质量的改善效果突出。

Objective To explore the clinical effect of Liuwei Dihuang Pills combined with empagliflozin in treatment of type 2 diabetes. Methods A total of 102 patients with type 2 diabetes admitted to Beijing Friendship Hospital (Pinggu Hospital), Affiliated to Capital Medical University from March 2020 to February 2023 were selected as the study objects. All patients were divided into control group and treatment group according to different treatment methods, with 51 cases in each group. Patients in the control group were po administered with Empagliflozin Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Liuwei Dihuang Pills on the basis of the control group, 1 pill/time, twice daily. The treatment course of both groups was 12 weeks. After treatment, the clinical efficacy was evaluated, and the blood glucose indexes, islet function related indexes, quality of life scale (DMQLS) score, neutrophil lymphocyte ratio (NLR), serum triglyceride (TG), total cholesterol (TC), apoA1, and feeding inhibitory factor-1 (Nesfatin-1) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 96.08%, which was significantly higher than that of the control group (82.35%) (P < 0.05). After treatment, fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG) and glycosylated hemoglobin (HbA1c) in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, FPG, 2 h PG and HbA1c in the treatment group were lower than those in the control group (P < 0.05). After treatment, HOMA-IR and DMQLS scores in both groups were significantly decreased compared with before treatment, while QUICKI scores were significantly increased compared with before treatment (P < 0.05). After treatment, HOMA-IR and DMQLS scores in the treatment group were lower than those in the control group, and QUICKI scores were higher than those in the control group, with statistical significance (P < 0.05). After treatment, whole blood NLR, serum TG, TC and Nesfatin-1 levels in 2 groups were significantly decreased compared with before treatment, and serum ApoA1 levels were significantly increased (P < 0.05). After treatment, whole blood NLR, serum TG, TC and Nesfatin-1 levels in the treatment group were lower than those in the control group, and serum ApoA1 level was higher than that in the control group (P < 0.05). Conclusion Liuwei Dihuang Pills combined with empagliflozin has achieve satisfactory effect in treatment of type 2 diabetes, and can effectively reduce the inflammatory state of the body, correct the disorder of lipid metabolism, which can improve the blood sugar control, islet function and quality of life of patients.

R977

吴阶平医学基金会临床科研专项资助基金（320.6750.18528）