目的 探讨天麦消渴片联合罗格列酮治疗2型糖尿病的临床疗效。方法 选取2014年3月-2015年11月在上海市普陀区中心医院接受治疗的2型糖尿病患者86例,随机分为对照组和治疗组,每组各43例。对照组口服罗格列酮钠片,1片/次,1次/d,最大剂量为2片/d。治疗组在对照组基础上口服天麦消渴片,2片/次,2次/d。两组患者均连续治疗12周。观察两组治疗后临床疗效,比较治疗前后血脂、血糖、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平变化情况。结果 治疗后,对照组与治疗组有效率分别为76.74%、93.02%,两组差异比较有统计学意义(P<0.05)。治疗后,两组TG、TC和LDL-C均明显降低,HDL-C升高,与治疗前比较差异有统计学意义(P<0.05)。治疗组的TC、TG、LDL-C和HDL-C改善程度均明显优于对照组(P<0.05)。治疗后,两组FPG、2 h PG和HbAlc水平比治疗前均明显降低(P<0.05);且治疗组降低程度优于对照组(P<0.05)。治疗后,两组患者HOMA-β升高,HOMA-IR降低,与治疗前比较差异有统计学意义(P<0.05)。治疗组HOMA-β和HOMA-IR的改善程度优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者血清TNF-α、IL-6含量均较同组治疗前显著降低(P<0.05);且治疗组比对照组降低的更显著(P<0.05)。结论 采用天麦消渴片联合罗格列酮治疗2型糖尿病疗效显著,可明显改善胰岛素抵抗和提高胰岛素敏感性,有利于纠正血脂异常和减轻机体炎症反应状态,具有一定的临床应用推广价值。

ObjectiveTo observe the clinical efficacy of Yangzheng Xiaoji Capsules combined with FOLFIRI scheme in treatment of colorectal cancer. Methods Patients (84 cases) with colorectal cancer who received surgical treatment in Shaanxi Provincial Tumor Hospital from April 2013 to March 2015 were numbered according to the order of registration and admission, and divided into the control group and treatment group according to the random number table method, and each group had 42 cases. The patients in the control group were treated by FOLFIRI chemotherapy scheme. The patients in the treatment group were po administered with Yangzheng Xiaoji Capsules, 4 capsules/time, three times daily. The patients in two groups were treated for two courses. After treatment, the clinical efficacies were evaluated, and the changes of T lymphocyte subsets (CD³⁺, CD⁴⁺, and CD⁸⁺) and NK cell activity were compared between the two groups. In the same time, incidence of adverse reactions and improvement of quality of life between two groups were analyzed. Results After treatment, the clinical efficacies in the control and treatment groups were 61.90% and 85.71%, respectively, and there was difference between two groups (P < 0.05). After treatment, CD³⁺, CD⁴⁺ and NK activity of the treatment group were significantly increased, while CD⁸⁺ activity was decrease, and the difference was statistically significant in the same group (P < 0.05). And those immune function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the incidence rates of myelosuppression and constipation in the treatment group were 2.38% and 4.76%, and lower than those in the control group (P < 0.05). The incidence rates of nausea/vomiting, hepatorenal dysfunction, diarrhea, and mucosal inflammation were slightly lower than those in the control group, but the differences were not statistically significant. After treatment, KPS score in the treatment group were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the rise ranges in the treatment group higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Yangzheng Xiaoji Capsules combined with FOLFIRI scheme has clinical curative effect in the treatment of colorectal cancer, can strengthen immunity, improve the quality of life of patients, is less adverse reactions, which has a certain clinical application value.