目的 探讨津力达颗粒联合达格列净片治疗老年2型糖尿病的临床效果。方法 选取2017年9月-2019年5月内蒙古自治区人民医院收治的84例2型糖尿病老年患者，随机分成对照组（42）和治疗组（42例）。对照组晨服达格列净片，10 mg/次，1次/d。治疗组在对照组基础上口服津力达颗粒，1袋/次，3次/d。两组均连续治疗12周。观察两组患者临床疗效，同时比较治疗前后两组患者体质量指数（BMI）值、外周血中性粒细胞与淋巴细胞比值（NLR）、胰岛素抵抗（HOMA-IR）值、胰岛β细胞功能（HOMA-β）值及血清糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后2 h血糖（2 h PG）、C反应蛋白（CRP）、淀粉样蛋白A（AA）、丙二醛（MDA）、超氧化物歧化酶（SOD）水平。结果 治疗后，对照组和治疗组总有效率分别为81.0%、95.2%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者血清HbA1c、FPG和2 h PG水平及BMI值均显著低于治疗前（P<0.05），且治疗组下降程度比对照组更显著（P<0.05）。治疗后，两组患者外周血NLR值和血清CRP、AA水平均显著降低（P<0.05），且治疗组上述微炎症标志物均显著低于对照组（P<0.05）。治疗后，两组患者HOMA-IR值及血清MDA水平较治疗前均显著降低（P<0.05），而HOMA-β值和血清SOD水平均显著增加（P<0.05），且治疗组以上指标的改善效果更明显（P<0.05）。结论 津力达颗粒联合达格列净片治疗老年2型糖尿病的整体疗效确切，有助于控制血糖，改善机体微炎症状态，纠正体内氧化应激，保护胰岛功能。

Objective To investigate the clinical effect of Jinlida Granules combined with dapagliflozin in treatment of elderly type 2 diabetes mellitus. Methods Patients (84 cases) with type 2 diabetes mellitus in Inner Mongolia People's Hospital from September 2017 to May 2019 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Dapagliflozin Tablets in the morning, 10 mg/time, once daily. Patients in the treatment group were po administered with Jinlida Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the living ability, the BMI, NLR of peripheral blood, the value of HOMA-IR and HOMA-β, the serum level of HbA1c, FPG, 2 h PG, CRP, AA, MDA and SOD in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.0% and 95.2%, respectively, and there were differences between two groups (P<0.05). After treatment, the serum level of HbA1c, FPG and 2 h PG, and BMI in two groups were significantly decreased (P<0.05), and the glucose metabolism index and BMI value in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the NLR of peripheral blood, and the serum level of CRP and AA in two groups were significantly decreased (P<0.05), and the micro-inflammatory indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the value of HOMA-IR and the serum level of MDA in two groups were significantly decreased (P<0.05), but the value of HOMA-β and the serum level of SOD were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Jinlida Granules combined with dapagliflozin in treatment of elderly type 2 diabetes mellitus have overall curative effect, which is helpful for controlling the blood glucose, improving micro-inflammatory state, correcting oxidative stress, and protecting of islet function.

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