目的 探讨消渴清颗粒联合恩格列净治疗2型糖尿病的临床疗效。方法 选取2019年7月-2020年7月商丘市第三人民医院收治的150例2型糖尿病患者为研究对象，根据用入院号的奇偶数分成对照组（75例）和治疗组（75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消渴清颗粒，6 g/次，3次/d。两组均经8周治疗后进行效果评价。观察两组的临床疗效，比较两组治疗前后血糖相关指标、血糖波动指标和血清学因子的变化情况。结果 经治疗，治疗组的总有效率为98.67%，明显高于对照组（82.67%，P<0.05）。经治疗，治疗组空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbAlc）、胰岛素（FINS）水平均较治疗前显著降低（P<0.05）；治疗后，治疗组血糖相关指标低于对照组（P<0.05）。经治疗，两组HOMA-β均增高，而HOMA-IR均降低（P<0.05）；治疗后，治疗组HOMA-β高于对照组，而HOMA-IR低于对照组（P<0.05）。经治疗，两组患者血糖标准差（SDBG）、平均血糖波动幅度（MAGE）、24 h血糖波动次数（NGE）及24 h血糖平均绝对差（MODD）均较治疗前显著降低（P<0.05）；且治疗后，治疗组血糖波动指标显著低于对照组（P<0.05）。经治疗，两组血清趋化素、生长分化因子-15（GDF-15）、单核细胞趋化蛋白-1（MCP-1）、淀粉样蛋白A（SAA）水平均显著降低，但1-磷酸鞘氨醇（SIP）显著升高（P<0.05）；治疗后，治疗组趋化素、GDF-15、MCP-1、SAA水平低于对照组，而SIP高于对照组（P<0.05）。结论 消渴清颗粒联合恩格列净治疗2型糖尿病患者具有较好的临床疗效，可有效降低患者血糖水平，改善机体趋化素、GDF-15、MCP-1、SAA、SIP水平，并有效保护胰岛β细胞功能，有着良好的临床应用价值。

Objective To investigate the clinical efficacy of Xiaokeqing Granules combined with empagliflozin in treatment of type 2 diabetes. Methods A total of 150 patients with type 2 diabetes who were admitted to Shangqiu Third People's Hospital from July 2019 to July 2020 were selected as the research objects, and they were divided into control group (75 cases) and treatment group (75 cases) according to the odd-even number of admission number. 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 Xiaokeqing Granules on the basis of the control group, 6 g/time, three times daily. Both groups were evaluated after 8 weeks of treatment. The clinical efficacy of the two groups was observed, and the changes of blood glucose related indexes, blood glucose fluctuation indexes and serological factors before and after treatment were compared between the two groups. Results After treatment, the total effective rate of treatment group was 98.67%, which was significantly higher than that of control group (82.67%, P<0.05). After treatment, the levels of FPG, 2 h PG, HbAlc, and FINS in treatment group were significantly decreased compared with before treatment (P<0.05). After treatment, the blood glucose related indexes in treatment group were lower than those in control group (P<0.05). After treatment, HOMA-β increased and HOMA-IR decreased in both groups (P<0.05). After treatment, HOMA-β in the treatment group was higher than that in the control group, while HOMA-IR was lower than that in the control group (P<0.05). After treatment, SDBG, MAGE, NGE and MODD in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the blood glucose fluctuation indexes of treatment group were significantly lower than those of control group (P<0.05). After treatment, the levels of serum chemokine, GDF-15, MCP-1, and SAA in both groups were significantly decreased, but the level of SIP was significantly increased (P<0.05). After treatment, the levels of chemokine, GDF-15, MCP-1, and SAA in the treatment group were lower than those in the control group, while SIP was higher than that in the control group (P<0.05). Conclusion Xiaokeqing Granules combined with empagliflozin has a good clinical effect in treatment of type 2 diabetes, and can effectively reduce the patient's blood glucose levels, and also can improve the body chemokine, GDF-15, MCP-1, SAA, SIP levels, and effectively protect the function of pancreatic beta cells, which has a good clinical application value.

R977

河南省医学科技攻关计划项目（LHGJ20191500）