目的 探讨消渴丸联合达格列净治疗2型糖尿病的临床效果。方法 选取2019年1月—2021年8月淮南东方医院集团总医院收治的106例2型糖尿病患者，使用随机数字表法将这106例患者分成对照组和治疗组，每组各53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消渴丸，10丸/次，3次/d，饭前温开水送服。观察两组连续治疗12周后的降糖疗效。比较治疗前后两组糖代谢及胰岛功能指标[空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、胰岛β细胞功能指数（HOMA-β）、胰岛素抵抗指数（HOMA-IR）]、血液流变学指标[血浆黏度（PV）、红细胞聚集指数（EAI）、红细胞变形指数（EDI）、红细胞比容（HCT）]及血清肿瘤坏死因子（TNF）-α、一氧化氮（NO）、超氧化物歧化酶（SOD）、丙二醛（MDA）水平。结果 治疗后，治疗组患者总有效率是94.3%，较对照组的81.1%显著提高（P<0.05）。治疗后，两组FPG、2 h PG、HbA1c及HOMA-IR均显著降低，HOMA-β则均显著增高（P<0.05）；但均以治疗组改善更显著（P<0.05）。治疗后，两组血液流变学参数PV、EAI、EDI、HCT值均显著低于治疗前（P<0.05）；且均以治疗组的改善更显著（P<0.05）。治疗后，两组患者血清TNF-α、MDA水平均显著下降，血清NO、SOD水平均显著升高（P<0.05）；且治疗后，治疗组血清TNF-α、NO、SOD和MDA水平的改善较对照组更显著（P<0.05）。结论 消渴丸联合达格列净治疗2型糖尿病能获得安全、良好的降糖效果，并能进一步改善患者胰岛功能及血液流变学状态，减轻炎症及氧化应激损伤，保护血管内皮功能，值得临床推广应用。

Objective To investigate the clinical effect of Xiaoke Pills combined with dapagliflozin in treatment of type 2 diabetes. Methods A total of 106 patients with type 2 diabetes admitted to Huainan Oriental Hospital Group General Hospital from January 2019 to August 2021 were selected and divided into control group and treatment group by random number table method, with 53 cases in each group. Patients in the control group were po administered with Dapagliflozin Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Xiaoke Pills on the basis of the control group, 10 pills/time, three times daily. The hypoglycemic efficacy of the two groups after continuous treatment for 12 weeks was observed. The glucose metabolism and pancreatic islet function indexes[fasting blood glucose (FPG), 2h postprandial blood glucose (2h PG), glycosylated hemoglobin (HbA1c), pancreatic islet β-cell function index (HOMA-β), insulin resistance index (HOMA-β), HOMA-IR, hemorheological indexes[plasma viscosity (PV), erythrocyte aggregation index (EAI), erythrocyte deformability index (EDI), hematocrit (HCT)] and serum tumor necrosis factor (TNF)-α, monoxide Nitrogen (NO), superoxide dismutase (SOD), malondialdehyde (MDA) levels were compared between the two groups before and after treatment. The adverse reactions of the two groups were recorded. Results After treatment, the total effective rate of the treatment group was 94.3%, which was significantly higher than that of the control group (81.1%, P < 0.05). After treatment, FPG, 2 h PG, HbA1c and HOMA-IR were significantly decreased, while HOMA-β was significantly increased in both groups (P < 0.05). However, the improvement was more significant in the treatment group (P < 0.05). After treatment, the values of hemorheology parameters PV, EAI, EDI and HCT in the two groups were significantly lower than those before treatment (P < 0.05). The improvement in treatment group was more significant (P < 0.05). After treatment, the serum levels of TNF-α and MDA were significantly decreased, and the serum levels of NO and SOD were significantly increased in the two groups (P < 0.05). After treatment, the serum levels of TNF-α, NO, SOD and MDA in the treatment group were improved more significantly than those in the control group (P < 0.05). Conclusion Xiaoke Pills combined with dapagliflozin has good hypoglycemic effect in treatment of type 2 diabetes, and can further improve islet function and hemorheology status, reduce inflammation and oxidative stress injury, and protect vascular endothelial function, which is worthy of clinical application

R977