目的 探讨消渴丸联合度拉糖肽注射液和盐酸二甲双胍片治疗2型糖尿病的疗效。方法 选取2023年12月—2025年1月邯郸市中心医院收治的118例2型糖尿病患者，采用随机数字表法将患者分为对照组和治疗组，每组各59例。两组均口服盐酸二甲双胍片，0.5 g/次，2次/d。对照组接受度拉糖肽注射液，1.5 mg/次，1次/周。治疗组在对照组的基础上口服消渴丸，5丸/次，3次/d。两组均治疗3个月。比较两组临床疗效、生活质量、糖代谢、胰岛功能和血清指标。结果 治疗组的总有效率为94.92%，高于对照组的总有效率79.66%（P＜0.05）。治疗后，两组糖尿病控制状况评价量表（CSSD70）评分上升，糖尿病特异性生存质量量表（A-DQOL）、汉密尔顿抑郁量表（HAMD）评分下降（P＜0.05）；且治疗组CSSD70评分高于对照组，A-DQOL、HAMD评分低于对照组（P＜0.05）。治疗后，两组空腹血糖（FBG）、糖化血红蛋白（HbA1c）下降（P＜0.05），且治疗组FBG、HbA1c低于对照组（P＜0.05）。治疗后，两组空腹胰岛素（FINS）、稳态模型评估-胰岛素抵抗指数（HOMA-IR）下降，胰岛素敏感性指数（ISI）、胰岛素作用指数（IAI）升高（P＜0.05）；且治疗组的FINS、HOMA-IR低于对照组，ISI、IAI高于对照组（P＜0.05）。治疗后，两组血清内皮素-1（ET-1）、凝血酶调节蛋白（TM）水平下降，血清总抗氧化能力（T-AOC）、超氧化物歧化酶（SOD）水平升高（P＜0.05），且治疗组血清ET-1、TM水平低于对照组，血清T-AOC、SOD水平高于对照组（P＜0.05）。结论 消渴丸联合度拉糖肽注射液和盐酸二甲双胍片治疗2型糖尿病的效果显著，可有效改善胰岛功能和降低血糖，调节糖代谢水平，减轻机体氧化应激和胰岛素抵抗，改善血管内皮功能。

Objective To explore the clinical efficacy of Xiaoke Pills combined with Dulaglytide Injection and Metformin Hydrochloride Tablets in treatment of type 2 diabetes mellitus. Methods 118 Patients with type 2 diabetes mellitus admitted to Handan Central Hospital from December 2023 to January 2025 were selected. Using a random number table method, the patients were divided into control group and treatment group, with 59 cases in each group. Two groups were po administered with Metformin Hydrochloride Tablets at 0.5 g per time, twice daily. The control group received Dulaglytide Injection at 1.5 mg per time, once weekly. The treatment group additionally took Xiaoke Pillson the base of the control group's regimen, 5 pills per time, three times daily. Two groups were treated for 3 months. The clinical efficacy, quality of life, glucose metabolism, pancreatic islet function, and serum indicators were compared between two groups. Results The total clinical effective rate of the treatment group was 94.92%, which was higher than 79.66% in the control group (P < 0.05). After treatment, the Diabetes Control Status Evaluation Scale (CSSD70) scores increased, while the adjusted Diabets Quality of Life (A-DQOL) scores and Hamilton Depression Scale (HAMD) scores decreased in two groups (P < 0.05). And the CSSD70 score in the treatment group was higher than that in the control group, while the A-DQOL and HAMD scores were lower (P < 0.05). After treatment, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) levels decreased in two groups (P < 0.05), and FBG and HbA1c levels in the treatment group showed lower than the control group (P < 0.05). After treatment, fasting insulin (FINS) and the homeostasis model assessment-insulin resistance index (HOMA-IR) decreased, while the insulin sensitivity index (ISI) and insulin action index (IAI) increased in two groups (P < 0.05). And the FINS and HOMA-IR levels in the treatment group were lower than those in the control group, while the ISI and IAI were higher (P < 0.05). After treatment, serum levels of endothelin-1 (ET-1) and thrombomodulin (TM) decreased, while the total antioxidant capacity (T-AOC) and superoxide dismutase (SOD) increased in two groups (P < 0.05). And the serum levels of ET-1 and TM in the treatment group were lower than those in the control group, while the serum levels of T-AOC and SOD were higher (P < 0.05). Conclusion The combination of Xiaoke Pills and Dulaglytide Injection and Metformin Hydrochloride Tablets has significant efficacy in treatment of type 2 diabetes mellitus, can effectively improving pancreatic islet function, reducing blood glucose, regulating glucose metabolism levels, alleviating oxidative stress and insulin resistance, and enhancing vascular endothelial function.

R977

河北省卫生健康委医学科学研究课题（20191847）