目的 观察参地益阴胶囊联合达格列净治疗老年2型糖尿病的临床疗效。方法 选取2023年1月—2025年1月承德市中心医院收治的80例血糖控制不佳老年2型糖尿病患者，依据随机数字法分为对照组和治疗组，每组各40例。对照组患者口服达格列净片，10 mg/次，每日1次。治疗组在对照组的基础上口服参地益阴胶囊，4粒/次，每日3次。两组用药12周。观察两组的临床疗效，比较两组胰岛素β细胞抵抗指数（HOMA-IR）、胰岛素β细胞分泌功能指数（HOMA-β）、简易健康调查表（SF-36）评分、空腹血糖（FPG）、2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、血清成纤维细胞生长因子21（FGF21）、血清超氧化物歧化酶（SOD）、半乳糖凝集素3（Gal-3）、血清内皮素（ET-1）水平。结果 治疗后，治疗组总有效率是95.00%，显著高于对照组的80.00%（P＜0.05）。治疗后，两组SF-36评分、HOMA-β指数显著升高，而HOMA-IR指数显著降低（P＜0.05）；治疗后，治疗组SF-36评分、HOMA-β指数高于对照组，HOMA-IR指数低于对照组（P＜0.05）。治疗后，两组FPG、2 hPG、HbA1c水平均较同组治疗前显著降低（P＜0.05）；治疗后，与对照组对比，治疗组FPG、2 hPG、HbA1c水平均更低（P＜0.05）。治疗后，两组FGF21、ET-1、Gal-3水平均显著降低，而SOD升高（P＜0.05）；治疗后，与对照组对比，治疗组患者FGF21、ET-1、Gal-3水平均较低，且治疗组SOD水平升高（P＜0.05）。结论 参地益阴胶囊联合达格列净治疗血糖控制不佳老年2型糖尿病效果明显，能平稳控制血糖，恢复胰岛β细胞功能，减弱机体炎症反应，提高患者生活质量，值得借鉴与应用。

Objective To explore the clinical study of Shendi Yiyin Capsules combined with dapagliflozin in treatment of elderly type 2 diabetes patients. Methods From January 2023 to January 2025, 80 elderly patients with type 2 diabetes who had poor blood sugar control and admitted to Chengde Central Hospital were selected and divided into control group and treatment group according to the random number method, with 40 cases in each group. Patients in control group were given oral Dapagliflozin Tablets, 10 mg each time, once daly. Patients in treatment group took Shendi Yiyin Capsules orally on the basis of control group, 4 capsules each time, 3 times daily. Both groups were treated with medication for 12 weeks. The clinical efficacy of two groups was observed. The levels of HOMA-IR, HOMA-β, SF-36 score, FPG, 2 hPG, HbA1c, FGF21, SOD, Gal-3, and ET-1 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, significantly higher than that of the control group (80.00%, P < 0.05). After treatment, the SF-36 scores and HOMA-β of both groups significantly increased, but HOMA-IR significantly decreased (P < 0.05). After treatment, the SF-36 score and HOMA-β of treatment group were higher than those of control group, but the HOMA-IR was lower than that of control group (P< 0.05). After treatment, the levels of FPG, 2 hPG, and HbA1c in both groups were significantly lower than those before treatment in same group (P < 0.05). After treatment, compared with the control group, the levels of FPG, 2 hPG, and HbA1c in treatment group were all lower (P < 0.05). After treatment, the levels of FGF21, ET-1, and Gal-3 in both groups significantly decreased, but SOD increased (P < 0.05). After treatment, compared with the control group, the levels of FGF21, ET-1, and Gal-3 in the treatment group were all lower, but the level of SOD in treatment group increased (P < 0.05). Conclusion The combination of Shendi Yiyin Capsules and dapagliflozin has a remarkable effect in treatment of elderly patients with type 2 diabetes who had poor blood sugar control. It can stably control blood sugar, restore the function of pancreatic β cells, reduce the inflammatory response of body, and improve the life quality of patients, which is worthy of reference and application.

R977

河北省医学科学研究重点课题计划项目（20231375）