目的 探讨芪蛭降糖片联合度拉糖肽对2型糖尿病患者血糖和胰岛素功能的影响。方法 选择2023年12月—2024年12月辽阳市中心医院收治的2型糖尿病患者128例，采用随机数字表法将其分为对照组（64例）与治疗组（64例）。对照组经皮下注射度拉糖肽注射液，起始剂量为0.75 mg/次，1次/周，为进一步改善血糖控制，剂量可增加至1.5 mg/次，1次/周。治疗组在对照组基础上口服芪蛭降糖片，5片/次，3次/d，两组治疗疗程均为3个月。观察两组患者的临床疗效，比较两组患者治疗前后血糖指标[空腹血糖（FBG）、糖化血红蛋白（HbA1c）、餐后2 h血糖（2 h PG）]、胰岛素功能指标[空腹胰岛素（FIns）、胰岛β细胞功能（HOMA-β）、胰岛β细胞功能（HOMA-IR）]。结果 与对照组相比，治疗组显示出更高的总有效率（95.31% vs 82.81%），差异具有统计学意义（P＜0.05）。与治疗前相比，两组治疗后FBG、2 h PG、HbA1c水平均明显下降（P＜0.05）；且治疗组患者血糖指标水平显著低于对照组（P＜0.05）。治疗后，两组FIns与HOMA-IR均较治疗前显著下降，而HOMA-β水平显著升高（P＜0.05），同时治疗组胰岛素功能指标的改善情况明显优于对照组（P＜0.05）。结论 芪蛭降糖片联合度拉糖肽治疗2型糖尿病患者的临床疗效显著，在降低血糖的同时，能够改善胰岛素功能，安全性高。

Objective To investigate the effects of Qizhi Jiangtang Tablets combined with dulaglutide on blood glucose and insulin function in patients with type 2 diabetes mellitus. Methods A total of 128 patients with type 2 diabetes mellitus admitted to Liaoyang Central Hospital from December 2023 to December 2024 were enrolled and randomly divided into a control group (64 cases) and a treatment group (64 cases) using a random number table method. The control group received subcutaneous injection of dulaglutide at a starting dose of 0.75 mg, once weekly; the dose could be increased to 1.5 mg once weekly for further glycemic control. The treatment group received oral Qizhi Jiangtang Tablets (5 tablets, three times daily) on the basis of the control group. Both groups were treated for 3 months. The clinical efficacy was observed, and blood glucose parameters [fasting blood glucose (FBG), glycated hemoglobin (HbA1c), 2-hour postprandial blood glucose (2 h PG)] and insulin function parameters [fasting insulin (FIns), homeostatic model assessment of β-cell function (HOMA-β), homeostatic model assessment of insulin resistance (HOMA-IR)] were compared between the two groups before and after treatment. Results Compared with the control group, the treatment group showed a significantly higher clinical effective rate (95.31% vs 82.81%, P < 0.05). After treatment, FBG, 2 h PG, and HbA1c levels decreased significantly in two groups compared with before treatment (P < 0.05). The treatment group had significantly lower levels of these blood glucose parameters than the control group (P < 0.05). After treatment, FIns and HOMA-IR decreased significantly, while HOMA-β increased significantly in both groups (P < 0.05). The improvement in insulin function parameters was significantly greater in the treatment group than in the control group (P < 0.05). Conclusion Qizhi Jiangtang Tablets combined with dulaglutide demonstrates significant clinical efficacy in the treatment of patients with type 2 diabetes mellitus. It not only reduces blood glucose levels but also improves insulin function with high safety.

R977

辽宁省重点研发计划指导计划项目(2022045031)