目的 观察玉泉丸对气阴两虚型接受胰岛素治疗的糖尿病患者血糖波动的影响。方法 选取本院2012年1月—2014年8月符合西医糖尿病和中医气阴两虚证诊断标准并接受胰岛素治疗的患者106例, 随机分为治疗组和对照组, 所有受试者延续原胰岛素治疗方案, 治疗组给予玉泉丸的中药颗粒剂, 每日1次, 对照组不予中药治疗, 但仍进行相应的随访。疗程28 d。试验开始和结束时分别评估中医证候积分和动态血糖监测系统(CGMS)获得的平均血糖水平(MBG)、低血糖的时间百分率(DBLL)、血糖水平的标准差(SDBG)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)和日间血糖平均绝对差(MODD)。结果 治疗组咽干口燥、倦怠乏力、多食易饥、气短懒言、手足心热、自汗、心悸、失眠、舌象的证候积分治疗后较治疗前有明显改善(P<0.05);两组治疗后比较, 治疗组对中医症候的咽干口燥、手足心热、自汗、心悸、失眠、舌象改善作用明显优于对照组(P<0.05)。治疗组患者治疗后MAGE和MODD较治疗前减小(P<0.05), MAGE治疗前后差值与对照组治疗前后差值组间比较, 差异显著(P<0.05)。结论 玉泉丸干预可以改善气阴两虚型接受胰岛素治疗的糖尿病患者的中医证候及血糖波动水平。

Objective To observe the effect of Yuquan Pill on the blood glucose fluctuation of diabetic patients receiving insulin therapy with the deficiency type of qi and yin. Methods One hundred and six patients in Nanjing city hospital of traditional Chinese medicine from January 2012 to August 2014, with the diabetes mellitus in the view of Western medicine and with deficiency of both qi and yin diagnosis standard according to the theory of traditional Chinese medicine (TCM), were selected and randomly divided into treatment group and control group. The original insulin therapy of all subjects continues. The patients in treatment group were given Yuquan Pill, once daily. The patients in control group were not treated by Chinese materia medica, but kept corresponding follow-up. The course of treatment was 28 d. These indicators were to assess at the beginning and end of the research, including the mean blood glucose level (MBG), duration below low limit (DBLL), standard deviation of blood glucose (SDBG), largest amplitude glycemic excursions (LAGE), mean amplitude of glycemic excursions (MAGE), and means of daily differencies (MODD). Results In the treatment group, dry mouth and throat, fatigue, eat easy to hunger, shortness of breath, sweating, palpitation, cardiac heat, syndrome integral treatment of insomnia, and tongue were improved significantly compared with before the treatment (P < 0.05); The two groups after treatment, TCM syndromes of throat dry, feverish feeling in palms and soles, sweating, palpitations, insomnia, and tongue coating were better improved significantly in the treatment than those in the control group (P < 0.05). The MAGE of the patients in the treatment group decreased after the treatment compared with those before treatment (P < 0.05). The MAGE level was decreased apparently compared with the control group. Conclusion This study shows that the fluctuation of blood glucose levels in diabetic patients receiving insulin therapy with the deficiency type of qi and yin can be improved by the treatment of Yuquan Pill.

南京市卫生局资助青年课题(QYK11136)