本文選題：2 + 型糖尿病　； 參考：《華北理工大學(xué)》2015年碩士論文

【摘要】：目的觀察芩連降糖方聯(lián)合胰島素治療2型糖尿病濕熱證患者的療效,通過比較患者用藥前后的癥狀體征的改變、胰島素用量的調(diào)整、各化驗(yàn)指標(biāo)的差異,證實(shí)芩連降糖方的臨床療效。方法1研究對象本次試驗(yàn)病例選自2013年6月至2014年10月之間華北理工大學(xué)附屬唐山市中醫(yī)醫(yī)院內(nèi)二門診的2型糖尿病患者98例,治療組50例,對照組48例。2研究方法挑選符合納入標(biāo)準(zhǔn)的濕熱證型的2型糖尿病患者,將其隨機(jī)分為兩組,均給予胰島素諾和靈30R治療(早晚餐前半小時(shí)注射),治療組在此基礎(chǔ)上加用芩連降糖方(早晚餐后半小時(shí),每次200ml),4周為一個(gè)療程,觀察3個(gè)療程。3觀察指標(biāo)統(tǒng)計(jì)患者年齡、性別、病程、體重指數(shù)、空腹血糖、餐后兩小時(shí)血糖、糖化血紅蛋白、血脂四項(xiàng)、血壓、胰島素用量、低血糖次、血糖達(dá)標(biāo)時(shí)間、胰島素達(dá)標(biāo)用量等指標(biāo)以及中醫(yī)癥狀情況,記錄不同化驗(yàn)指標(biāo)的變化,將上述資料應(yīng)用SPSS 17.0進(jìn)行統(tǒng)計(jì)分析,以獲得兩組治療前后的療效差異。結(jié)果1糖化血紅蛋白:兩組治療后值低于治療前,療后治療組糖化血紅蛋白值低于對照組(P0.05)差異有統(tǒng)計(jì)學(xué)意義。2空腹血糖:兩組治療后值均低于治療前值,組間比較療后第8、12周治療組空腹血糖值低于對照組(P0.05);餐后兩小時(shí)血糖:兩組治療后值均低于治療前值(P0.05),組間比較治療后第12周治療組餐后兩小時(shí)血糖低于對照組(P0.05)。3血脂四項(xiàng):治療組療后血脂四項(xiàng)值均低于治療前(P0.05);療后組間比較:治療組總膽固醇及高密度膽固醇值低于對照組(P0.05)。4體重指數(shù):治療組療后體重指數(shù)值低于治療前數(shù)值(P0.05),對照組無明顯改變;療后組間比較治療組體重指數(shù)低于對照組(P0.05)。5胰島素用量:兩組治療后均較治療前胰島素用量減少(P0.05);療后組間比較,在第8及12周治療組胰島素用量低于對照組(P0.05)。應(yīng)用胰島素達(dá)標(biāo)時(shí)間:治療組時(shí)間短于對照組(P0.05);胰島素達(dá)標(biāo)時(shí)用量:治療組用量低于對照組(P0.05)差異有統(tǒng)計(jì)學(xué)意義。6低血糖發(fā)生次數(shù):治療組低血糖發(fā)生次數(shù)低于對照組(P0.05)。7療后中醫(yī)療效比較:治療組共50人,總有效44人,有效率為88.00%,對照組48人,總有效33人,有效率為68.75%(P0.05)差異有統(tǒng)計(jì)學(xué)意義。中醫(yī)單項(xiàng)癥候積分比較:療后治療組在多食易饑、胸脘腹脹、乏力倦怠、氣短懶言、小便黃赤、舌紅苔膩、形體肥胖方面優(yōu)于對照組(P0.05)。8安全性指標(biāo)檢查:兩組治療前后患者在血壓、肝功、腎功、血常規(guī)方面未見明顯異常,未出現(xiàn)不良反應(yīng)事件發(fā)生。結(jié)論芩連降糖方聯(lián)合胰島素應(yīng)用,能降低2型糖尿病濕熱證患者的糖化血紅蛋白、血糖、血脂四項(xiàng)、體重指數(shù)的數(shù)值,能夠改善中醫(yī)癥狀;且能夠減少低血糖次數(shù)的發(fā)生、減少胰島素用量及達(dá)標(biāo)時(shí)間,療效肯定。
[Abstract]:Objective to observe the curative effect of Qinlianjiangtang decoction combined with insulin in treating type 2 diabetes mellitus with damp-heat syndrome, and to compare the changes of symptoms and signs before and after treatment, the adjustment of insulin dosage, and the differences of test indexes. To confirm the clinical effect of Qinlianjiangtang prescription. Methods 1 from June 2013 to October 2014, 98 patients with type 2 diabetes mellitus were selected from Tangshan Hospital of traditional Chinese Medicine affiliated to North China University of Technology. In the control group, 48 cases of type 2 diabetes with damp-heat syndrome were selected and randomly divided into two groups. All of them were treated with insulin novolin 30R (half an hour before breakfast and half an hour before meal). The treatment group was treated with Qilianjiangtang recipe (200ml / min for 4 weeks after half a meal in the morning and evening). Three courses of treatment were observed and the age of the patients was counted. Gender, course of disease, body mass index, fasting blood glucose, two hours postprandial blood glucose, glycosylated hemoglobin, four items of blood lipid, blood pressure, insulin dosage, hypoglycemia, blood glucose standard time, insulin standard dosage, and TCM symptoms, etc. The changes of different test indexes were recorded and the above data were statistically analyzed with SPSS 17.0 in order to obtain the difference of curative effect between the two groups before and after treatment. Results (1) glycosylated hemoglobin: the value of glycosylated hemoglobin in the treatment group was lower than that in the control group (P 0.05). The fasting blood glucose level in the treatment group was lower than that in the control group at week 8 and 12 after treatment, and the two hours postprandial blood glucose in the treatment group was lower than that in the control group (P 0.05). The blood glucose in the treatment group was lower than that in the control group at the 12th week after treatment, and that in the treatment group was lower than that in the control group at the 12th week after treatment. Four items of blood lipids: after treatment, the blood lipid levels in the treatment group were lower than those in the pre-treatment group, and the comparison between the treatment groups: the total cholesterol and high density cholesterol values in the treatment group were lower than those in the control group (P 0.050.4. body mass index): the body weight index value of the treatment group was lower than that of the treatment group after treatment. There was no significant change in the former value of P0.05A in the control group. Body mass index (BMI) of the treatment group was lower than that of the control group (P 0.05). The insulin dosage of the treatment group was lower than that of the control group (P 0.05) after treatment, and that of the treatment group was lower than that of the control group (P 0.05) at the 8th and 12th week after treatment. The time of using insulin to reach the standard: the time of treatment group was shorter than that of control group (P 0.05); the dosage of insulin in treatment group was lower than that of control group (P 0.05). There was significant difference in the frequency of hypoglycemia: the frequency of hypoglycemia in treatment group was lower than that in control group. Comparison of the efficacy of traditional Chinese Medicine (TCM) after treatment in the control group P0.057.The treatment group consisted of 50 patients, The total effective rate was 88.00, the control group was 48, the total effective rate was 33, and the effective rate was 68.75 (P 0.05). Comparison of TCM single symptom score: after treatment, the treatment group is prone to hunger, abdominal distension, fatigue, shortness of breath, yellow red urination, red tongue fur and greasy tongue, The safety index of body obesity was better than that of control group (P 0.05.8): there was no obvious abnormality in blood pressure, liver function, renal function and blood routine before and after treatment, and no adverse events occurred in the two groups. Conclusion Qinlianjiangtang prescription combined with insulin can reduce the levels of glycosylated hemoglobin, blood glucose, blood lipid, body mass index, and reduce the frequency of hypoglycemia in patients with type 2 diabetes mellitus. Reducing the dosage of insulin and meeting the standard time, the curative effect is positive.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R259

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