1.广东省代谢病中西医结合研究中心,广东省广州市番禺区大学城外环东路280号,510006
2.广东药科大学
gyguoyz@163.com,(020)39352609
收稿:2021-05-31,
修回:2021-09-30,
纸质出版:2022-01-02
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彭云娇,刘晓敏,孟珍珍等.贞术调脂胶囊联合西医常规疗法治疗老年2型糖尿病患者35例实效性真实世界研究[J].中医杂志,2022,63(01):43-49.
PENG Yunjiao,LIU Xiaomin,MENG Zhenzhen,et al.Zhenzhu Tiaozhi Capsule (贞术调脂胶囊) Combined with Conventional Western Medicine in the Treatment of 35 Elderly Patients with Type 2 Diabetes: A Real-world Pragmatic Study[J].Journal of Traditional Chinese Medicine,2022,63(01):43-49.
彭云娇,刘晓敏,孟珍珍等.贞术调脂胶囊联合西医常规疗法治疗老年2型糖尿病患者35例实效性真实世界研究[J].中医杂志,2022,63(01):43-49. DOI: 10.13288/j.11-2166/r.2022.01.009.
PENG Yunjiao,LIU Xiaomin,MENG Zhenzhen,et al.Zhenzhu Tiaozhi Capsule (贞术调脂胶囊) Combined with Conventional Western Medicine in the Treatment of 35 Elderly Patients with Type 2 Diabetes: A Real-world Pragmatic Study[J].Journal of Traditional Chinese Medicine,2022,63(01):43-49. DOI: 10.13288/j.11-2166/r.2022.01.009.
目的
2
观察贞术调脂胶囊联合西医常规疗法治疗老年2型糖尿病的有效性和安全性。
方法
2
基于真实世界采用实效性对照试验的设计方法,选择65例已确诊的老年2型糖尿病患者,根据患者意愿分为西医常规治疗组35例与贞术调脂胶囊组30例。西医常规治疗组根据诊疗指南给予饮食和运动指导、口服降糖药治疗,贞术调脂胶囊组在西医常规治疗的基础上加服贞术调脂胶囊,每次4粒(0.63 g/粒),每日3次。两组均连续治疗12周。治疗前后检测两组患者空腹静脉血浆葡萄糖(FBG)、糖化血红蛋白(HbA1c)水平,并判定FBG和HbA1c的达标情况;进行焦虑自评量表(SAS)、抑郁自评量表(SDS)、健康自评简表(SF-36)和糖脂代谢病中医证候量表评分。治疗期间记录低血糖事件及不良事件发生情况。
结果
2
贞术调脂胶囊组平均年龄大于西医常规治疗组,治疗前使用西药降糖药物种类少于西医常规治疗组(
P
<0.05)。两组治疗后FBG和HbA1c水平、FBG和HbA1c的达标情况与本组治疗前比较差异均无统计学意义(
P
>0.05);治疗后贞术调脂胶囊组FBG水平低于西医常规治疗组,FBG达标情况优于西医常规治疗组(
P
<0.05)。采用Logistic回归调整变量,结果显示,贞术调脂胶囊组的FBG达标率是西医常规治疗组的3.8倍[95%
CI
(1.0,14.2),
P
=0.046]。贞术调脂胶囊组治疗期间发生低血糖事件3例(8.6%),低于西医常规治疗组的9例(30.0%,
P
=0.026)。治疗后贞术调脂胶囊组患者SAS评分、SDS评分、SF-36评分和糖脂代谢病中医证候量表评分与本组治疗前比较差异有统计学意义(
P
<0.05);治疗后与西医常规治疗组比较,贞术调脂胶囊组患者SF-36评分和糖脂代谢病中医证候量表评分差异有统计学意义(
P
<0.05)。两组治疗期间均未发生不良事件。
结论
2
贞术调脂胶囊联合西医常规治疗在降低血糖、减少低血糖事件、改善抑郁及临床症状、提高整体健康状态方面优于单纯西医常规治疗,可获得多重获益,且安全性好。
Objective
2
To explore the effectiveness and safety of
Zhenzhu Tiaozhi Capsule
(贞术调脂胶囊, ZTC) combined with conventional western medicine for elderly patients with type 2 diabetes (T2D).
Methods
2
With the design of real-world pragmatic controlled trial design, 65 elderly T2D patients were divided into conventional western medicine (WM) group (35 cases) and ZTC group (30 cases) according to patients' willingness. The WM group was given diet and exercise guidance and oral hypoglycemic medications according to the guideline, while the ZTC group was additionally given ZTC, 4 capsules each time (0.63 g each capsule), three times daily; the treatments in both groups lasted for 12 weeks. The levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) were tested before and after treatment, and whether they were up to standards were assessed. The Zung self-rating anxiety scale (SAS), the Zung self-rating depression scale (SDS), the 36-item short form health survey (SF-36) and the traditional Chinese medicine (TCM) syndrome scale of glycolipid metabolism disease were assessed. The hypoglycemic events and adverse events were recorded during the treatment.
Results
2
The mean age of the ZTC group was higher, and the use of hypoglycemic medications before treatment were less than that of the WM group (
P
<0.05). The levels of FBG and HbA1c and the rates of these levels up to standards after treatment were not significantly different with those before treatment in both groups (
P
>0.05). The FBG level was lower, and the rate of the FBG level up to standard was higher in ZTC group than that in WM group after treatment (
P
<0.05). After adjusted with Logistic regression, the rate of the FBG level up to standard of ZTC group was 3.8 times that of WM group with 95% confidence interval (CI) 1.0-14.2,
P
=0.046. There were 3 (8.6%) cases of hypoglycemia in the ZTC group during treatment, which was lower than the 9 cases (30.0%) in the WM group (
P
=0.026). After treatment, the SAS score, SDS score, SF-36 score and the TCM syndrome scale score were significantly different with those before treatment in both groups (
P
<0.05); the SF-36 score and the TCM syndrome scale score of the ZTC group were significantly different with those of the WM group (
P
<0.05). There were no adverse events during treatment in both groups.
Conclusion
2
ZTC combined with conventional WM is superior to WM alone in lowering blood sugar, reducing hypoglycemia, improving depression and clinical symptoms, and increasing overall health condition, with multiple benefits and sound safety.
中国医学会老年医学分会 , 中国老年医学会糖尿病专业委员会 . 中国老年糖尿病诊疗指南(2021年版) [J]. 中华糖尿病杂志 , 2021 , 13 ( 1 ): 14 - 46 .
International Diabetes Federation . IDF Diabetes Atlas . 9th ed . [EB/OL].( 2019-11-14 )[ 2021-05-30 ].
Brussels,Belgium , 2019 . https://www.diabetesatlas.org/ https://www.diabetesatlas.org/ .
International Hypoglycaemia Study Group . Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management [J]. Lancet Diabe Endocrin , 2019 , 7 ( 5 ): 385 - 396 .
TRENTO M , RABALLO M , TREVISAN M , et al . A cross-sectional survey of depression, anxiety, and cognitive function in patients with type 2 diabetes [J]. Acta Diabetol , 2012 , 49 ( 3 ): 199 - 203 .
JING X , CHEN J , DONG Y , et al . Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis [J]. Health Qual Life Outcomes , 2018 , 16 : 189 . doi: 10.1186/s12955-018-1021-9 http://dx.doi.org/10.1186/s12955-018-1021-9 .
BEI W , WANG Y , CHEN J , et al . Chinese medicine FTZ recipe protects against high-glucose-induced beta cell injury through alleviating oxidative stress [J]. Evid Based Complement Alternat Med , 2019 : 6378786 . doi: 10.1155/2019/6378786 http://dx.doi.org/10.1155/2019/6378786 .
HU X , WANG M , GUO J , et al . The Chinese herbal medicine FTZ attenuates insulin resistance via IRS1 and PI3K in vitro and in rats with metabolic syndrome [J]. J Transl Med , 2014 , 12 : 47 . doi: 10.1186/1479-5876-12-47 http://dx.doi.org/10.1186/1479-5876-12-47 .
SHENGHUA P , ZIQIN Z , SHUYU T , et al . An integrated fecal microbiome and metabolome in the aged mice reveal anti-aging effects from the intestines and biochemical mechanism of FuFang zhenshu TiaoZhi(FTZ) [J]. Biomed Pharmacother , 2020 , 121 : 109421 . doi: 10.1016/j.biopha.2019.109421 http://dx.doi.org/10.1016/j.biopha.2019.109421 .
唐立 , 康德英 , 喻佳洁 , 等 . 实效性随机对照试验:真实世界研究的重要设计 [J]. 中国循证医学杂志 , 2017 , 17 ( 9 ): 999 - 1004 .
中华医学会糖尿病学分会 . 中国2型糖尿病防治指南(2017年版) [J]. 中国实用内科杂志 , 2018 , 38 ( 4 ): 292 - 344 .
SEAQUIST ER , ANDERSON J , CHILDS B , et al . Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society [J]. Diabetes Care , 2013 , 36 ( 5 ): 1384 - 1395 .
WILLIAM WK , ZUNG MD . A rating instrument for anxiety disorders [J]. Psychosomatics , 1971 , 12 ( 6 ): 371 - 379 .
ZUNG WK . A self-rating depression scale [J]. Arch Gen Psychiatry , 1965 , 12 : 63 - 70 . doi: 10.1001/archpsyc. 1965.01720310065008 http://dx.doi.org/10.1001/archpsyc.1965.01720310065008 .
李鲁 , 王红妹 , 沈毅 . SF-36健康调查量表中文版的研制及其性能测试 [J]. 中华预防医学杂志 , 2002 , 36 ( 2 ): 38 - 42 .
FERRANNINI E , CUSHMAN WC . Diabetes and hypertension: the bad companions [J]. Lancet , 2012 , 380 ( 9841 ): 601 - 610 .
诸骏仁 , 高润霖 , 赵水平 , 等 . 中国成人血脂异常防治指南(2016年修订版) [J]. 中华健康管理学杂志 , 2017 , 11 ( 1 ): 7 - 28 .
FANG XY , CHEN Q , HOU YP , et al . Factors related to frailty of the elderly in community [J]. Chin J Gerontol , 2019 , 39 ( 2 ): 467 - 470 .
BICKETT A , TAPP H . Anxiety and diabetes: innovative approaches to management in primary care [J]. Exp Biol Med , 2016 , 241 ( 15 ): 1724 - 1731 .
李敏谦 , 林育 , 项磊 , 等 . 瘅浊与糖脂代谢病 [J]. 世界中医药 , 2019 , 14 ( 3 ): 652 - 655 .
郭姣 . 糖脂代谢病(瘅浊)中西医结合诊疗技术规范 [J]. 世界中医药 , 2019 , 14 ( 3 ): 771 - 782 .
胡旭光 , 郭姣 , 贝伟剑 , 等 . 复方贞术调脂胶囊对MS大鼠胰岛素抵抗及胰岛素信号PI-3K的影响 [J]. 中药新药与临床药理 , 2012 , 23 ( 2 ): 140 - 143 .
姚红霞 , 郭姣 , 唐春萍 , 等 . 复方贞术调脂胶囊对大鼠非酒精性脂肪肝调脂保肝作用及机制研究 [J]. 中草药 , 2011 , 42 ( 10 ): 2074 - 2077 .
SONG L , ZHANG D , GUO J , et al . The traditional Chinese medicine formula Fufang-Zhenzhu-Tiaozhi protects myocardia from injury in diabetic minipigs with coronary heart disease [J]. Biomed Pharmacother , 2021 , 137 : 111343 . doi: 10.1016/j.biopha. 2021. 111343 http://dx.doi.org/10.1016/j.biopha.2021.111343 .
徐跃峰 . 养阴消渴汤联合门冬胰岛素注射液治疗老年2型糖尿病临床研究 [J]. 实用糖尿病杂志 , 2017 , 13 ( 3 ): 17 - 18 .
刘瑞霞 , 曾建平 , 崔德芝 , 等 . 降糖增敏汤治疗老年2型糖尿病胰岛素抵抗临床研究 [J]. 山东中医药大学学报 , 2016 , 40 ( 5 ): 439 - 441 .
钟慧玲 , 谢琼 , 吴坚 , 等 . 消渴丸联合二甲双胍治疗老年2型糖尿病临床研究 [J]. 亚太传统医药 , 2017 , 13 ( 19 ): 143 - 144 .
倪青 , 倪炎炎 , 张美珍 , 等 . 葛根芩连汤加减治疗胃肠湿热型老年2型糖尿病的疗效观察 [J]. 疑难病杂志 , 2021 , 20 ( 6 ): 569 - 573 .
WHITMER RA , KARTER AJ , YAFFE K , et al . Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus [J]. JAMA , 2009 , 301 ( 15 ): 1565 - 1572 .
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