1.厦门大学附属第一医院,福建省厦门市思明区镇海路55号,361003
2.贵州百灵企业集团制药股份有限公司
3.云南省滇南中心医院
4.贵州中医药大学第二附属医院
5.扬州市中医院
6.河北省中医院
7.北京中医药大学东直门医院
8.河南省中医院
9.长春中医药大学附属医院
10.亳州市人民医院
11.云南省中医医院
12.安徽中医药大学第一附属医院
13.北京协和医院
14.上海中医药大学附属曙光医院
15.山东中医药大学附属医院
通信作者:xmyangshuyu@xmu. edu. cn
收稿:2025-07-16,
修回:2025-10-16,
纸质出版:2026-01-17
移动端阅览
赵能江,李津,夏文等.苗药糖宁通络片治疗糖尿病前期患者的多中心、随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(02):166-172.
ZHAO Nengjiang,LI Jin,XIA Wen,et al.A Multicentered,Randomized Double-Blind,Placebo-Controlled Trial of Miao Medicine Tangning Tongluo Tablets(糖宁通络片)in Patients with Prediabetes[J].Journal of Traditional Chinese Medicine,2026,67(02):166-172.
赵能江,李津,夏文等.苗药糖宁通络片治疗糖尿病前期患者的多中心、随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(02):166-172. DOI: 10.13288/j.11-2166/r.2026.02.009.
ZHAO Nengjiang,LI Jin,XIA Wen,et al.A Multicentered,Randomized Double-Blind,Placebo-Controlled Trial of Miao Medicine Tangning Tongluo Tablets(糖宁通络片)in Patients with Prediabetes[J].Journal of Traditional Chinese Medicine,2026,67(02):166-172. DOI: 10.13288/j.11-2166/r.2026.02.009.
目的
2
观察苗药糖宁通络片治疗糖尿病前期患者的有效性和安全性,为糖尿病早期干预提供依据。
方法
2
采用随机、双盲、安慰剂对照的试验设计,纳入全国14家医院180例糖尿病前期患者,分为糖宁通络组与安慰剂组各90例。糖宁通络组采用糖宁通络片+生活方式干预,安慰剂组给与安慰剂+生活方式干预,两组疗程均为12周。治疗后观察主要疗效指标(从首次用药开始12周内进展为2型糖尿病的发病率)、次要疗效指标[包括治疗前后体重、体重指数(BMI)、腰臀比、空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、尿白蛋白/肌酐比值(UA
CR)、胰岛素抵抗指数(HOMA-IR)、0~120分血糖曲线下面积(AUC
0~120 min
)];评价肝肾功能等安全性指标;采用多因素Logistic回归分析和多元线性回归分析评价糖宁通络片对各结局指标的影响;并根据BMI进行探索性亚组分析。
结果
2
糖宁通络组和安慰剂组分别有85例和79例完成研究。治疗3个月后,糖宁通络组和安慰剂组2型糖尿病发病率分别为4.71%(4/85)和13.92%(11/79),差异有统计学意义(
P
<0.05)。Logistic回归分析提示,糖宁通络片能降低糖尿病发生风险74.4%[
OR
=0.256,95%
CI
(0.066,0.812),
P
<0.05]。两组患者次要疗效指标及安全性指标比较差异均无统计学意义(
P
>0.05)。亚组分析显示,在BMI<24 kg/m
2
亚组患者中,糖宁通络组的FPG和AUC
0~120 min
较安慰剂组降低(
P
<0.05)。
结论
2
糖宁通络片可降低糖尿病前期患者进展为2型糖尿病的发病率,具有较好的安全性,且在BMI<24 kg/m²的患者中降糖效果更佳。
Objective
2
To evaluate the efficacy and safety of
Tangning Tongluo Tablets
(糖宁通络片, TTT) in patients with prediabetes.
Methods
2
Using a randomized, double-blind, placebo-controlled trial design, 180 patients with prediabetes were enrolled from 14 hospitals nationwide and randomly assigned to a TTT group or a placebo group, with 90 cases in each group. The TTT group received TTT plus lifestyle intervention, while the placebo group received placebo plus lifestyle intervention. The treatment duration for both groups was 12 weeks. After treatment, the primary efficacy outcome (incidence of progression to type 2 diabetes mellitus within 12 weeks from the first administration)and secondary efficacy outcomes, including body weight, body mass index (BMI), waist-to-hip ratio, fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycated hemoglobin (HbA1c), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), urinary albumin-to-creatinine ratio (UACR), homeostasis model assessment of insulin resistance (HOMA-IR), and the area under the glucose curve from 0 to 120 minutes (AUC
0~120 min
), were assessed. Multivariate logistic regression and multiple linear regression analyses were
performed to evaluate the effects of TTT on outcome measures. Safety indicators, including liver and renal function, were also evaluated, and exploratory subgroup analyses were conducted based on BMI.
Results
2
A total of 85 patients in the TTT group and 79 patients in the placebo group completed the study. After 3 months of treatment, the incidence of type 2 diabetes mellitus was 4.71% (4/85) in the TTT group and 13.92% (11/79) in the placebo group, with a statistically significant difference (
P
<0.05). Logistic regression analysis indicated that TTT reduced the risk of developing diabetes by 74.4% [
OR
=0.256, 95%
CI
(0.066,0.812),
P
<0.05]. No statistically significant diffe-rences were observed between the two groups in secondary efficacy outcomes or safety indicators (
P
>0.05). Subgroup analysis showed that among patients with BMI below 24 kg/m², fasting blood glucose (FBG)and AUC
0~120 min
were significantly lower in the TTT group than in the placebo group (
P
<0.05).
Conclusion
2
TTT can reduce the incidence of progression from prediabetes to type 2 diabetes mellitus and are safe and effective. The glucose-lowering effect may be more pronounced in patients with below 24 kg/m².
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