摘要
目的探究桑枝总生物碱片联合达格列净对2型糖尿病(Type 2 diabetes mellitus,T2DM)患者血糖波动、胰岛β细胞功能和血清胃饥饿素(Ghrelin)及核连蛋白2(Recombinant nucleobindin 2,NUCB-2)水平的影响。方法选取2021年3月—2024年3月期间常熟市中医院(常熟市新区医院)收治的106例T2DM患者,按随机数字表法分为对照组和治疗组,每组各53例。对照组予以常规治疗及达格列净治疗,治疗组在对照组基础上联合桑枝总生物碱片治疗。治疗3个月后,观察比较两组患者血糖指标[空腹血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2 hour postprandial glucose,2 h PG)和糖化血红蛋白(Glycosylated hemoglobin,HbA1c)]、血糖波动水平[血糖值标准差(Standard deviation of blood glucose,SDBG)、平均血糖波动幅度(Mean amplitude of glycemic excuisions,MAGE)、最大血糖漂移幅度(Largest amplitude of glycemic excursions,LAGE)、日间血糖平均绝对值差(Means of daily differences,MODD)和餐后血糖波动幅度(Postprandial glucose excursion,PPGE)]、胰岛β细胞功能指标水平[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostasis model assessment forβcell function index,HOMA-β)]以及血清Ghrelin、NUCB-2水平。结果治疗后两组患者血糖FBG、2 h PG、HbA1c水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血糖FBG、2 h PG、HbA1c水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者血糖SDBG、MAGE、LAGE、MODD和PPGE水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血糖SDBG、MAGE、LAGE、MODD和PPGE水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FINS、HOMA-β水平均较治疗前升高,HOMA-IR水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组FINS、HOMA-β水平均较对照组明显升高,HOMA-IR水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者Ghrelin水平均治疗前升高,NUCB-2水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组Ghrelin水平较对照组明显升高,NUCB-2水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗后治疗组总有效率96.23%(51/53)明显高于对照组84.91%(45/53),差异有统计学意义(P<0.05)。治疗期间,治疗组不良反应发生率15.09%(8/53)与对照组11.32%(6/53)比较,差异无统计学意义(P>0.05)。结论桑枝总生物碱片联合达格列净能有效降低T2DM患者血糖指标,控制血糖波动,同时还能改善胰岛β细胞功能和血清Ghrelin、NUCB-2水平,且安全性较好。
Objective To investigate the influence of Ramulus Mori alkaloid tablets combined with dapagliflozin on blood glucose fluctuations,isletβ-cell function,serum ghrelin,and nucleobindin-2(NUCB-2)levels in patients with type 2 diabetes mellitus(T2DM).Methods A total of 106 patients with T2DM who were treated at Changshu Hospital of Traditional Chinese Medicine(Changshu New District Hospital)between March 2021 and March 2024 were selected.They were divided into a control group and a treatment group using the random number table method,with 53 cases in each group.The control group received routine treatment along with dapagliflozin,while the treatment group was additionally treated with Ramulus Mori alkaloid tablets.The levels of blood glucose indicators(fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG),and glycosylated hemoglobin(HbAlc)),blood glucose fluctuations(standard deviation of blood glucose(SDBG)),mean amplitude of glycemic excursions(MAGE),largest amplitude of glycemic excursions(LAGE),mean of daily dfferences(MODD),and postprandial glucose excursion(PPGE),isletβ-cell function indicators(fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),and homeostasis model assessment ofβ-cell function index(HOMA-β)),and serum ghrelin and NUCB-2 levels were observed and compared between groups after three-month treatment.Results After treatment,the levels of FBG,2hPG,and HbAlc were decreased in both groups,and the difference was statistically significant(P<0.05).The levels in the treatment group were significantly lower than those in the control group(P<O.05).The levels of SDBG,MAGE,LAGE,MODD,and PPGE in both groups were reduced after treatment(P<0.05),and the levels in the treatment group were significantly reduced compared to the control group(P<0.05).After treatment,the FINS and HOMA-βlevels in the two groups were enhanced,while the HOMA-IR level was reduced(P<0.05).The levels of FINS and HOMA-βin the treatment group were significantly higher than those in the control group,while the level of HOMA-IR was significantly lower(P<0.05).After treatment,the ghrelin level in both groups was elevated,while the NUCB-2 level was lowered(P<0.05),and the treatment group showed a significantly higher level of ghrelin but significantly lower NUCB-2 level compared to the control group(P<0.05).The total effective rate in the treatment group was 96.23%(51/53),which was significantly higher than 84.91%(45/53)in the control group(P<0.05).During treatment,the incidence of adverse reactions was 15.09%(8/53)in the treatment group and 11.32%(6/53)in the control group,with no statistical difference between the two(P>0.05).Conclusion Ramulus Mori alkaloid tablets combined with dapagliflozin can effectively reduce blood glucose levels of T2DM patients,control blood glucose fluctuations,and improve isletβ-cell function,serum ghrelin levels,and NUCB-2 levels while ensuring good safety.
作者
金艺璇
吴卫明
钱玲玲
陈新宇
韩佳妮
JIN Yi-xuan;WU Wei-ming;QIAN Ling-ling;CHEN Xin-yu;HAN Jia-ni(Changshu Hospital of Traditional Chinese Medicine(Changshu New District Hospital),Changshu Jiangsu 215500)
出处
《世界中西医结合杂志》
2025年第2期370-376,共7页
World Journal of Integrated Traditional and Western Medicine
基金
2023年度常熟市科技计划项目(CY202306)。
关键词
桑枝总生物碱片
达格列净
2型糖尿病
血糖波动
胰岛Β细胞功能
胃饥饿素
核连蛋白2
Ramulus Mori Alkaloid Tablet
Dapagliflozin
Type 2 Diabetes Mellitus
Blood Glucose Fluctuation
Isletβ-Cell Function
Ghrelin
Nucleotidenectin-2
