目的 观察大柴胡汤加减联合利拉鲁肽对肥胖2型糖尿病患者胰岛素抵抗、β-细胞功能和低度炎症反应的影响.方法 将86例肥胖2型糖尿病患者随机分为观察组和对照组各43例.对照组给予利拉鲁肽皮下注射治疗,观察组在对照组治疗基础上加服大柴胡汤加减方治疗.治疗3个月后,对比2组体质量、BMI、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、β-细胞功能指数(HOMA-β)及炎性细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、脂联素(ADP)]水平的变化情况,并评估临床疗效.结果 观察组治疗后总有效率为88.4%,明显高于对照组的69.8%(P<0.05);2组治疗后体质量、BMI、FPG、2hPG、HbA1c、HOMA-IR、TNF-α、IL-6水平均显著降低(P均<0.05),HOMA-β、ADP水平均明显升高(P均<0.05),且观察组治疗后上述指标改善情况均明显优于对照组(P均<0.05).结论 大柴胡汤加减联合利拉鲁肽治疗肥胖T2DM,能够有效纠正患者体内低度炎症反应和糖代谢紊乱,减轻体质量,并能显著改善IR和β-细胞功能,疗效确切.%Objective It is to observe the effects of Dachaihu decoction combined with Liraglutide on insulin resist -ance,beta-cell function and low inflammatory response in obese type 2 diabetic patients.Methods 86 obese patients with type 2 diabetes were randomly divided into observation group and control group, each group had 43 cases.The control group was treated with subcutaneous injection of lilarupeptide,and the observation group was treated with Dachaihu decoc-tion based on the treatment of the control group.After treatment for 3 months,the changes of body mass,BMI,glucose me-tabolism index[fasting plasma glucose(FPG), 2 h postprandial blood glucose(2hPG), glycosylated hemoglobin (HbA1c)],the index of insulin resistance(HOMA-IR),beta cell function index(HOMA-beta)and inflammatory cyto-kines[(tumor necrosis factor alpha(TNF-alpha),interleukin 6(IL-6)and adiponectin(ADP)]of both groups were com-pared,and the clinical efficacy was evaluated.Results The total effective rate was 88.4% after treatment, significantly higher than 69.8%in the control group(P<0.05).After treatment body mass,BMI,the levels of FPG,2hPG,HbA1c, HOMA-IR,TNF-a,IL-6 were significantly decreased(P<0.05), that of HOMA-beta, ADP were significantly increased (P<0.05)in both groups,the improvements of above indexes after treatment in observation group were significantly better than that of control group(P<0.05).Conclusion Dachaihu decoction combined with Liraglutide can effectively correct low-grade inflammation and sugar metabolism disorder, reduce body quality, and can significantly improve IR and beta cell function in the treatment of obesity with type 2 diabetes mellitus,the curative effect is definite.
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