Objective It is to observe the effects of Huangqi Xiaoke decoction combined with liraglutide on glucose and lipid metabolism and serum adipocytokines in patients with type 2 diabetes mellitus (T2DM) whose HbA1c is still not up to standard after oral administration of various hypoglycemic agents. Methods A total of 160 patients with T2 DM who had not received normal HbA1c after oral administration of various hypoglycemic agents were randomly divided into observation group (80 cases) and control group (80 cases). The control group was treated with liraglutide and the observation group was given Huangqi Xiaoke decoction based on the control group, both groups were treated for 12 weeks. The improvement of TCM symptoms and HbA1c compliance were observed, the changes of blood glucose and serum adipokines and serum adipokines at different time points before and after treatment were recorded. The adverse reactions of the two groups were statistically analyzed. Results The effective rate of TCM symptom treatment and HbA1c compliance rate and composite end point compliance rate in the observation group were significantly higher than those in the control group (P ＜ 0. 05) , and HbA1c was significantly lower than the control group (P ＜ 0. 05). Fasting blood glucose (FPG) , 2-hour postprandial blood glucose (2hPG) , mean of daily difference of blood glucose (MODD) , mean amplitude of glycemic excursions (MAGE) , insulin secretion index (HOMA-β) , insulin resistance index (HOMA-IR) was significantly improved after 6, 12 weeks of treatment in the two groups, and the improvements of the observation group were better than that of the control group (P ＜0. 05). The levels of TG, TC, HDL-C, and LDL-C were significantly improved at the 12 th week of treatment, the improvements of TG and TC in the observation group were significantly better than that in the control group (P ＜ 0. 05). the levels of serum visfatin, leptin, resistin and IL-6 were significantly decreased while that of adiponectin was increased at the 6th and 12 th week of treatment (P ＜ 0. 05) , the improvements of the above indicators were significantly better than that of the control group (P ＜ 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞ 0. 05). Conclusion Liraglutide combined with Huangqi Xiaoke decoction can significantly improve the symptoms of diabetes and islet β-cell function, regulate blood lipid and blood glucose disorder in the treatment of T2 DM with substandard HbA1c after oral administration of various hypoglycemic drugs, the mechanism may be related to the regulation of serum adipocytokines.%目的 观察黄芪消渴方联合利拉鲁肽对口服多种降糖药治疗后糖化血红蛋白 (HbA1c) 仍不达标的2型糖尿病 (T2DM) 患者糖脂代谢、血清脂肪细胞因子的影响.方法 将160例接受口服多种降糖药治疗后HbA1c仍不达标的T2DM患者随机分为观察组80例和对照组80例, 对照组给予利拉鲁肽治疗, 观察组在对照组治疗基础上给予黄芪消渴汤治疗, 疗程均为12周.观察2组治疗后中医症状改善情况及Hb A1c达标情况, 并记录2组治疗前后不同时间点血糖血脂指标、血清脂肪细胞因子的变化情况, 统计2组不良反应.结果 观察组治疗后的中医症状治疗有效率和Hb A1c达标率、复合终点达标率均显著高于对照组 (P均＜0. 05) , 且HbA1c明显低于对照组 (P均＜0. 05) ; 2组治疗第6周、12周的空腹血糖 (FPG) 、餐后2 h血糖 (2hPG) 、日间血糖平均绝对差 (MODD) 、平均血糖波动幅度 (MAGE) 、胰岛素分泌指数 (HOMA-β) 、胰岛素抵抗指数 (HOMA-IR) 均显著改善, 且观察组改善情况优于对照组 (P均＜0. 05) ; 2组治疗第12周的TG、TC、HDL-C、LDL-C水平均显著改善 (P均＜0. 05) , 观察组TG、TC改善情况均明显优于对照组 (P均＜0. 05) ; 2组治疗第6周、12周血清内脂素、瘦素、抵抗素、IL-6水平均显著降低 (P均＜0. 05) , 脂联素水平均显著升高 (P均＜0. 05) , 观察组以上指标改善情况均明显优于对照组 (P均＜0. 05) ; 2组治疗过程中不良反应发生率比较差异无统计学意义 (P＞ 0. 05) .结论 利拉鲁肽联合黄芪消渴方治疗口服多种降糖药治疗后Hb A1c仍不达标的T2DM患者, 能够显著改善患者糖尿病症状和胰岛β细胞功能, 调节血脂血糖紊乱, 且作用安全, 机制可能与调节血清脂肪细胞因子水平有关.
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