Abstract:

Objective　To observe the effects of Yiqi Tongluo Formula on serum levels of apolipoprotein B (apoB), apolipoprotein A-Ⅰ (ApoA-Ⅰ), and glucagon-like peptide 1 (GLP-1) and glucose metabolism in patients with type 2 diabetes mellitus (T2DM). Methods　A total of 98 patients with T2DM treated at Shangluo Central Hospital from August 2020 to August 2023 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 49 cases in each group. There were 24 males and 25 females in the control group; they were (47.85±6.14) years old; their disease course was (8.34±2.48) years. There were 22 males and 27 females in the observation group; they were (46.59±6.03) years old; their disease course was (8.56±2.25) years. The control group took conventional treatment and mecobalamin tablets, and the observation group conventional treatment, mecobalamin tablets, and Yiqi Tongluo Formula, for 2 months. The clinical efficacies, scores of traditional Chinese medicine syndromes, serum levels of ApoB, ApoA-Ⅰ, and GLP-1, glucose metabolism, lower limb nerve conduction velocities, and adverse reactions were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate in the observation group was higher than that in the control group [95.92% (47/49) vs. 79.59% (39/49); χ²=6.078; P<0.05]. The total score of traditional Chinese medicine syndromes in the observation group was lower than that in the control group (3.89±1.03 vs. 4.94±1.21), with a statistical difference (t=4.625; P<0.05). The level of ApoB in the observation group was lower than that in the control group [(0.94±0.17) g/L vs. (1.05±0.25) g/L]; the levels of ApoA-Ⅰ and GLP-1 0 min and 2 h after oral glucose tolerance test (OGTT) in the observation group were higher than those in the control group [(1.18±0.21) g/L vs. (1.06±0.15) g/L, (132.47±15.21) g/L vs. (118.37±16.45) g/L, and (154.23±21.43) mol/L vs. (125.91±23.59) mol/L]; there were statistical differences (t=2.547, 3.255, 5.030, and 8.636; all P<0.05). The levels of fasting blood glucose (FBG), 1-hour postprandial blood glucose (1hPBG), 2-hour postprandial blood glucose (2hPBG), and glycated hemoglobin (HbA1c) in the observation group were lower than those in the control group [(6.51±0.82) mmol/L vs. (7.49±1.18) mmol/L, (8.53±1.19) mmol/L vs. (9.04±1.05) mmol/L, (10.57±1.38) mmol/L vs. (11.26±1.43) mmol/L, and (6.17±0.52)% vs. (6.96±0.68)%], with statistical differences (t=4.774, 2.250, 2.430, and 6.460; all P<0.05). The motor nerve conduction velocities (MNCV) and sensory nerve conduction velocities (SNCV) of median nerve and common peroneal nerve in the observation group were higher than those in the control group [(47.24±2.58) m/s vs. (44.32±3.14) m/s, (47.25±3.73) m/s vs. (45.09±3.26) m/s, (43.58±4.33) m/s vs. (41.04±4.51) m/s, (42.10±3.45) m/s vs. (39.61±3.27) m/s], with statistical differences (t=5.030, 3.052, 2.844, and 3.667; all P<0.05). Conclusion　Yiqi Tongluo Formula combined with mecobalamin tablets can improve clinical therapeutic effects on patients with T2DM, improve their serum factor levels and glucose metabolism, and accelerate their lower limb nerve conduction velocity.

Key words:

Type 2 diabetes mellitus, Yiqi Tongluo , Formula, Apolipoprotein, Glucagon-like peptide 1, Glucose metabolism

摘要：

目的　观察益气通络方对2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清载脂蛋白B（apolipoprotein B，ApoB）、载脂蛋白A-Ⅰ（apolipoprotein A-Ⅰ，ApoA-Ⅰ）、胰高血糖素样肽-1 （glucagon-like peptide-1，GLP-1）水平及糖代谢的影响。方法　选取商洛市中心医院2020年8月至2023年8月收治的98例T2DM患者进行随机对照试验。采用随机数字表法将其分为对照组和观察组，每组49例。对照组男24例，女25例，年龄（47.85±6.14）岁，病程（8.34±2.48）年。观察组男22例，女27例，年龄（46.59±6.03）岁，病程（8.56±2.25）年。对照组在常规治疗的基础上加用甲钴胺片，观察组在对照组基础上加用益气通络方；两组均治疗2个月。比较两组临床疗效，中医证候积分，血清ApoB、ApoA-Ⅰ、GLP-1水平，糖代谢，下肢神经传导速度，不良反应。采用χ²检验和t检验进行统计分析。结果　观察组总有效率高于对照组［95.92%（47/49）比79.59%（39/49）；χ²=6.078，P<0.05］。观察组中医证候积分总分低于对照组［（3.89±1.03）分比（4.94±1.21）分］，差异有统计学意义（t=4.625，P<0.05）。观察组ApoB水平低于对照组［（0.94±0.17）g/L比（1.05±0.25）g/L］，ApoA-Ⅰ、口服葡萄糖耐量试验（oral glucose tolerance test，OGTT）0 min GLP-1、OGTT 2 h GLP-1水平均高于对照组［（1.18±0.21）g/L比（1.06±0.15）g/L、（132.47±15.21）g/L比（118.37±16.45）g/L、（154.23±21.43）mol/L比（125.91±23.59）mol/L］，差异均有统计学意义（t=2.547、3.255、5.030、8.636，均P<0.05）。观察组空腹血糖（fasting blood glucose，FBG）、餐后1 h血糖（postprandial 1 h blood glucose，1hPBG）、餐后2 h血糖（postprandial 2 h blood glucose，2hPBG）、糖化血红蛋白（hemoglobin A1c，HbA1c）水平均低于对照组［（6.51±0.82）mmol/L比（7.49±1.18）mmol/L、（8.53±1.19）mmol/L比（9.04±1.05）mmol/L、（10.57±1.38）mmol/L比（11.26±1.43）mmol/L、（6.17±0.52）%比（6.96±0.68）%］，差异均有统计学意义（t=4.774、2.250、2.430、6.460，均P<0.05）。观察组正中神经运动神经传导速度（motor nerve conduction velocity，MNCV）、感觉神经传导速度（sensory nerve conduction velocity，SNCV）和腓总神经MNCV、SNCV均高于对照组［（47.24±2.58）m/s比（44.32±3.14）m/s、（47.25±3.73）m/s比（45.09±3.26）m/s、（43.58±4.33）m/s比（41.04±4.51）m/s、（42.10±3.45）m/s比（39.61±3.27）m/s］，差异均有统计学意义（t=5.030、3.052、2.844、3.667，均P<0.05）。结论　益气通络方联合甲钴胺片能提高T2DM患者临床疗效，改善患者血清因子水平及糖代谢，加快患者下肢神经传导速度。

关键词:

2型糖尿病, 益气通络方, 载脂蛋白, 胰高血糖素样肽-1, 糖代谢