【摘要】：目的：探討中醫(yī)學(xué)對(duì)2型糖尿病合并高脂血癥的認(rèn)識(shí),通過(guò)臨床隨機(jī)對(duì)照實(shí)驗(yàn),觀察清熱化濕方在治療2型糖尿病合并高脂血癥濕熱內(nèi)蘊(yùn)證的臨床療效,并為其臨床使用提供理論依據(jù)。方法：采用1：1平行對(duì)照原則分組,選擇2型糖尿病合并高脂血癥濕熱內(nèi)蘊(yùn)證的患者60例,分為治療組、對(duì)照組各30例。兩組均進(jìn)行常規(guī)降糖、降脂等基礎(chǔ)治療。在此基礎(chǔ)上治療組加用清熱化濕方治療。4周為一個(gè)療程,共3個(gè)療程。3個(gè)療程后分析兩組患者癥狀體征及實(shí)驗(yàn)室檢查客觀指標(biāo)方面的差異,并評(píng)估安全性指標(biāo)。結(jié)果：本臨床采用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行分析,表明：①兩組患者的性別、年齡、病程、中醫(yī)證候積分以及各項(xiàng)實(shí)驗(yàn)室檢查指標(biāo)做治療前組間均衡性比較,并無(wú)顯著性差異(P0.05),具有可比性。②兩組治療后均能有效改善患者臨床癥狀(P0.01),治療組中醫(yī)證候積分改善優(yōu)于對(duì)照組(P0.01)。中醫(yī)證候療效總有效率比較,治療組明顯優(yōu)于對(duì)照組(90%:50%),有統(tǒng)計(jì)學(xué)差異(P0.01)。③疾病療效總有效率方面,治療組優(yōu)于對(duì)照組(86.67%：56.67%),有統(tǒng)計(jì)學(xué)差異(P0.05)。④血糖、糖化血紅蛋白、血脂在治療后兩組均有改善(P0.05),且治療組效果較對(duì)照組為佳(P0.05)。⑤血液流變學(xué)方面,兩組均能改善血液流變學(xué)的部分指標(biāo)(P0.05),但組間比較無(wú)明顯統(tǒng)計(jì)學(xué)差異。⑥兩組均未見(jiàn)嚴(yán)重不良反應(yīng),肝腎功能檢查均在正常范圍內(nèi)。結(jié)論：清熱化濕方治療2型糖尿病合并高脂血癥濕熱內(nèi)蘊(yùn)證,能夠改善患者臨床各項(xiàng)癥狀,以及實(shí)驗(yàn)室指標(biāo)血糖、血脂、糖化血紅蛋白及血流動(dòng)力學(xué)。從初步研究來(lái)看,清熱化濕方聯(lián)合西藥治療相對(duì)單純西藥治療效果有明顯的優(yōu)勢(shì),且無(wú)不良反應(yīng),安全有效,值得深入研究及推廣。
[Abstract]:Objective: to explore the understanding of type 2 diabetes mellitus with hyperlipidemia in traditional Chinese medicine (TCM), and to observe the clinical effect of clearing heat and removing dampness prescription in treating type 2 diabetes mellitus with hyperlipidemia and hyperlipidemia. And to provide the theoretical basis for its clinical use. Methods: sixty patients with type 2 diabetes mellitus complicated with hyperlipidemia and dampness and heat accumulation were divided into treatment group (n = 30) and control group (n = 30). Both groups were treated with conventional hypoglycemic and lipid-lowering therapy. On this basis, the treatment group was treated with Qingre Huazheng recipe for 4 weeks as a course of treatment for 3 courses. After 3 courses of treatment, the differences of symptoms, signs and objective indexes of laboratory examination between the two groups were analyzed, and the safety indexes were evaluated. Results: the clinical analysis with SPSS22.0 software showed that the sex, age, course of disease, TCM syndromes integral and laboratory examination indexes of the two groups were compared before treatment. There was no significant difference (P0.05). 2 the two groups can effectively improve the clinical symptoms after treatment (P0.01). The improvement of TCM syndromes in the treatment group is better than that in the control group (P0.01). Compared with the total effective rate of TCM syndromes, the treatment group was obviously superior to the control group (90: 50%), and there was statistical difference (P0.01) in the total effective rate of the disease curative effect. The treatment group was superior to the control group (86.67%) (86.67%), there was statistical difference (P0.05) in blood sugar, glycosylated hemoglobin, Blood lipids were improved in both groups after treatment (P0.05), and the effect of the treatment group was better than that of the control group (P0.05). Both groups could improve some indexes of hemorheology (P0.05), but there was no significant difference between the two groups. 6. There was no serious adverse reaction in both groups, and the liver and kidney function were in the normal range. Conclusion: the treatment of type 2 diabetes mellitus with hyperlipidemia and damp-heat accumulation can improve the clinical symptoms, blood sugar, blood lipids, glycosylated hemoglobin and hemodynamics. According to the preliminary study, the combination of clearing heat and removing dampness prescription and western medicine has obvious advantages over that of pure western medicine, and has no adverse reactions, is safe and effective, and is worth further study and popularization.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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