基于TyG指数对益气健脾汤治疗2型糖尿病胰岛素抵抗的临床疗效观察

Clinical Efficacy Observation of Replenishing Qi to Invigorate the Spleen Decoction in the Treatment of Insulin Resistance in Type 2 Diabetes Mellitus Based on the TyG Index

摘要: 目的：观察益气健脾汤治疗2型糖尿病胰岛素抵抗的临床疗效，阐述TyG指数对胰岛素抵抗指数的补充作用。方法：选取就诊于本院内分泌老年病科符合2型糖尿病胰岛素抵抗患者60例，随机分组，分为对照组30例和治疗组30例，对照组给予盐酸二甲双胍片，治疗组在对照组治疗的基础上加用益气健脾汤，观察经过8周的治疗后，患者脾气亏虚证候的评分变化，以及与之相关的血糖指标、空腹胰岛素指标、血脂指标和胰岛素抵抗指标(TyG指数、HOMA-IR、TG/HDL-C)的具体改善情况。结果：脾气亏虚证候的评分方面，治疗后的脾气亏虚证候均低于治疗前(p < 0.05)，且治疗组的脾气亏虚证候均低于对照组(p < 0.05)；血糖指标及空腹胰岛素指标方面，治疗后的空腹血糖、餐后2小时血糖、糖化血红蛋白、空腹胰岛素指标均低于治疗前(p < 0.05)，且治疗组的空腹血糖、餐后2小时血糖、糖化血红蛋白、空腹胰岛素指标均低于对照组(p < 0.05)；血脂相关指标方面，治疗后甘油三酯、胆固醇、低密度脂蛋白均低于治疗前，高密度脂蛋白均高于治疗前(p < 0.05)，且治疗组的胆固醇、低密度脂蛋白均低于对照组，高密度脂蛋白均高于对照组(p < 0.05)；胰岛素抵抗指数方面，治疗后TyG指数、HOMA-IR、TG/HDL-C比值均低于治疗前(p < 0.05)，且治疗组的TyG指数、HOMA-IR、TG/HDL-C比值均低于对照组(p < 0.05)。结论：益气健脾汤能明显改善糖脂代谢、胰岛素抵抗，改善相关中医症状。

Abstract: Objective: To observe the clinical efficacy of replenishing Qi to invigorate the spleen decoction in the treatment of insulin resistance in type 2 diabetes mellitus (spleen qi deficiency type) Methods: 60 patients with type 2 diabetes mellitus insulin resistance were selected from the Department of Endocrinology and Geriatrics of the Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, randomly divided into the control group (n = 30 cases) and the treatment group (n = 30 cases), and the control group was given metformin hydrochloride tablets, and the treatment group was given replenishing Qi to invigorate the spleen decoction on the basis of the control group’s treatment, and the spleen Qi deficiency syndrome scores, blood glucose-related indexes, lipid-related indexes, and insulin resistance-related indexes (including TyG indexes) were observed after 8 weeks of treatment, etc. Results: In terms of spleen Qi deficiency symptoms scores, the scores post-treatment were lower than pre-treatment (p < 0.05), and the treatment group’s scores were lower than the control group’s (p < 0.05). For blood glucose and fasting insulin indicators, post-treatment fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, and fasting insulin indicators were lower than pre-treatment (p < 0.05), and lower in the treatment group than the control group (p < 0.05). Regarding blood lipid-related indicators, post-treatment triglycerides, cholesterol, and low-density lipoprotein were lower than pre-treatment, while high-density lipoprotein was higher than pre-treatment (p < 0.05), with cholesterol and low-density lipoprotein being lower in the treatment group than the control group, and high-density lipoprotein being higher (p < 0.05). For insulin resistance indices, post-treatment TyG index, HOMA-IR, and TG/HDL-C ratios were lower than pre-treatment (p < 0.05), and lower in the treatment group compared to the control group (p < 0.05). Conclusion: Replenishing Qi to invigorate the spleen decoction could significantly improve glycolipid metabolism, insulin resistance and improve related TCM symptoms.