目的 觀察參地益陰膠囊聯(lián)合達格列凈治療老年2型糖尿病的臨床療效。方法 選取2023年1月—2025年1月承德市中心醫(yī)院收治的80例血糖控制不佳老年2型糖尿病患者，依據(jù)隨機數(shù)字法分為對照組和治療組，每組各40例。對照組患者口服達格列凈片，10 mg/次，每日1次。治療組在對照組的基礎上口服參地益陰膠囊，4粒/次，每日3次。兩組用藥12周。觀察兩組的臨床療效，比較兩組胰島素β細胞抵抗指數(shù)（HOMA-IR）、胰島素β細胞分泌功能指數(shù)（HOMA-β）、簡易健康調查表（SF-36）評分、空腹血糖（FPG）、2 h血糖（2 hPG）、糖化血紅蛋白（HbA1c）、血清成纖維細胞生長因子21（FGF21）、血清超氧化物歧化酶（SOD）、半乳糖凝集素3（Gal-3）、血清內皮素（ET-1）水平。結果 治療后，治療組總有效率是95.00%，顯著高于對照組的80.00%（P＜0.05）。治療后，兩組SF-36評分、HOMA-β指數(shù)顯著升高，而HOMA-IR指數(shù)顯著降低（P＜0.05）；治療后，治療組SF-36評分、HOMA-β指數(shù)高于對照組，HOMA-IR指數(shù)低于對照組（P＜0.05）。治療后，兩組FPG、2 hPG、HbA1c水平均較同組治療前顯著降低（P＜0.05）；治療后，與對照組對比，治療組FPG、2 hPG、HbA1c水平均更低（P＜0.05）。治療后，兩組FGF21、ET-1、Gal-3水平均顯著降低，而SOD升高（P＜0.05）；治療后，與對照組對比，治療組患者FGF21、ET-1、Gal-3水平均較低，且治療組SOD水平升高（P＜0.05）。結論 參地益陰膠囊聯(lián)合達格列凈治療血糖控制不佳老年2型糖尿病效果明顯，能平穩(wěn)控制血糖，恢復胰島β細胞功能，減弱機體炎癥反應，提高患者生活質量，值得借鑒與應用。

Objective To explore the clinical study of Shendi Yiyin Capsules combined with dapagliflozin in treatment of elderly type 2 diabetes patients. Methods From January 2023 to January 2025, 80 elderly patients with type 2 diabetes who had poor blood sugar control and admitted to Chengde Central Hospital were selected and divided into control group and treatment group according to the random number method, with 40 cases in each group. Patients in control group were given oral Dapagliflozin Tablets, 10 mg each time, once daly. Patients in treatment group took Shendi Yiyin Capsules orally on the basis of control group, 4 capsules each time, 3 times daily. Both groups were treated with medication for 12 weeks. The clinical efficacy of two groups was observed. The levels of HOMA-IR, HOMA-β, SF-36 score, FPG, 2 hPG, HbA1c, FGF21, SOD, Gal-3, and ET-1 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, significantly higher than that of the control group (80.00%, P < 0.05). After treatment, the SF-36 scores and HOMA-β of both groups significantly increased, but HOMA-IR significantly decreased (P < 0.05). After treatment, the SF-36 score and HOMA-β of treatment group were higher than those of control group, but the HOMA-IR was lower than that of control group (P< 0.05). After treatment, the levels of FPG, 2 hPG, and HbA1c in both groups were significantly lower than those before treatment in same group (P < 0.05). After treatment, compared with the control group, the levels of FPG, 2 hPG, and HbA1c in treatment group were all lower (P < 0.05). After treatment, the levels of FGF21, ET-1, and Gal-3 in both groups significantly decreased, but SOD increased (P < 0.05). After treatment, compared with the control group, the levels of FGF21, ET-1, and Gal-3 in the treatment group were all lower, but the level of SOD in treatment group increased (P < 0.05). Conclusion The combination of Shendi Yiyin Capsules and dapagliflozin has a remarkable effect in treatment of elderly patients with type 2 diabetes who had poor blood sugar control. It can stably control blood sugar, restore the function of pancreatic β cells, reduce the inflammatory response of body, and improve the life quality of patients, which is worthy of reference and application.

R977

河北省醫(yī)學科學研究重點課題計劃項目（20231375）