CAJ | 학술논문

目的：探索临床2型糖尿病中医药序贯疗法，为临床推广应用提供中西医结合理论和实践依据。方法：选用临床确诊的2型糖尿病患者经饮食、运动和口服降糖西药控制不良，且中医辨证属阴虚热盛、气阴两虚者为研究对象，加服石斛合剂序贯1、2、3方，每次循环后复查临床中医证候、空腹血糖（FBG）、餐后血糖（2hBG）、甘油三酯（TG）、总胆固醇（TC）、血压（BP），2次循环后加测糖化血红蛋白（HbAlc）。结果：石斛合剂序贯疗法可明显改善2型糖尿病阴虚热盛、气阴两虚证者燥热、烦渴、盗汗等临床症状，且所有患者治疗后HbAlc和FBG或2hBG较治疗前至少下降10%以上，HOMA-IR、TC、TG、Bp均明显改善，与治疗前比较P均<0.01。结论：2型糖尿病属本虚（阴虚气虚）标实（热瘀浊）疾病。石斛合剂序贯疗法（滋阴清热、益气活血，清肝泄浊）不仅可有效改善患者临床症状体征，而且具有显著降低患者血糖，改善血压、调整血脂作用，方法简单易行便于临床推广应用。
목적：탐색림상2형당뇨병중의약서관요법，위림상추엄응용제공중서의결합이론화실천의거。방법：선용림상학진적2형당뇨병환자경음식、운동화구복강당서약공제불량，차중의변증속음허열성、기음량허자위연구대상，가복석곡합제서관1、2、3방，매차순배후복사림상중의증후、공복혈당（FBG）、찬후혈당（2hBG）、감유삼지（TG）、총담고순（TC）、혈압（BP），2차순배후가측당화혈홍단백（HbAlc）。결과：석곡합제서관요법가명현개선2형당뇨병음허열성、기음량허증자조열、번갈、도한등림상증상，차소유환자치료후HbAlc화FBG혹2hBG교치료전지소하강10%이상，HOMA-IR、TC、TG、Bp균명현개선，여치료전비교P균<0.01。결론：2형당뇨병속본허（음허기허）표실（열어탁）질병。석곡합제서관요법（자음청열、익기활혈，청간설탁）불부가유효개선환자림상증상체정，이차구유현저강저환자혈당，개선혈압、조정혈지작용，방법간단역행편우림상추엄응용。
Objective:To study the clinical sequential treatment of integrative medicine for T2DM, and provide a theoretical and practical basis for clinical wide application. Methods:Study objects are those clinical diagnosis of type 2 diabetes (T2DM) whose blood sugar still poorly controlled through diet, exercise and oral hypoglycemic medicine, and the TCM differentiation belong to Asthenia Yin generates heat or asthenia of both Qi-Yin. One course of treatment included Dendrobium Compound (DC) sequential 1,2,3 about for one months. After each course of treatment, changes in clinical syndromes, fasting blood glucose (FBG), postprandial blood glucose (2hBG), glycated hemoglobin (HbAlc), triglyceride (TG), total cholesterol (TC) and blood pressure (BP) were observed. Results:After treatment, not only symptoms as dryness-heat, thirst, Yin deficiency and night sweats were improved obviously, but also levels of FBG, 2hBG, HbAlc, HOMA-IR, TC, TG and Bp were decreased significantly in comparing with those of before treatment (both P<0.01). Conclusion:Sequential treatment of dendrobium compound (nourish Yin invigorating Qi and promote blood circulation, to remove the evil of blood stasis , clear away dryness-fire and wetness) for T2DM patients could effective improve clinical symptoms, stable blood sugar, adjust blood pressure and blood lipid, the methods is easy for clinical usage and application.