健脾祛湿法联合GLP-1RA周制剂治疗脾虚湿蕴证2型糖尿病合并肥胖OA

Objective To explore the efficacy of the therapy for invigorating the spleen and eliminating dampness combined with glucagon like peptide-1 receptor agonist(GLP-1RA)weekly preparation in the treatment of type 2 diabetes(T2DM)with the syndrome of spleen deficiency and dampness retention coupled with obesity.Methods A total of 98 T2DM patients with the syndrome of spleen deficiency and dampness retention combined with obesity were randomly divided into group A and group B,with 49 cases in each group.Group A was treated with GLP-1RA weekly preparation liraglutide,while group B was given the intervention for strengthening the spleen and dispelling dampness on the basis of group A.Both groups received continuous treatment for 2 months.The clinical efficacy after 2 months of treatment,including TCM syndrome scores,physical indicators,insulin resistance status,and indicators related to the insulin receptor substrate-1(IRS-1)/phosphatidylinositol-3(PI3K)/protein kinase B(Akt)signaling pathway before and after 2 months of treatment,as well as adverse reactions during the treatment period were compared between the two groups.Results After 2 months of treatment,the total effective rate,insulin secretion index(HOMA-β),expression levels of serum IRS-1 mRNA,PI3K mRNA,and Akt mRNA of group B were significantly higher,while the TCM syndrome scores,body mass index(BMI),waist circumference,levels of serum fasting insulin(FINS),and insulin resistance index(HOMA-IR)were significantly lower in group B(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The therapy for invigorating the spleen and eliminating dampness combined with GLP-1RA weekly preparation has a better therapeutic effect in the treatment of T2DM with the syndrome of spleen deficiency and dampness retention coupled with obesity,and has good safety.