摘要
随着生活方式的迅速变化,肥胖和糖尿病的发病率逐年上升,2型糖尿病合并肥胖的患者也在不断增加。传统2型糖尿病合并肥胖的治疗主要是通过生活方式、药物治疗及手术治疗进行干预,但传统的治疗方案存在难以长期坚持、胃肠道反应、术后并发症或减重效果不稳定的问题。因此,开辟新的治疗方案来提高降糖减重效果成为临床的迫切需求。传统的治疗方案忽略了中医的重要性,中医不仅安全性高,且治疗效果巩固、持久、不易反弹。我们在长期的临床工作中以生活方式干预为基础,运用中西医结合的治疗方案,发挥中西医在肥胖型2型糖尿病治疗中的特有优势,为患者提供更加合适的治疗方案。现报道1例肥胖型2型糖尿病患者病例,该患者合并高血压、高血脂,且存在甲状腺结节,有潜在甲状腺癌的风险,不能使用胰高糖素样肽-1(Glucagon-like Peptide-1,GLP-1)受体激动剂,在生活方式干预的基础上,经二甲双胍缓释片、阿卡波糖胶囊、达格列净片口服联合中药内服治疗后降糖、减重效果明显。文章回顾性分析该患者的诊疗经过,期望为后续同类患者的治疗提供参考。
With rapid changes in lifestyle,the prevalence of obesity and diabetes is increasing every year,and the number of patients with type 2 diabetes mellitus(T2DM)complicated with obesity is also on the rise.The traditional treatment of T2DM complicated with obesity is mainly through lifestyle,drug therapy and surgical intervention,but the traditional treatment plan has problems such as difficult long-term adherence,gastrointestinal reaction,postoperative complications and unstable weight loss effect.Therefore,it is urgent to develop a new treatment plan to improve the effect of glucose reduction and weight loss.Traditional treatment schemes ignore the importance of traditional Chinese medicine,which is not only safe,but also stable,lasting and not easy to rebound.In our long-term clinical work,based on lifestyle intervention,we apply the treatment plan of the integrative medicine to give full play to the unique advantages of TCM and Western medicine in the treatment of obese T2DM,and provide patients with more appropriate treatment plans.One case of obese T2DM is reported.The patient is complicated with hypertension,hyperlipidemia,thyroid nodules,and a potential risk of thyroid cancer.Glucagon-like peptide-1(GLP-1)agonist cannot be used.Based on lifestyle intervention,metformin sustained release tablets,acarbose capsules,dagliazine tablets combined with oral administration of Chinese medicinal materials are given orally,and the hypoglycemic and weight loss effects are obvious.The diagnosis and treatment process of this patient is retrospectively analyzed to provide a reference for the subsequent treatment of similar patients.
作者
卢庆
倪洪岗
甘庆
刘信
杜正举
LU Qing;NI Honggang;GAN Qing;LIU Xin;DU Zhengju
出处
《中医临床研究》
2023年第36期119-123,共5页
Clinical Journal Of Chinese Medicine
关键词
肥胖型2型糖尿病
代谢综合征
中西医结合疗法
病例报告
Obesity type 2 diabetes mellitus
Metabolic syndrome
The integrative medicine
Case report
作者简介
卢庆(1997-),女,贵州中医药大学硕士研究生,研究方向为中西医结合临床及民族医药研究;通讯作者:倪洪岗(1977-),主任医师,硕士生导师,研究方向为中西医结合临床及民族医药研究。
