【摘要】 目的 探讨“健脾生肌”法中医干预对腹型肥胖糖尿病合并肌肉减少症（简称肌少症）患者预后的影响。方法 回顾性选取2023年8月—2024年10月天水市中医医院内分泌一科收治的60例腹型肥胖糖尿病合并肌少症者的临床资料，按照治疗方法分组。西医组30例采取基础治疗，中西医组30例在西医组基础上增加“健脾生肌”法中医干预。12周后，比较其临床疗效、治疗前后相关检查指标[糖化血红蛋白（glycosylated hemoglobin A1c, HbA1c）、餐后2 h血糖、空腹血糖、胰岛素抵抗指数（insulin resistance index, IRI）、25-羟基维生素D]，肌力水平[肌肉指数（muscle index, SMI）、肌肉力量、肌肉功能]。结果 中西医组治疗总有效率高于西医组，差异有统计学意义（P<0.05）。治疗前，两组HbA1c、餐后2 h血糖、空腹血糖、IRI、25-羟基维生素D水平比较，差异均无统计学意义（P均>0.05）；治疗后，中西医组HbA1c、餐后2 h血糖、空腹血糖、IRI低于西医组，25-羟基维生素D高于西医组，差异均有统计学意义（P均<0.05）。治疗后，中西医组SMI、肌肉力量、肌肉功能高于西医组，差异均有统计学意义（P均<0.05）。结论 “健脾生肌”法中医干预可提升腹型肥胖糖尿病合并肌少症患者临床疗效，改善患者血糖及胰岛素抵抗程度，辅助增加25-羟基维生素D水平，明显提升患者SMI、肌肉力量及肌肉功能。更多还原

【Abstract】 Objective To explore the effect of traditional Chinese medicine intervention on the prognosis of patients with abdominal obesity diabetes mellitus complicated with sarcopenia by "Jianpi Shengji" method. Methods The clinical data of 60 patients with abdominal obesity diabetes mellitus complicated with sarcopenia admitted to the Department of Endocrinology I, Tianshui City Traditional Chinese Medicine Hospital from August 2023 to October 2024 were retrospectively selected and grouped according to treatment methods. 30 cases in the western medicine group were treated with basic treatment, and 30 cases in the Chinese and western medicine group were treated with traditional Chinese medicine intervention of "Jianpi Shengji" method on the basis of the western medicine group. After 12 weeks, the clinical efficacy, related test indexes before and after treatment [glycosylated hemoglobin A1c(HbA1c), 2 h postprandial blood glucose, fasting blood glucose, insulin resistance index(IRI), 25-hydroxyvitamin D], muscle strength level [muscle index(SMI), muscle strength, muscle function] were compared. Results The total effective rate of the Chinese and western medicine group was higher than that of the western medicine group, and the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in HbA1c, 2 h postprandial blood glucose, fasting blood glucose, IRI and 25-hydroxyvitamin D levels between the two groups(all P>0.05). After treatment, HbA1c, 2 h postprandial blood glucose, fasting blood glucose and IRI in the Chinese and western medicine group were lower than those in the western medicine group, and 25-hydroxyvitamin D was higher than that in the western medicine group, the differences were statistically significant(all P<0.05). After treatment, SMI, muscle strength and muscle function in the Chinese and western medicine group were higher than those in the western medicine group, and the differences were statistically significant(all P<0.05).Conclusion The traditional Chinese medicine intervention of "Jianpi Shengji" method can improve the clinical efficacy of patients with abdominal obesity diabetes mellitus complicated with sarcopenia, improve the blood glucose and insulin resistance of patients, assist in increasing the level of 25-hydroxyvitamin D, and significantly improve the muscle index, muscle strength and muscle function of patients.更多还原