【目的】 观察补肾健脾方联合短期胰岛素强化治疗对脾肾两虚型2型糖尿病患者胰岛β细胞去分化的影响。【方法】 将70例 脾肾两虚型 2型糖尿病患者随机分为对照组和观察组，每组各 35例。对照组给予胰岛素强化治疗，观察组在对照组的基础 上给予补肾健脾方治疗，疗程为2周。观察2组患者治疗前后中医证候积分、血糖水平、血清高迁移率族蛋白B1（HMGB1）、 白细胞介素1β（IL-1β）、肿瘤坏死因子α（TNF-α）、胰岛素原/胰岛素比值（PI/I）的变化情况。【结果】（1）脱落情况方面：治疗 过程中，对照组脱落 1例，观察组脱落 2例，最终对照组 34例、观察组 33例患者纳入疗效统计。（2）中医证候积分方面：治 疗后，2组患者的中医证候积分均较治疗前明显降低（P＜0.05），且观察组的降低幅度明显优于对照组（P＜0.05）。（3）血糖水 平方面：治疗后，2组患者的空腹血糖（FPG）、餐后2 h血糖（2hPG）水平均较治疗前明显降低（P＜0.05），且观察组的降低幅 度均明显优于对照组（P＜0.05）。（4）HMGB1水平方面：治疗后，2组患者的HMGB1水平均较治疗前明显降低（P＜0.05），且 观察组的降低幅度明显优于对照组（P＜0.05）。（5）炎症因子水平方面：治疗后，2组患者血清IL-1β、TNF-α水平均较治疗前 明显降低（P＜0.05），且观察组的降低幅度均明显优于对照组（P＜0.05）。（6）PI/I值方面：治疗后，2组患者的PI/I值均较治疗 前明显降低（P＜0.05），且观察组的降低幅度明显优于对照组（P＜0.05）。【结论】 补肾健脾方联合短期胰岛素强化治疗可有效 改善脾肾两虚型2型糖尿病患者的胰岛功能，其机制可能与解除高糖毒性、降低炎症因子水平，从而抑制胰岛β细胞去分化 有关。

Objective To observe the effect of Bushen Jianpi Prescription， a prescription with the actions of tonifying the kidney and strengthening the spleen， combined with short-term intensive insulin therapy on dedifferentiation of pancreatic beta-cells in patients with type 2 diabetes mellitus（T2DM）of spleen and kidney deficiency type. Methods Seventy patients with T2DM of spleen and kidney deficiency type were randomly divided into control group and observation group，with 35 cases in each group. The control group was treated with intensive insulin therapy，and the observation group was treated with Bushen Jianpi Prescription on the basis of treatment for the control group. The course of treatment lasted for 2 weeks. The changes of TCM syndrome score，and levels of blood glucose，serum high mobility group protein B1（HMGB1），interleukin 1β（IL-1β），tumor necrosis factor α （TNF-α）and the ratio of proinsulin to insulin（PI/I）in the two groups were observed before and after treatment.Results（1）During the treatment， one case in the control group and 2 cases in the observation group fell off. Eventually， 34 cases in the control group and 33 cases in the observation group were included in the efficacy statistics.（2）After treatment，the scores of TCM syndromes in the two groups were significantly lower than those before treatment（P＜0.05），and the decrease in the observation group was significantly superior to that in the control group（P＜0.05）.（3）After treatment，the levels of fasting plasma glucose（FPG）and 2-hour postprandial plasma glucose（2hPG）in the two groups were significantly lower than those before treatment（P＜0.05），and the decrease in the observation group was significantly superior to that in the control group （P＜0.05）.（4）After treatment，the level of HMGB1 in the two groups was significantly lower than that before treatment（P＜0.05）， and the decrease in the observation group was significantly superior to that in the control group（P＜0.05）.（5）After treatment，the serum levels of inflammatory factors of IL-1β and TNF-α in the two groups were significantly lower than those before treatment（P＜0.05），and the decrease in the observation group was significantly superior to that in the control group（P＜0.05）.（6）After treatment，the PI/I ratio of the two groups was significantly lower than that before treatment（P＜0.05），and the decrease of the observation group was significantly superior to that of the control group （P＜0.05）. Conclusion Bushen Jianpi Prescription combined with short-term intensive insulin therapy can effectively improve the islet function of patients with T2DM of spleen and kidney deficiency type. The mechanism may be related to the relief of high-glucose toxicity and the decrease of the inflammatory factor levels， thus to inhibit the dedifferentiation of pancreatic beta-cells.

R259.871

广东省中医药局科研项目（编号：20212190）；广州市中医药和中西医结合科技项目（编号：20232A010023）；广州市番禺区科技 计划重点医疗卫生项目（编号：2022-Z04-109）；广东祈福医院院内项目（编号：QF20222210）