Clinical Observation Of Tian Wang Bu Xin Dan In The Treatment Of Dawn Phenomenon In Patients With Yin Blood Deficiency Diabetes Mellitus Complicated With Insomnia

Objective:Fasting blood glucose plays an important role in the whole process of diabetes management.The dawn phenomenon is closely related to many factors that affect fasting blood glucose.The purpose of this subject is to observe the changes of fasting blood glucose through the improvement of dawn phenomenon,so as to provide treatment ideas for well controlling patients’ blood glucose and improving the rate of saccharification.Methods:We collected 74 patients with type 2 diabetes and insomnia accompanied dawn phenomenon in Xiamen Hospital of traditional Chinese medicine.According to the randomized controlled study,they were randomly divided into the experimental group(37cases)and the control group(37 cases).The experimental group was given the original hypoglycemic regimen plus Chinese medicine,while the control group took the original hypoglycemic regimen as the treatment plan,and the treatment course was 4 weeks.Fasting blood glucose,TCM syndrome score,glycosylated hemoglobin,Pittsburgh sleep quality score index,the number of cases of dawn phenomenon,growth hormone and cortisol were measured before and after treatment.Using spss25 0 statistical software was used for statistical analysis to objectively evaluate the effectiveness and safety of Tian Wang Bu Xin Dan in treating dawn phenomenon in patients with diabetes mellitus complicated with insomnia due to yin deficiency and blood deficiency.Results:1.In this study,a total of 74 patients with diabetes and insomnia with dawn phenomenon in Xiamen Hospital of traditional Chinese Medicine in January 2021-December 2021,were enrolled in the study in December.37 cases in each group were treated for 4 weeks and followed up 2 months after treatment.During the treatment period,2 cases fell off in the experimental group(all excluded because they could not follow the medication requirements),and 35 cases were actually completed;In the control group,1 case dropped out(active withdrawal),and 36 cases actually completed;After calculation,the total sample shedding rate is 4.05%.2.Comparison of baseline data: before treatment,the two groups were statistically analyzed in terms of gender,age,fasting blood glucose,glycosylated hemoglobin,TCM symptom score,PSQI score,cortisol,growth hormone and other indicators,which showed that P > 0.05,indicating that the data were comparable.3.After 4 weeks of treatment,the total effective rates of TCM syndromes in the experimental group and the control group were 88.6% and 55.6% respectively.Compared with the two groups,the experimental group had more advantages;In terms of TCM syndrome score,both groups can improve TCM syndrome score(P<0.05),and the experimental group is better than the control group,the difference is statistically significant(P<0.05);The comparison of curative effects of single TCM symptoms showed that there was significant difference between the two groups in the improvement of symptoms of "difficulty in falling asleep,dry mouth and thirst"(P<0.05);There was no significant difference in "sleepless all night,palpitation and forgetfulness"(P >0.05).4.The treatment schemes of the two groups can reduce the baseline levels of glycosylated hemoglobin and fasting blood glucose before treatment(P < 0.05).There is no difference in the total effective rate and level of glycosylated hemoglobin and fasting blood glucose between the two groups after treatment(P > 0.05),suggesting that the drug schemes of the experimental group and the control group can improve the blood glucose level,and there is no significant difference in the overall curative effect.5.After 4 weeks of treatment,the incidence of dawn phenomenon in the experimental group was 37% and that in the control group was 61%.Through statistical comparison,there was a difference in the incidence of dawn phenomenon between the two groups(P<0.05),suggesting that the control effect of dawn phenomenon is significant under the intervention of traditional Chinese medicine.6.The PSQI score of the two groups after treatment decreased compared with that before treatment(P<0.05),and the comparison between the groups after treatment showed that P <0.05,which can be considered that the effect of reducing the score in the experimental group is more obvious.7.There was no significant difference in cortisol between the two groups before and after treatment.It can be considered that the treatment scheme of the two groups had no significant effect on cortisol;The comparison of growth hormone before and after treatment in the experimental group(P<0.05),the comparison of growth stimulating hormone before and after treatment in the control group(P>0.05),and the comparison of growth hormone levels between the two groups after treatment(P>0.05),suggesting that Tianwang Buxin Dan has an effect on the level of growth hormone,but the curative effect is not significant.8.The results of blood routine examination,liver and kidney function of all patients were in line with the normal range.There was no significant difference in various data indexes(P >0.05),and there were no adverse events and adverse reactions,suggesting that the treatment schemes of the two groups are safe in the process of clinical treatment.Conclusions:The combination of "Tian Wang Bu Xin Dan" and "hypoglycemic drugs" can improve the clinical symptoms and blood sugar levels of patients with insomnia due to yin deficiency and blood deficiency,and has obvious advantages in the evaluation of TCM syndromes and the incidence of dawn phenomenon.