中西医药结合治疗２型糖尿病临床探究.docVIP

中西医药结合治疗２型糖尿病临床探究 　 作者：谢培凤　关崧　商学征　周晖　盛彤　易文明　马家驹　高彦彬 【摘要】 目的 观察中西医药结合对2型糖尿病(DM)血糖及胰岛β细胞功能相关指标的影响。方法 60例使用口服降糖西药而血糖控制不佳的2型DM患者分为2组，对照组30例患者继续原治疗方案，试验组30例患者在原治疗方案基础上再加用金芪降糖片，每次8～10片，3次/d。12周后观察血糖、胰岛素、C肽、糖化血红蛋白(HbA1C )及血脂的变化；同时以HOMA模型计算胰岛素分泌指数(Homa -β)、Homa胰岛素抵抗指数(Homa-IR)。结果 12周后，试验组空腹血糖、餐后2 h血糖、HbA1C和总胆固醇、三酰甘油显著下降，对照组无明显变化，两组差异有非常显著意义(Plt;0.01)；空腹胰岛素、C肽无明显变化(Pgt;0.05)，餐后2 h胰岛素、C肽升高(Plt;0.01)，且两组差异有统计学意义(Plt;0.01) Homa-β上升了10±0.6，Homa-IR下降0.7±0.5(Plt;0.01) 结论 对于2型糖尿病患者辩证为气阴两虚火旺者，在应用西药降血糖时加用中成药金芪降糖片，还能改善胰岛B细胞功能。 　　【关键词】 血糖；胰岛功能；金芪降糖片 　　 　　【Abstract】 Objective To investigate the effects of western medicine combining with traditional Chinese medicine on patients with T2DM and function of islet β cell.Methods 60 Type 2 diabetic patients with poor western medicine controlled Blood glucose were randomly divided into 2 groups，the control group and the trial group.30 patients from the control group continue the original treatment.The trial group added Jinqijiangtangpian on the basis of the original treatment，8-10 tablets each time，threes times a day.Blood glucose ，C peptide ，HbA1C and blood fat were measured after 12 weeks and HOMA-β as well as Homa-IR were calculated by HOMA model.Results After 12 weeks ，FBG ，2 h PBG ，HbA1C and TC and TG were significantly lower than the control group(Plt;0.01).No difference were found in fasting insulin and C peptide(Pgt;0.05).2 h postprandial insulin and C peptide rose(Plt;0.01).Homa-β rose by 10±0.6.Homa-IR declined by 0.7±0.5(Plt;0.01).Conclusions To the patients with deficiency of both vital energy and yin，treatment of the Chinese formulated product Jinqijiangtangpian on the basis of western medicine can improve the islet β-cell function. 　　【Key words】 Blood glucose；Function of Islets；Jinqijiangtangpian 　　 　　随着人类生活方式和饮食习惯的改变，以及人口的老龄化，糖尿病已经成为人类健康的主要威胁之一。最近研究显示对患者的血糖进行强化控制有助于减少与糖尿病(diabetes mellitus，DM)相关事件的发生率，高血糖尤其是餐后高血糖是心血管疾病中一个独立的危险因子。中医学认为，DM的发病机制是在先天禀赋不足、素体阴虚的基础上，加上情志不遂、饮食失调、辛苦劳累从而引起阴虚化热而至致。早期阴虚燥热、中期气阴两虚，晚期阴阳两虚。金芪降糖片方中生黄芪补气健脾，金