开郁清胃颗粒对不同血糖水平患者β细胞功能的影响  

Effect of Kaiyuqingwei Granules on beta-cell function in patients with different blood glucose levels

作　　者：赵昱[1] 仝小林[2] 刘素宾[3] 陈良[4] 王霞[5] 

机构地区：[1]北京民航总医院,北京100025 [2]中国中医科学院广安门医院,北京100053 [3]北京大学第一医院,北京100034 [4]北京中医药大学,北京100029 [5]北京积水潭医院,北京100035

出　　处：《北京中医药大学学报》2006年第9期635-640,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：首都医学发展基金项目(No.Ⅲ-24)

摘　　要：目的探讨复方开郁清胃颗粒对不同血糖水平患者胰岛β细胞功能的影响以及不同浓度葡萄糖、血糖水平和β细胞功能之间的关系。方法将受试者根据口服葡萄糖耐量试验(OGTT)2h血糖(PBG)分为3组。第1组:7.8mmol/L≤PBG<11.1mmol/L;第2组:11.1mmol/L≤PBG<16.7mmol/L;第3组:PBG>16.7mmol/L。观察62例糖代谢异常患者在开郁清胃颗粒治疗前后的各项指标变化并用OGTT数据评估β细胞功能:计算HOMAβ细胞功能指数(HBCI)、糖负荷30min胰岛素增值与30min血糖增值的比值(ΔI30/ΔG30)及胰岛素曲线下面积(INSAUC)。结果①第1组、第2组患者在开郁清胃颗粒治疗前后体重及腰臀围、血糖、血脂明显改善,胰岛素敏感指数增加,而各点胰岛素(lNS)水平呈下降趋势,HBCI及ΔI30/ΔG30升高,INSAUC减小。②第3组患者血糖、血脂下降,胰岛素敏感指数增加,而各点lNS水平无明显变化,HBCI、ΔI30/ΔG30略有升高,而INSAUC前后对照无统计学意义。结论当PBG<16.7mmol/L开郁清胃颗粒通过降糖、降脂、增加胰岛素敏感性改善糖代谢异常患者β细胞功能,特别是对β细胞早相分泌较好的改善作用与糖负荷后2h血糖的显著降低密切相关;当PBG>16.7mmol/L时,高浓度葡萄糖抑制胰岛素分泌,表现出葡萄糖毒性作用,β细胞功能受损明显,开郁清胃颗粒通过降糖减毒使β细胞功能有所恢复。Objective To study the effect of Kaiyuqingwei Granules on the beta-cell function in patients with different blood glucose levels, and discuss the relationship of different plasma glucose levels, blood glucose and beta-cell function. Methods Subjects were divided into three groups according to 2 h postprandial blood glucose（PBG） levels of oral glucose tolerance test（OGTI＇） as foLLows-Group 1,7.8mmol/L≤PBG 〈 11 . 1 mmol/L; Group 2,11.1 mmol/L≤PBG 〈 16.7 mmol/L; Group 3, PBG 〉 16.7 mmol/L. Sixty-two patients with abnormal glycometabolism were observed before and after treatment by Kaiyuqingwei Granules and OGTr data was used to calculate Homa β-cell function index （HBCI）, the ratio of insulin increment to PBG increment 30 min after glucose load（ ΔI30/ΔG30）and insulin area under curve （INSAUC） to evaluate beta-cell function. Results ①In Group 1 and Group 2, after treatment by Kaiyuqingwei Granules,the body weight, blood glucose and blood fat of patients were improved. Insulin sensibility index （ISI） and HBCI. ΔI30/ΔG30 increased, while INSAUC and insulin at different time decreased. ②In Group 3, blood glucose and blood fat of patients decreased and ISI increased after treatment. HBCI and ΔI30/ΔG30 increased a little,while INSAUC and insulin of different time point had no change. Conclusion When PBG 〈 16.7 mmol/L, Kaiyuqingwei Granules improve β-cell fanction by decreasing blood glucose and blood fat and increasing insulin sensibility. The improvement of the earlyphase insulin secretion is closely associated with the significant decrease of blood glucose 2 h after glucose load. When PBG 〉 16.7 mmol/L, high-level glucose restrains insulin secretion of beta-cells, which indicates that glucose toxicity does a lot of damage to beta-cell function. Kaiyuqingwei Granules improve beta-cell function by decreasing blood glucose and attenuate glucose toxicity.

关 键 词：开郁清胃颗粒 葡萄糖 血糖 Β细胞功能 

分 类 号：R258.71[医药卫生—中医内科学]