中医温阳健脾法与降糖药合用治疗2型糖尿病胰岛素抵抗阳虚患者70例  

Yang-warming and Spleen-strengthening Therapy Combined with Antihyperglycemic Drugs for the Treatment of Insulin Resistance in Type 2 Diabetes with Yang Deficiency:An Observation of 70 Cases

作　　者：阮永队[1] 陈红梅[1] 莫冰泉 刘小琼[1] 

机构地区：[1]广东省东莞市塘厦人民医院中医科,东莞523721

出　　处：《广州中医药大学学报》2007年第3期184-187,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨温阳健脾法对2型糖尿病胰岛素抵抗患者在降糖、调脂、提高胰岛素敏感性等方面的作用。【方法】将105例2型糖尿病伴高胰岛素血症而中医辨证属脾肾阳虚的患者按2∶1比例随机分为观察组(70例)和对照组(35例)。两组均服用二甲双胍片,观察组加服温阳健脾汤(药物组成:熟附子、生黄芪、干姜、炙甘草、红参、肉桂、白术、云苓、熟地、山茱萸、山药、吴茱萸、当归、柴胡、白芍、鬼箭羽),8周为1个疗程,检测两组治疗前后胰岛素敏感性指标和血脂水平的变化,并观察两组临床疗效和毒副反应情况。【结果】在改善胰岛素敏感性指标方面,治疗后两组空腹血糖均下降,且下降程度相当(P>0.05),而观察组餐后2 h血糖下降和胰岛素敏感指数的提高均较对照组有显著性意义(P<0.05)。在调节血脂方面,观察组治疗后血清高密度脂蛋白胆固醇(HDL-C)水平有显著性提高(P<0.05),血清甘油三酯(TG)水平有显著性降低(P<0.01);对照组治疗后各项血脂指标均无显著性变化(P>0.05)。总疗效评价:观察组临床治愈11例,显效24例,有效22例,无效13例,总有效率为81.43%;对照组临床治愈5例,显效6例,有效11例,无效13例,总有效率为62.86%;观察组的疗效优于对照组(P<0.05)。【结论】中医温阳健脾法与降糖药合用对2型糖尿病胰岛素抵抗有较好的疗效。[ Objective] To investigate the effect of yang-wanning and spleen-strengthening therapy combined with antihyperglycemic drugs on decreasing blood glucose and lipid, and on increasing insulin sensitivity in patients with insulin resistance in type 2 diabetes. [ Methods] One hundred and five patients with type 2 diabetes complicated with hyperinsulinemia were classified into k!dney-yang deficiency. The patients were randomized into two groups. Both groups A （ n = 70） and B （ n = 35） received mefformin. Meanwhile, group A was treated with Wenyang Jianpi Decoction （mainly composed of Radix Aconiti Lateralis Preparata, Radix Astragali, Rhizoma Zingiberis, Radix Glycyrrhizac Preparata, Radix Ginseng, Cortex Cinnamomi, Rhizoma Atractylodis Macrocephalae, Poria, etc.）. Eight weeks constituted one treatment course. After treatment, insulin sensitivity index （ISI） and blood lipid levels were detected, therapeutic effect was evaluated, and toxic and side effects were also observed. [ Results] After treatment, the decrease of fasting blood glucose （FBG） in group A was similar to group B （ P 〉 0.05）, but the decrease of 2-hour postprandial blood glucose level and the increase of ISI in group A were superior to those in group B （ P 〈 0.05）. In group A, serum high-density lipoprotein cholesterol （HDL-C） level increased and triglyceride level decreased as compared with those before treatment （ P 〈 0.05 or P 〈 0.01 ） ; the difference of blood lipid levels was insignificant in group B before and after treatment （ P 〉 0.05）. For the therapeutic effect, 11 patients were cured, 24 markedly effective, 22 effective, 13 ineffective and the total effective rate was 81.43% in group A; 5 patients were cured, 6 markedly effective, 11 effective, 13 ineffective and the total effective rate was 62.86% in group B. No obvious toxic and side effects were observed in the two groups during the treatment. [ Conclusion] Yang-warming and spleenstrengthening therapy combined with antihyperglyeemie drugs

关 键 词：糖尿病 非胰岛素依赖型/中西医结合疗法 胆固醇/血液 甘油三酯类/血液 胰岛素抗药性/中药疗法 温阳健脾汤/治疗应用 

分 类 号：R587.1[医药卫生—内分泌]