开郁清热长期辨证论治2型糖尿病患者的胰岛β细胞分泌指数变化  

Variation of isletβ-cell secretary function on Type 2 diabetic patients with long-term treatment based on syndrome differentiation

作　　者：张寅[1] 仝小林[1] 胡镜清[1] 刘保延[2] 

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《中华中医药杂志》2009年第8期1030-1034,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点基础研究发展计划(973计划)项目(No.2006CB504601)

摘　　要：目的:探索开郁清热法长期辨证论治2型糖尿病病例的胰岛功能、糖化血红蛋白以及相关主要症状的变化情况和中药配伍规律。方法:基于中医诊疗实际情况进行符合纳入标准的回顾性研究,所有纳入病例的中医治疗时间均超过6个月,按照就诊时的血糖控制状态并以每3个月为观测时点。结果:①辨证论治9个月、21个月及以上的病例,其胰岛β细胞功能与辨治初诊前相比有所恢复,胰岛β细胞分泌功能指数(HOMA2-%B)有统计学意义,P<0.05;②辨证论治6个月、15个月及以上的病例,其糖化血红蛋白(HbA1C)与辨治初诊前相比降低,结果有统计学意义,P<0.05;③长期辨证论治可使患者口渴、便秘、胃胀等症状好转或减轻,且用药存在一定规律性。结论:长期辨证论治具有降糖和(或)胰岛保护及主症改善的趋势;辨证论治个体诊疗的回顾性研究数据亟待科学、客观的临床评价。Objective： To explore variation of HOMA2-%B, HbA1C, present symptoms and TCM compatibility on T2DM patients with long-term treatment based on syndrome differentiation. Methods： It is a retrospective study in view of actual TCM treatment. All patients who were fit for standards have been treated with TCM based on syndrome differentiation. Their treatment courses are all more than 6 months. Observational statistical data is measured on every 3 months. Results： ① Index number of islet g -cell secretary function（HOMA2-%B）of patients treated with TCM have been improving than those before preliminary diagnosis on 9 months/21 months （P〈0.05）; ②Glycosylated hemoglobin （HbA1C） of patients treated with TCM are lower than those before preliminary diagnosis on 6 months/15 months and above （P〈0.05）; ③Long-term treatment based on syndrome differentiation can relieve thirsty, constipation, gastric distention, etc. And Medication can be show off some regularities. Conclusion： It is a tendency that long-term treatment based on syndrome differentiation can cut down blood glucose and（or） islet β -cell function protection. But retrospective individual treatment based on syndrome differentiation has been need scientific and objective clinical evaluation above all.

关 键 词：2型糖尿病 辨证论治 长期病例 回顾性研究 胰岛功能 糖化血红蛋白 

分 类 号：R259[医药卫生—中西医结合]