开郁清热方对肥胖2型糖尿病肝胃郁热证患者β细胞功能的影响  

Influence of Kaiyu Qingre Fang on β-cell function in patients with obese type 2 diabetes(syndrome of heat depression in liver and stomach)

作　　者：赵昱[1] 陈良[2] 董柳[2] 毕桂芝[3] 仝小林[2] 

机构地区：[1]北京民航总医院,北京100123 [2]中国中医科学院广安门医院 [3]首都医科大学燕京医学院

出　　处：《北京中医药大学学报》2013年第7期488-492,496,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京市中医药科技基金资助项目(No.JJ2007-036)

摘　　要：目的研究开郁清热方对肥胖2型糖尿病肝胃郁热证患者β细胞功能的影响,探讨该方是否对胰岛素分泌的时相、数量和质量有改善作用。方法将入组患者随机分为2组:中药开郁清热组和西药二甲双胍组,每组用药12周,通过口服75 g葡萄糖粉做胰岛素耐量实验,检测2组患者实验前后0、30、120 min血糖,同步测免疫反应性胰岛素(IRI)、真胰岛素(TI)和胰岛素原(PI),应用早期胰岛素分泌指数(EISI)、Homa-β细胞功能指数(HBCI)、胰岛素抵抗指数(HOMA-IR)等指标评价β细胞功能。结果经开郁清热方治疗后,患者体重指数(BMI)由治疗前(30.1±2.18)降低至(28.3±2.37),HBCI由治疗前(39.71±27.20)提高至(54.13±40.65),HOMA-IR由治疗前(4.13±1.70)减低至(3.00±1.37),较西药二甲双胍组具有统计学意义。结论开郁清热方的药物组成没有肝肾毒性,安全性能良好,具有较好的降糖、降脂作用,可能机制是通过改善β细胞后相分泌使得血糖整体水平下降,糖毒性的减少使得胰岛功能改善,胰岛素抵抗程度减轻。Objective To study the influence of Kaiyu Qingre Fang on β-cell function in patients with obese type 2 diabetes （ syndrome of heat depression in liver and stomach）, and investigate the improving effects of Kaiyu Qingre Fang on phase, quantity and quality of insulin secretion. Methods The patients were randomly divided into Kaiyu Qingre Fang group （Kaiyu group ） and metformin group. The two groups were given treatment for 12 weeks. Oral glucose tolerance test （OGTY） was carried out through orally taking 75 g glucose powder. The level of plasma glucose were detected in two groups at the time points of 0 minute, 30 minutes and 120 minutes before and after the experiment, and simultaneously the changes of immunoreactive insulin （IRI）, true insulin （TI） and proinsulin （PI） were detected. β-cell function was reviewed by applying early insulin secretion index （EISI）, Homa-beta-cell index （HBCI） and HOMA-insulin resistance index （HOMA-IR）. Results After treatment, body mass index （BMI） decreased from （30.1 ±2.18） to （28.3±2.37）, HBCI increased from （39.71 ±27.20） to （54.13± 40.65 ）, and HOMA-IR decreased from （4.13± 1.70） to. （3. O0 ± 1.37 ） in Kaiyu group, and there was statistical significance compared with mefformin group. Conclusion The medicinal combination of Kaiyu Qingre Fang has no liver and kidney toxicity with higher safety, and it has effects of decreasingplasma glucose and blood fat. The mechanism may be integral level of plasma glucose through improving the glucose toxicity will make the improvement of related to that Kaiyu Qingre Fang can reduce the late phase secretion of βcells. The decrease of

关 键 词：开郁清热方 肥胖2型糖尿病 肝胃郁热证 Β细胞功能 

分 类 号：R255.4[医药卫生—中医内科学]