健脾清热化浊法改善2型糖尿病胰岛素抵抗的临床观察  

Clinical efficacy of spleen- strengthening,heat- clearing,and turbidity- eliminating therapy in treatment of insulin resistance in type 2 diabetes

作　　者：关芸 娄锡恩[2] 张丽萍[2] 白斌[3] 

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学第三附属医院,北京100029 [3]山西省太原市中医医院,山西太原030009

出　　处：《湖南中医杂志》2015年第5期4-6,共3页Hunan Journal of Traditional Chinese Medicine

基　　金：北京中医药大学自主选题资助项目(编号:2014-JYBZZ-XS-179)

摘　　要：目的:观察健脾清热化浊法对2型糖尿病肥胖患者伴胰岛素抵抗的临床疗效。方法:将62例诊断为2型糖尿病伴胰岛素抵抗且中医辨证为脾虚湿盛、痰热内郁的肥胖患者按随机、单盲原则分为治疗组32例和对照组30例,均进行基础治疗2周,对照组在基础治疗的同时予二甲双胍肠溶片治疗,治疗组在基础治疗的同时予健脾清热化浊为法的中药颗粒治疗。治疗8周后比较两组临床疗效,并检测两组治疗前后空腹血糖(FBG)、餐后2h血糖(2h PG)、空腹胰岛素(FINS)、血清脂联素(APN)、胆固醇(TC)、三酰甘油(TG),计算胰岛素抵抗水平(IRI)。结果:总有效率治疗组为87.5%,对照组为53.33%,组间比较,差异有统计学意义(P<0.01);两组治疗后FBG、2h PG、FINS、IRI、TG、TC等与治疗前比较均有明显改善(P<0.01或P<0.05),且治疗组在改善2h PG、TC、APN等方面明显优于对照组(P<0.01或P<0.05)。结论:健脾清热化浊法能够降低2型糖尿病患者血糖,减轻胰岛素抵抗,改善脂代谢,其作用机制可能与升高血清脂联素水平相关。Objective： To observe the clinical efficacy of spleen- strengthening,heat- clearing,and turbidity-eliminating therapy in treating obese patients with type 2 diabetes and insulin resistance. Methods： A total of 62 obese patients with type 2 diabetes and insulin resistance,who had traditional Chinese medicine（ TCM） syndromes of spleen deficiency and dampness excess,as well as phlegm- heat and internal depression,were divided into treatment group（ n = 32） and control group（ n = 30） in a randomized,single- blinded trial. Both groups received basic treatment for two weeks. Besides the basic treatment,the control group received metformin enteric- coated tablets,and the treatment group received TCM granules（ spleen- strengthening,heat- clearing,and turbidity- eliminating therapy）. After 8 weeks of treatment,the treatment outcomes of the two groups were compared. And fasting blood glucose（ FBG）,2- hour postprandial glucose（ 2hPG）,fasting insulin（ FINS）,and serum levels of adiponectin（ APN）,total cholesterol（ TC）,and triglyceride（ TG） were measured for the two groups before and after treatment,and the levels of insulin resistance（ IRI） were calculated. Results： There was a significant difference in overall response rate between the treatment group and the control group（ 87. 50% vs 53. 33%,P〈0. 01）. After treatment,both groups showed significant improvements in FBG,2hPG,FINS,IRI,TG,and TC（ P〈0. 01 or P〈0. 05）,and the treatment group showed significant improvements in 2hPG,TC,and APN than the control group（ P〈0. 01 or P〈0. 05）. Conclusion： Spleen- strengthening,heat- clearing,and turbidity- eliminating therapy can reduce blood glucose and insulin resistance and improve lipid metabolism in patients with type 2 diabetes. Its action mechanism may be related to increasing serum level of adiponectin.

关 键 词：2型糖尿病 胰岛素抵抗 中医药疗法 健脾清热化浊法 

分 类 号：R259.871[医药卫生—中西医结合]