胰岛素抵抗相关性高血压炎症机制与瘀热证候的关系及针箭颗粒的干预研究
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摘要
目的：本课题是在论证高血压伴胰岛素抵抗的基础上,探讨胰岛素抵抗相关性高血压瘀热证候与炎症机制的关系,并拟证实具有清肝泄热、化瘀利水功效的针箭颗粒可以抑制炎症反应,改善胰岛素抵抗。
方法：共观察高血压患者90例,采用HOMA模型计算胰岛素抵抗指数(HOMA-IR),根据是否伴有胰岛素抵抗分为伴胰岛素抵抗的IR组40例和不伴胰岛素抵抗的NIR组50例,所有入选对象进行瘀热证候积分评估及空腹血糖、血清胰岛素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)等检测,对观测病例的体重指数、血压及上述检测指标进行统计,然后将40例IR患者进行随机分组,分为治疗组(针箭颗粒组)和对照组,经过8周后再次对40例患者进行瘀热证候积分评估及空腹血糖、血胰岛素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白等检测,使用SPSS 11.5对治疗组和对照组检测指标进行统计分析。
结果：1.IR组瘀热证候积分、空腹胰岛素、HOMA-IR、TNF-α、IL-6明显高于NIR组(P<0.05),且瘀热证候积分与TNF-α、IL-6、hsCRP存在显著正相关。
2.治疗后治疗组较对照组患者SBP、DBP水平、血中TG、FPG、FINS、HOMA-IR水平有明显降低,具有显著性差异(P<0.01或P<0.05)；治疗组与对照组比较患者血清TNF-α、IL-6、hs-CRP水平明显下降,具有统计学差异(P<0.05)；在中医证候积分,治疗组改善明显优于对照组(P<0.01)。
结论：1.炎症机制作为胰岛素抵抗发病机制之一,与高血压胰岛素抵抗的中医病理基础“瘀热”有一定的相关性
2.具有清肝泄热、化瘀利水功用的针箭颗粒可以抑制炎症反应、改善胰岛素抵抗及调脂等。
Objective:To discuss the relationship between the hypertension and insulin resistance, and then study the relationship between inflammatory mechanisms and Stasis heat symptoms, To confirm the zhenjian particles can inhibit the inflammation and improve the Stasis heat symptoms.
Methods:A total of 90 cases observed in patients with hypertension, According to the rating of HOMA-IR, these patients were divided into two groups, forty with IR and fifty with NIR, all patients were calculated points of Stasis heat symptoms and tested the FPG、FINS、TNF-α、IL-6、hs-CRP and lipid, to ensure that the experimental safety, the safety indexes were also tested. After that, the forty patients with IR were divided into two groups at random. There was no obvious difference in age, sex, illness course and severity degree between the two groups. The control group were treated by west medicine, while patients in the treatment group were treated by zhenjian particles everytime twice everyday on the basis of west medicine. The course of treatment lasted eight weeks, then the changes of insulin of laboratory indexes, the clinical symptoms and the degree of insulin resistance were observed.
Results:1.There was a Significant correlation between the calculated points of Stasis heat symptoms and TNF-α、IL-6、hs-CRP in the patients with IR.
2.After treatment,in the treatment group,the level of SBP、DBP、TG、FPG、FINS HOMA-IR were more remarkably reduced than in control group and the difference was significant between the two groups(P<0.05orP<0.01). The level of TNF-α、IL-6、hs-CRP in treatment group decreased more significantly than in control group, and the difference between two groups was statistical(P<0.05).At the aspect of treatment effect of traditional medicine, which in treatment group was ameliorated better than in the control group, and between the two groups difference was statistical(P<0.01).
Conclusion:1.As one of the mechanisms of insulin resistance, the inflammatory mechanisms and Stasis heat symptoms have significant correlation.
2. The zhenjian particles which function is qingganxiere and huayulishui can inhibit inflammation and improve insulin resistance and recuperate lipid.
方法：共观察高血压患者90例,采用HOMA模型计算胰岛素抵抗指数(HOMA-IR),根据是否伴有胰岛素抵抗分为伴胰岛素抵抗的IR组40例和不伴胰岛素抵抗的NIR组50例,所有入选对象进行瘀热证候积分评估及空腹血糖、血清胰岛素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)等检测,对观测病例的体重指数、血压及上述检测指标进行统计,然后将40例IR患者进行随机分组,分为治疗组(针箭颗粒组)和对照组,经过8周后再次对40例患者进行瘀热证候积分评估及空腹血糖、血胰岛素、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白等检测,使用SPSS 11.5对治疗组和对照组检测指标进行统计分析。
结果：1.IR组瘀热证候积分、空腹胰岛素、HOMA-IR、TNF-α、IL-6明显高于NIR组(P<0.05),且瘀热证候积分与TNF-α、IL-6、hsCRP存在显著正相关。
2.治疗后治疗组较对照组患者SBP、DBP水平、血中TG、FPG、FINS、HOMA-IR水平有明显降低,具有显著性差异(P<0.01或P<0.05)；治疗组与对照组比较患者血清TNF-α、IL-6、hs-CRP水平明显下降,具有统计学差异(P<0.05)；在中医证候积分,治疗组改善明显优于对照组(P<0.01)。
结论：1.炎症机制作为胰岛素抵抗发病机制之一,与高血压胰岛素抵抗的中医病理基础“瘀热”有一定的相关性
2.具有清肝泄热、化瘀利水功用的针箭颗粒可以抑制炎症反应、改善胰岛素抵抗及调脂等。
Objective:To discuss the relationship between the hypertension and insulin resistance, and then study the relationship between inflammatory mechanisms and Stasis heat symptoms, To confirm the zhenjian particles can inhibit the inflammation and improve the Stasis heat symptoms.
Methods:A total of 90 cases observed in patients with hypertension, According to the rating of HOMA-IR, these patients were divided into two groups, forty with IR and fifty with NIR, all patients were calculated points of Stasis heat symptoms and tested the FPG、FINS、TNF-α、IL-6、hs-CRP and lipid, to ensure that the experimental safety, the safety indexes were also tested. After that, the forty patients with IR were divided into two groups at random. There was no obvious difference in age, sex, illness course and severity degree between the two groups. The control group were treated by west medicine, while patients in the treatment group were treated by zhenjian particles everytime twice everyday on the basis of west medicine. The course of treatment lasted eight weeks, then the changes of insulin of laboratory indexes, the clinical symptoms and the degree of insulin resistance were observed.
Results:1.There was a Significant correlation between the calculated points of Stasis heat symptoms and TNF-α、IL-6、hs-CRP in the patients with IR.
2.After treatment,in the treatment group,the level of SBP、DBP、TG、FPG、FINS HOMA-IR were more remarkably reduced than in control group and the difference was significant between the two groups(P<0.05orP<0.01). The level of TNF-α、IL-6、hs-CRP in treatment group decreased more significantly than in control group, and the difference between two groups was statistical(P<0.05).At the aspect of treatment effect of traditional medicine, which in treatment group was ameliorated better than in the control group, and between the two groups difference was statistical(P<0.01).
Conclusion:1.As one of the mechanisms of insulin resistance, the inflammatory mechanisms and Stasis heat symptoms have significant correlation.
2. The zhenjian particles which function is qingganxiere and huayulishui can inhibit inflammation and improve insulin resistance and recuperate lipid.
引文
[1]Reaven GM. Role of insulin resistance in human disease (syndrome X):an expanded definition. Annu Rev Med.1993.44:121-31.
[2]Golay A, Schutz Y, Felber JP, de Fronzo RA, Jequier E. Lack of thermogenic response to glucose/insulin infusion in diabetic obese subjects. Int J Obes.1986.10(2):107-16.
[3]Reaven GM. The insulin resistance syndrome:definition and dietary approaches to treatment. Annu Rev Nutr.2005.25:391-406.
[4]Balkau B, Charles MA,Drivsholm T, et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab.2002.28(5): 364-376.
[5]李光伟,Step..L.检测人群胰岛素敏感性的一项新指数.中华内科杂志.1993.32(10)：656-660.
[6]Ishii K, Sasaki M, Yamaji S, Sakamoto S, Kitagaki H, Mori E. Relatively preserved hippocampal glucose metabolism in mild Alzheimer's disease. Dement Geriatr Cogn Disord.1998.9(6):317-322.
[7]李月英.高血压病患者胰岛素抵抗及其关联因素.心脏杂志.2004.(04)：349-350.
[8]王志华.高血压病患者胰岛素抵抗相关指标的变化.海南医学.2001.(12)：37-38.
[9]孙学东, 李靖, 刘雪平,等.高血压患者的胰岛素抵抗.中国临床康复.2005.(43)：141
[10]Holzl B, Iglseder B, Stadlmayr A,et al. Intima media thickness of carotid arteries is reduced in heterozygous carriers of the Gly972Arg variant in the insulin receptor substrate-1 gene. Eur J Clin Invest.2003. 33(2):110-116.
[11]Tack CJ, Smits P, Willemsen JJ, Lenders JW, Thien T, Lutterman JA. Effects of insulin on vascular tone and sympathetic nervous system in NIDDM. Diabetes.1996.45(1):15-22.
[12]Zemel MB. Insulin resistance vs. hyperinsulinemia in hypertension:insulin regulation of Ca2+transport and Ca (2+)-regulation of insulin sensitivity. J Nutr.1995.125(6 Suppl):1738S-1743S.
[13]Slater EE. Insulin resistance and hypertension. Hypertension.1991.18(3 Suppl):1108-1114.
[14]刘国杖,高润霖,李光伟,等.全国高血压、冠心病与糖尿病专题研讨会纪要[J].中华心血管杂志.1993,21：260
[15]Levy J, Zemel MB, Sowers JR. Role of cellular calcium metabolism in abnormal glucose metabolism and diabetic hypertension. Am J Med.1989.87(6A):7S-16S.
[16]Zemel MB, Bedford BA, Zemel PC, Marwah O, Sowers JR. Altered cation transport in non-insulin-dependent diabetic hypertension:effects of dietary calcium. [J] Hypertension Suppl.1988.6(4): S228-230.
[17]Frank HJ, Levin ER, Hu RM, Pedram A. Insulin stimulates endothelin binding and action on cultured vascular smooth muscle cells. Endocrinology.1993.133(3):1092-1097.
[18]陈颜芳,韩启德.胰岛素抵抗大鼠血压升高的血管机制[J].中国病理生理杂志,1998, 14(5)：458-461
[19]AxelrodL.Insulin ProstagL and the Pathogenesis of hypertension [J].Diabetes 1991,10:1223-1227
[20]Hofinann C, Lorenz K, Braithwaite SS, et al. Altered gene expression for tumor necrosis factor-alpha and its receptors during drug and dietary modulation of insulin resistance. Endocrinology.1994.134(1): 264-70.
[21]SaghizadM. The expression of TNF-a by human muscle:relationship to insulin resistance [J]. J Clin Invest,1996,97(1):111
[22]吴静.肿瘤坏死因子-α与胰岛素抵抗[J].国外医学内分泌学分册.1999,19(5)：220
[23]Kern PA. The expression of TNF-a in human adipose tissue regulation by obesity.weight lose and relationship to lipoprotein lipase [J].JClin Invest,1995,95(2):111
[24]HotamisligiT GS. Increased adipose tissue expression of TNF-a in human obesity and insulin resistance[J].JClin Invest.1995(2):409
[25]RotterV, Nagaevl, SmithU.Interleukin-6(IL-6)induces insulin resistance i3T3-L1 adiPoeytes and is, like IL-8 and tumor necrosis factor alpha, overexpressed in human fat cells from insulin-resistant[J].Biol Chem, 2003,278:457-458
[26]Path G, Bornstein SR, Gurniak M, Chrousos GP, Scherbaum WA, Hauner H. Human breast adipocytes express interleukin-6(IL-6)and its receptor system:increased IL-6 Production by beta-adrenergic activation and effects of IL-6 on adipocyte function[J].Clin Endocrinol Metab,2001,86:2281-2288
[27]Senn JJ, Klover PJ, Nowak IA, Mooney RA. Interleukin-6 induces cellular insulin resistance in hepatocytes [J]. Diabetes,2002,51:3391-3399
[28]RotterV, Nagaevl, SmithU.Interleukin-6(IL-6)induces insulin resistance i3T3-L1 adiPoeytes and is, like IL-8 and tumor necrosis factor alpha, overexpressed in human fat cells from insulin-resistant[J].Biol Chem, 2003,278:547-549
[30]Arner P. Insulin resistance in type 2 diabetes role of the adipokines[J].Curr MolMed,2005,5:333-339
[31]程伟,龙敏,严钟德等.血清hsCRP、sTNFR2与2型糖尿病及大血管病变关系探讨.重庆医学,2005.34(1)：19-20
[32]龙敏,严钟德.C-反应蛋白和糖尿病[J].国外医学内分泌分册,2002,22：753
[33]高燕.高血压患者糖耐量与超敏C反应蛋白的相关性[J].中华高血压杂志,2006,14：879-881
[34]WeyerC, FunahashiT, Tanaka S, et a.l Hypoadiponectin-emia in obesity and type 2 diabetes:close association with insulin resistance and hyper insulin emia[J]. Clin EndocrinolMetab,2001,86(5):1930-1935
[35]冯琴.胰岛素抵抗的中医病机证候特点.中西医结合学报.2005.(01)：63-65.
[36]张彤, 叶景华.运脾活血法治疗2型糖尿病胰岛素抵抗初探.新中医.2005.(02)：7-8.
[37]唐迎雪.2型糖尿病胰岛素抵抗与中医痰瘀毒相关性研究.中国医药学报.2004.(04)：237-239.
[38]张志玲, 张黎群.活血降糖饮治疗代谢综合征30例疗效观察.中医药临床杂志.2004.(04)：327-328.
[39]吴深涛.论浊毒与糖尿病糖毒性和脂毒性的相关性.中医杂志.2004.(09)：647-649.
[40]徐远.中医治疗代谢综合征的思路与方法.中医杂志.2003.(04)：301-302.
[41]中华人民共和国卫生部.中药新药临床研究指导原则·第2辑[M].1999.28-32
[42]蒋卫民, 唐蜀华.高血压病辨证分型与胰岛素抵抗关系的初步研究.中医杂志.1999.40(1)：45-46.
[43]王芸素, 陈宏珪.高血压病辨证分型与胰岛素抵抗的关系.中西医结合心脑血管病杂志.2004.2(10)：611-611.
[44]邵春林, 刘永明,沈琴峰.高血压病中医辨证分型与胰岛素抵抗及脂代谢关系探讨.河北中医.2004.26(3)：171-173.
[45]刘惠文, 姜亚云.高血压病患者胰岛素抵抗与中医辨证分型的相关性研究.中国中西医结合杂志.1999.19(4)：200-202.
[46]蒋卫民, 唐蜀华.高血压病胰岛素抵抗中医病机探析.中国中医急症.2006.15(4)：389-390.
[47]梁兴伦, 韩明向.胰岛素抵抗模型大鼠的中医证候研究.中国中西医结合杂志.2001.21(7)：528-530.
[48]周仲瑛.论瘀热[J].南京中医药大学学报,2006,22：273-276
[49]郭玉红.自拟清脑降压汤对高血压胰岛素抵抗的影响[J].中医药信息,2003,20(1)：48
[50]段学忠,李猷河,蔡新吉,等.益脉降压胶囊对老年高血压病患者胰岛素抵抗及肿瘤坏死因子的影响[J].中医药学刊,2002,20(4)：505-506
[51]刘彦晶.桃红二陈天麻饮对肥胖型高血压患者胰岛素抵抗的影响[J].中国中医药科技,2006,13(6)：432-433
[52]彭利,鲍宜桂,李忠业.复方鬼箭羽汤改善高血压病胰岛素抵抗和微循环的临床研究[J].陕西中医,2007,28(6)：677
[53]吴启锋,温茂祥,兰东辉,等.半夏白术天麻汤对痰湿壅盛型高血压病胰岛索抵抗及血脂的影响[J].福建中医学院学报,2007,17(2)：8-10
[54]张宇红,陆付耳,李江林,等.清热祛痰活血方对肥胖型高血压患者胰岛素抵抗的影响[J].中医杂志,2003,44(10)：747
[55]李文晞,吴伟,黄衍寿.补肾益心片改善高血压病胰岛素抵抗30例临床观察[J].新中医,2002,34(7)：34-35
[56]岳桂华,管琳,张效涛.黄连解毒降压汤改善高血压病胰岛素抵抗临床观察[J].山东中医杂志,2004,23(9)：529-530
[57]彭敏,杨平,刘培中.杞菊地黄汤改善高血压患者胰岛素抵抗的作用[J].中国中医药,2005,9(9)：44-45
[58]徐京育,苏润泽,张良.复方槐花降压冲剂治疗胰岛素抵抗性高血压[J].中西医结合心脑血管病杂志,2005,3(6)：489
[59]刘莉,金娟,于昊伟.加味建瓴汤对高血压患者胰岛素抵抗及血清TNF-α水平的影响[J].中医药信 息,2008,25(5)：68-70
[60]李运伦.黄连清降合剂治疗高血压病胰岛素抵抗43例临床研究[J].中西医结合心脑血管病杂志,2007,5(9)：791
[61]黄伟明,廖蔚茜,何泮,等.中西医结合改善高血压病胰岛素抵抗的临床观察[J].河北中医,2005,27(6)：439-440
[62]于健.葛根素对老年原发性高血压患者胰岛素抵抗的临床研究[J].临床荟萃,2002,17(21)：1244-1245
[63]余秀兰,赵华云,陈伟强.黄芪注射液联合厄贝沙坦对伴MS高血压患者血内皮素及胰岛素抵抗的影响[J].西北药学杂志,2007,22(2)：81-82
[64]卢健棋,曾丽绚.黄芪注射液对高血压病患者胰岛素抵抗影响的观察[J].江苏中医药,2004,25(7)：23-24
[65]国家技术监督管理局.中华人民共和国国家标准.中医临床诊疗术语.证候部分[S].中国标准出版社.中国标准出版社,1997年6月第一版18
[66]郑筱萸主编.中华人民共和国卫生部.中药新药临床指导原则[S].北京：中国医药科技出版社,2002,85-89
[67]蒋卫民,唐蜀华,陈晓虎,赵志英.高血压胰岛素抵抗患者瘀热证候的表现[J].四川中医,2008：25-26
[2]Golay A, Schutz Y, Felber JP, de Fronzo RA, Jequier E. Lack of thermogenic response to glucose/insulin infusion in diabetic obese subjects. Int J Obes.1986.10(2):107-16.
[3]Reaven GM. The insulin resistance syndrome:definition and dietary approaches to treatment. Annu Rev Nutr.2005.25:391-406.
[4]Balkau B, Charles MA,Drivsholm T, et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab.2002.28(5): 364-376.
[5]李光伟,Step..L.检测人群胰岛素敏感性的一项新指数.中华内科杂志.1993.32(10)：656-660.
[6]Ishii K, Sasaki M, Yamaji S, Sakamoto S, Kitagaki H, Mori E. Relatively preserved hippocampal glucose metabolism in mild Alzheimer's disease. Dement Geriatr Cogn Disord.1998.9(6):317-322.
[7]李月英.高血压病患者胰岛素抵抗及其关联因素.心脏杂志.2004.(04)：349-350.
[8]王志华.高血压病患者胰岛素抵抗相关指标的变化.海南医学.2001.(12)：37-38.
[9]孙学东, 李靖, 刘雪平,等.高血压患者的胰岛素抵抗.中国临床康复.2005.(43)：141
[10]Holzl B, Iglseder B, Stadlmayr A,et al. Intima media thickness of carotid arteries is reduced in heterozygous carriers of the Gly972Arg variant in the insulin receptor substrate-1 gene. Eur J Clin Invest.2003. 33(2):110-116.
[11]Tack CJ, Smits P, Willemsen JJ, Lenders JW, Thien T, Lutterman JA. Effects of insulin on vascular tone and sympathetic nervous system in NIDDM. Diabetes.1996.45(1):15-22.
[12]Zemel MB. Insulin resistance vs. hyperinsulinemia in hypertension:insulin regulation of Ca2+transport and Ca (2+)-regulation of insulin sensitivity. J Nutr.1995.125(6 Suppl):1738S-1743S.
[13]Slater EE. Insulin resistance and hypertension. Hypertension.1991.18(3 Suppl):1108-1114.
[14]刘国杖,高润霖,李光伟,等.全国高血压、冠心病与糖尿病专题研讨会纪要[J].中华心血管杂志.1993,21：260
[15]Levy J, Zemel MB, Sowers JR. Role of cellular calcium metabolism in abnormal glucose metabolism and diabetic hypertension. Am J Med.1989.87(6A):7S-16S.
[16]Zemel MB, Bedford BA, Zemel PC, Marwah O, Sowers JR. Altered cation transport in non-insulin-dependent diabetic hypertension:effects of dietary calcium. [J] Hypertension Suppl.1988.6(4): S228-230.
[17]Frank HJ, Levin ER, Hu RM, Pedram A. Insulin stimulates endothelin binding and action on cultured vascular smooth muscle cells. Endocrinology.1993.133(3):1092-1097.
[18]陈颜芳,韩启德.胰岛素抵抗大鼠血压升高的血管机制[J].中国病理生理杂志,1998, 14(5)：458-461
[19]AxelrodL.Insulin ProstagL and the Pathogenesis of hypertension [J].Diabetes 1991,10:1223-1227
[20]Hofinann C, Lorenz K, Braithwaite SS, et al. Altered gene expression for tumor necrosis factor-alpha and its receptors during drug and dietary modulation of insulin resistance. Endocrinology.1994.134(1): 264-70.
[21]SaghizadM. The expression of TNF-a by human muscle:relationship to insulin resistance [J]. J Clin Invest,1996,97(1):111
[22]吴静.肿瘤坏死因子-α与胰岛素抵抗[J].国外医学内分泌学分册.1999,19(5)：220
[23]Kern PA. The expression of TNF-a in human adipose tissue regulation by obesity.weight lose and relationship to lipoprotein lipase [J].JClin Invest,1995,95(2):111
[24]HotamisligiT GS. Increased adipose tissue expression of TNF-a in human obesity and insulin resistance[J].JClin Invest.1995(2):409
[25]RotterV, Nagaevl, SmithU.Interleukin-6(IL-6)induces insulin resistance i3T3-L1 adiPoeytes and is, like IL-8 and tumor necrosis factor alpha, overexpressed in human fat cells from insulin-resistant[J].Biol Chem, 2003,278:457-458
[26]Path G, Bornstein SR, Gurniak M, Chrousos GP, Scherbaum WA, Hauner H. Human breast adipocytes express interleukin-6(IL-6)and its receptor system:increased IL-6 Production by beta-adrenergic activation and effects of IL-6 on adipocyte function[J].Clin Endocrinol Metab,2001,86:2281-2288
[27]Senn JJ, Klover PJ, Nowak IA, Mooney RA. Interleukin-6 induces cellular insulin resistance in hepatocytes [J]. Diabetes,2002,51:3391-3399
[28]RotterV, Nagaevl, SmithU.Interleukin-6(IL-6)induces insulin resistance i3T3-L1 adiPoeytes and is, like IL-8 and tumor necrosis factor alpha, overexpressed in human fat cells from insulin-resistant[J].Biol Chem, 2003,278:547-549
[30]Arner P. Insulin resistance in type 2 diabetes role of the adipokines[J].Curr MolMed,2005,5:333-339
[31]程伟,龙敏,严钟德等.血清hsCRP、sTNFR2与2型糖尿病及大血管病变关系探讨.重庆医学,2005.34(1)：19-20
[32]龙敏,严钟德.C-反应蛋白和糖尿病[J].国外医学内分泌分册,2002,22：753
[33]高燕.高血压患者糖耐量与超敏C反应蛋白的相关性[J].中华高血压杂志,2006,14：879-881
[34]WeyerC, FunahashiT, Tanaka S, et a.l Hypoadiponectin-emia in obesity and type 2 diabetes:close association with insulin resistance and hyper insulin emia[J]. Clin EndocrinolMetab,2001,86(5):1930-1935
[35]冯琴.胰岛素抵抗的中医病机证候特点.中西医结合学报.2005.(01)：63-65.
[36]张彤, 叶景华.运脾活血法治疗2型糖尿病胰岛素抵抗初探.新中医.2005.(02)：7-8.
[37]唐迎雪.2型糖尿病胰岛素抵抗与中医痰瘀毒相关性研究.中国医药学报.2004.(04)：237-239.
[38]张志玲, 张黎群.活血降糖饮治疗代谢综合征30例疗效观察.中医药临床杂志.2004.(04)：327-328.
[39]吴深涛.论浊毒与糖尿病糖毒性和脂毒性的相关性.中医杂志.2004.(09)：647-649.
[40]徐远.中医治疗代谢综合征的思路与方法.中医杂志.2003.(04)：301-302.
[41]中华人民共和国卫生部.中药新药临床研究指导原则·第2辑[M].1999.28-32
[42]蒋卫民, 唐蜀华.高血压病辨证分型与胰岛素抵抗关系的初步研究.中医杂志.1999.40(1)：45-46.
[43]王芸素, 陈宏珪.高血压病辨证分型与胰岛素抵抗的关系.中西医结合心脑血管病杂志.2004.2(10)：611-611.
[44]邵春林, 刘永明,沈琴峰.高血压病中医辨证分型与胰岛素抵抗及脂代谢关系探讨.河北中医.2004.26(3)：171-173.
[45]刘惠文, 姜亚云.高血压病患者胰岛素抵抗与中医辨证分型的相关性研究.中国中西医结合杂志.1999.19(4)：200-202.
[46]蒋卫民, 唐蜀华.高血压病胰岛素抵抗中医病机探析.中国中医急症.2006.15(4)：389-390.
[47]梁兴伦, 韩明向.胰岛素抵抗模型大鼠的中医证候研究.中国中西医结合杂志.2001.21(7)：528-530.
[48]周仲瑛.论瘀热[J].南京中医药大学学报,2006,22：273-276
[49]郭玉红.自拟清脑降压汤对高血压胰岛素抵抗的影响[J].中医药信息,2003,20(1)：48
[50]段学忠,李猷河,蔡新吉,等.益脉降压胶囊对老年高血压病患者胰岛素抵抗及肿瘤坏死因子的影响[J].中医药学刊,2002,20(4)：505-506
[51]刘彦晶.桃红二陈天麻饮对肥胖型高血压患者胰岛素抵抗的影响[J].中国中医药科技,2006,13(6)：432-433
[52]彭利,鲍宜桂,李忠业.复方鬼箭羽汤改善高血压病胰岛素抵抗和微循环的临床研究[J].陕西中医,2007,28(6)：677
[53]吴启锋,温茂祥,兰东辉,等.半夏白术天麻汤对痰湿壅盛型高血压病胰岛索抵抗及血脂的影响[J].福建中医学院学报,2007,17(2)：8-10
[54]张宇红,陆付耳,李江林,等.清热祛痰活血方对肥胖型高血压患者胰岛素抵抗的影响[J].中医杂志,2003,44(10)：747
[55]李文晞,吴伟,黄衍寿.补肾益心片改善高血压病胰岛素抵抗30例临床观察[J].新中医,2002,34(7)：34-35
[56]岳桂华,管琳,张效涛.黄连解毒降压汤改善高血压病胰岛素抵抗临床观察[J].山东中医杂志,2004,23(9)：529-530
[57]彭敏,杨平,刘培中.杞菊地黄汤改善高血压患者胰岛素抵抗的作用[J].中国中医药,2005,9(9)：44-45
[58]徐京育,苏润泽,张良.复方槐花降压冲剂治疗胰岛素抵抗性高血压[J].中西医结合心脑血管病杂志,2005,3(6)：489
[59]刘莉,金娟,于昊伟.加味建瓴汤对高血压患者胰岛素抵抗及血清TNF-α水平的影响[J].中医药信 息,2008,25(5)：68-70
[60]李运伦.黄连清降合剂治疗高血压病胰岛素抵抗43例临床研究[J].中西医结合心脑血管病杂志,2007,5(9)：791
[61]黄伟明,廖蔚茜,何泮,等.中西医结合改善高血压病胰岛素抵抗的临床观察[J].河北中医,2005,27(6)：439-440
[62]于健.葛根素对老年原发性高血压患者胰岛素抵抗的临床研究[J].临床荟萃,2002,17(21)：1244-1245
[63]余秀兰,赵华云,陈伟强.黄芪注射液联合厄贝沙坦对伴MS高血压患者血内皮素及胰岛素抵抗的影响[J].西北药学杂志,2007,22(2)：81-82
[64]卢健棋,曾丽绚.黄芪注射液对高血压病患者胰岛素抵抗影响的观察[J].江苏中医药,2004,25(7)：23-24
[65]国家技术监督管理局.中华人民共和国国家标准.中医临床诊疗术语.证候部分[S].中国标准出版社.中国标准出版社,1997年6月第一版18
[66]郑筱萸主编.中华人民共和国卫生部.中药新药临床指导原则[S].北京：中国医药科技出版社,2002,85-89
[67]蒋卫民,唐蜀华,陈晓虎,赵志英.高血压胰岛素抵抗患者瘀热证候的表现[J].四川中医,2008：25-26
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