黄连多糖联合甘精胰岛素治疗2型糖尿病胰岛素抵抗
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摘要
目的:观察黄连多糖联合甘精胰岛素治疗2型糖尿病胰岛素抵抗的临床疗效。方法:190例2型糖尿病胰岛素抵抗患者按照抽签方式随机平均分为对照组和观察组。对照组给予二甲双胍联合甘精胰岛素,观察组给予黄连多糖联合甘精胰岛素,两组均治疗3个疗程。比较两组患者治疗前后血脂水平:三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low density lipoprotein,LDL-C),血糖水平:餐后2小时血糖(2 hours postprandial blood glucose,2hPG)、空腹血糖(fasting blood-glucose,FPG)、糖化血红蛋白(glycated hemoglobins,Hb A1c),血液流变学相关指标:全血高切还原黏度、全血低切还原黏度、血浆黏度、纤维蛋白原,胰岛素相关指标:空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(Insulin resistance index,IRI)、胰岛素敏感指数(insulin sensitive index,IAI),并比较两组患者临床疗效。结果:两组患者治疗后TC、TG、LDL-C、FPG、2hPG、Hb A1c、全血高切还原黏度、全血低切还原黏度、血浆黏度、纤维蛋白原、FINS、IRI水平均显著低于治疗前,HDL-C、IAI均显著增高,差异有统计学意义(P <0. 05);且观察组治疗后上述各项指标均优于对照组治疗后,差异有统计学意义(P <0. 05)。观察组有效率为92. 63%,对照组有效率为81. 05%,两组有效率比较,差异有统计学意义(P <0. 05)。结论:黄连多糖联合甘精胰岛素治疗2型糖尿病胰岛素抵抗疗效显著,可显著改善血脂、血糖水平及胰岛素抵抗指数,提高胰岛素敏感性。
Objective: To observe the clinical efficacy of Huanglian polysaccharide combined with insulin glargine in treatment of insulin resistance of type 2 diabetes. Methods: 190 patients with insulin resistance in type 2 diabetes were randomly divided into control group and observation group. The control group was given metformin combined with insulin glargine,and the observation group was given Huanglian polysaccharide combined with insulin glargine. Both groups were treated for 3 courses. The blood lipid levels of the two groups were compared before and after treatment,namely,triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDL-C),low density lipoprotein( low density). Lipoprotein,LDL-C),blood glucose levels: 2 hours postprandial blood glucose( 2 hPG),fasting blood-glucose( FPG),glycated hemoglobins( Hb A1 c) and hemorheology Indicators such as whole blood high-cut reduction viscosity,whole blood low-cut reduction viscosity,plasma viscosity,fibrinogen,insulin-related indicators: fasting insulin( FINS),insulin resistance index( IRI),insulin sensitivity index( insulin sensitive index,IAI). The clinical efficacy of the two groups of patients was compared. Results: After treatment,TC,TG,LDL-C,FPG,2 hPG,Hb A1 c,whole blood high-reduction reduction viscosity,whole blood low-cut reduction viscosity,plasma viscosity,fibrinogen,FINS,IRI levels in the two groups were significantly lowered than those Before treatment. The increase of HDL-C and IAI of both groups was statistically significant( P < 0. 05). The above indexes of the observation group were better than those of the control group,and the difference was statistically significant( P < 0. 05). The effective rate of the observation group was 92. 63%,and the effective rate of the control group was 81. 05%. The effective rate of the two groups was statistically significant( P < 0. 05). Conclusion: Huanglian polysaccharide combined with insulin glargine has significant curative effect on insulin resistance of type 2 diabetes,which can significantly improve blood lipid,blood sugar level and insulin resistance index,and improve insulin sensitivity.
Objective: To observe the clinical efficacy of Huanglian polysaccharide combined with insulin glargine in treatment of insulin resistance of type 2 diabetes. Methods: 190 patients with insulin resistance in type 2 diabetes were randomly divided into control group and observation group. The control group was given metformin combined with insulin glargine,and the observation group was given Huanglian polysaccharide combined with insulin glargine. Both groups were treated for 3 courses. The blood lipid levels of the two groups were compared before and after treatment,namely,triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDL-C),low density lipoprotein( low density). Lipoprotein,LDL-C),blood glucose levels: 2 hours postprandial blood glucose( 2 hPG),fasting blood-glucose( FPG),glycated hemoglobins( Hb A1 c) and hemorheology Indicators such as whole blood high-cut reduction viscosity,whole blood low-cut reduction viscosity,plasma viscosity,fibrinogen,insulin-related indicators: fasting insulin( FINS),insulin resistance index( IRI),insulin sensitivity index( insulin sensitive index,IAI). The clinical efficacy of the two groups of patients was compared. Results: After treatment,TC,TG,LDL-C,FPG,2 hPG,Hb A1 c,whole blood high-reduction reduction viscosity,whole blood low-cut reduction viscosity,plasma viscosity,fibrinogen,FINS,IRI levels in the two groups were significantly lowered than those Before treatment. The increase of HDL-C and IAI of both groups was statistically significant( P < 0. 05). The above indexes of the observation group were better than those of the control group,and the difference was statistically significant( P < 0. 05). The effective rate of the observation group was 92. 63%,and the effective rate of the control group was 81. 05%. The effective rate of the two groups was statistically significant( P < 0. 05). Conclusion: Huanglian polysaccharide combined with insulin glargine has significant curative effect on insulin resistance of type 2 diabetes,which can significantly improve blood lipid,blood sugar level and insulin resistance index,and improve insulin sensitivity.
引文
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[10]贾晓炜,贾贺堂,唐发宽.临床干预血糖漂移对老年2型糖尿病患者血管内皮指标相关性分析[J].中华老年心脑血管病杂志,2015,17(4):361-364.
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[12]许向红,金星,陈颖越,等. 2型糖尿病合并非酒精性脂肪性肝病与代谢综合征及胰岛素抵抗的关系研究[J].中国全科医学,2013,16(29):3419-3421.
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[14]孙科.连花荔芩愈肾汤治疗早期2型糖尿病肾病临床研究[J].中医学报,2015,30(10):1417-1419.
[15]熊雄,王懿萍,王岳峰,等.黄连多糖的降血糖活性研究[J].时珍国医国药,2013,24(10):2351-2353.
[2]吴国柱,杨士杰,蒋玉清,等.胰岛素样生长因子-1在代谢综合征大鼠和糖尿病大鼠膀胱中的表达变化[J].中华实验外科杂志,2015,32(9):2199-2202.
[3]洛佩,周里钢.减重手术改善2型糖尿病患者胰岛素抵抗及胰岛细胞功能的作用[J].中华全科医师杂志,2015,14(12):980-982.
[4]胡怡淳,倪海祥.无症状高尿酸血症对早期2型糖尿病肾病肾功能的影响及中医相关证型研究[J].云南中医学院学报,2015,38(6):75-78.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南[M].北京:北京大学医学出版社,2011.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
[7]杨光,李春霖,田慧,等.正常糖代谢、正常血糖高胰岛素血症及糖耐量低减人群胰岛素抵抗的评估[J].中华内科杂志,2015,54(9):795-797.
[8]管晓波,陆峥,郭珍,等.认知行为团体治疗对2型糖尿病患者糖代谢及焦虑抑郁情绪的影响[J].中华全科医师杂志,2015,14(3):206-211.
[9]牛小娟,许瑞元,郑艳宇,等.胰岛素治疗2型糖尿病患者对药物治疗依从性和糖尿病自我管理的随机对照实验[J].中华内分泌代谢杂志,2015,31(12):1031-1033.
[10]贾晓炜,贾贺堂,唐发宽.临床干预血糖漂移对老年2型糖尿病患者血管内皮指标相关性分析[J].中华老年心脑血管病杂志,2015,17(4):361-364.
[11]黄汉伟,黎健南,蔡雪,等. DPP-4抑制剂对胰岛素治疗2型糖尿病患者血糖波动的影响[J].重庆医学,2017,46(17):2365-2368.
[12]许向红,金星,陈颖越,等. 2型糖尿病合并非酒精性脂肪性肝病与代谢综合征及胰岛素抵抗的关系研究[J].中国全科医学,2013,16(29):3419-3421.
[13]陈筱云,段正胜. 2型糖尿病前期中医病机探讨[J].世界中西医结合杂志,2013,8(1):4-5.
[14]孙科.连花荔芩愈肾汤治疗早期2型糖尿病肾病临床研究[J].中医学报,2015,30(10):1417-1419.
[15]熊雄,王懿萍,王岳峰,等.黄连多糖的降血糖活性研究[J].时珍国医国药,2013,24(10):2351-2353.