世界中医药

目的：采用玉液汤加减治疗2型糖尿病的患者并观察其对B细胞功能、颈动脉内中膜厚度的影响。方法：选取2017年1月至2017年12月德州市中医院收治的2型糖尿病患者90例作为研究对象，根据就诊的先后顺序抽取随机数字将患者分为对照组和观察组，每组45例。对照组在基础治疗上予以口服盐酸二甲双胍缓释片，观察组在对照组基础上予以玉液汤加减，疗程3个月。在治疗前与治疗后，分别采集2组患者清晨空腹血液10 mL，使用全自动生化分析仪对患者空腹血糖及餐后2 h血糖、血清胆固醇（TC）、三酰甘油（TG），高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C）进行检测。同时常规检测空腹胰岛素（Fasting Insulin，FINS）和分泌C肽（C-Peptide，C-P），根据公式分别计算HOMA-B细胞功能胰岛素分泌指数（HOMA-Beta Cell Function Index，HBCI）和胰岛素抵抗指数（Insulin Resistance Index，IRI）；以及由超声科专人行颈部的颈动脉血管彩超测定颈动脉内中膜厚度（Intima-media Thickness，IMT）。结果：治疗后2组患者空腹血糖及餐后2 h血糖均明显降低，差异有统计学意义（P<0.05），且观察组优于对照组，差异有统计学意义（P<0.05）。在治疗结束后，患者的TG、TCHO、HDL-C、LDL-C水平均较治疗前明显下降，差异有统计学意义（P<0.05）；但观察组与对照组在治疗后的水平差异无统计学意义（P>0.05）。治疗后2组患者的FINS、C-P、HBCI水平均明显升高，IRI明显降低（P<0.05），但在治疗后，观察组与对照组比较，差异无统计学意义（P>0.05）。治疗后2组患者的颈动脉内中膜厚度均较治疗前明显降低，差异有统计学意义（P<0.05），且观察组优于对照组，差异有统计学意义（P<0.05）。结论：玉液汤加减治疗2型糖尿病患者提高B细胞功能，改善其颈动脉内中膜厚度，延缓其大血管病变进展。

English Summary:

To observe the effect of modified Yuye Decoction on type 2 diabetes mellitus and its effect on β cell function and carotid intima-media thickness.Methods：A total of 90 patients with type 2 diabetes in the internal medicine of Dezhou Hospital of Traditional Chinese Medicine were selected during the period of January 2017 to December 2017.The patients were selected as the treatment group and the control group respectively according to the sequence of medical treatment，with 45 cases in each group.The control group received oral administration of Metformin Hydrochloride Sustained Release Tablets on the basis of treatment.The treatment group was given Yuye Decoction on the basis of the control group for 3 months.Before and after treatment，two groups of patients with early morning blood 10 mL were collected，and the automatic biochemical analyzer was used to test the patients' fasting blood glucose and postprandial 2 h blood sugar，serum cholesterol(TC)，glycerin three fat(TG)，high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C).At the same time，fasting insulin(FINS)and C peptide(C-Peptide，C-P)were measured.According to the formula，the function of HOMA-β cell function insulin secretion index(HOMA-Beta Cell function Index，HBCI)and insulin resistance index were calculated，and the specific human neck of the ultrasound department was carried out.Carotid artery INTIMA-MEDIATHICKNESS was measured by color Doppler ultrasound(IMT).Results：After treatment，fasting blood glucose and postprandial 2 h blood glucose were significantly decreased in the 2 groups(P<0.05)，and the treatment group was better than the control group(P<0.05).After treatment，the levels of TG，TCHO，HDL-C and LDL-C were significantly lower than those before treatment(P<0.05)，but there was no significant difference between the treatment group and the control group after treatment(P>0.05).After treatment，the levels of FINS，C-P and HBCI in the 2 groups increased significantly，and the IRI decreased significantly(P<0.05)，but after treatment，there was no significant difference between the treatment group and the control group(P>0.05).After treatment，the carotid artery intima-media thickness of the two groups was significantly lower than before treatment(P<0.05)，and the treatment group was better than the control group(P<0.05).Conclusion：Modified Yuye Decoction in the treatment of type 2 diabetes patients can improve the function of beta cell，improve the thickness of the medial membrane of the carotid artery，and postpone the progress of the major vascular diseases.It has a vital role in the development of human health and social and economic development.

查看全文查看/发表评论下载PDF阅读器