中西医结合治疗2型糖尿病胰岛素抵抗的临床观察

Combined Use of TCM and Western Medicine for Insulin Resistance in T2DM

目的:观察中西医结合治疗2型糖尿病患者胰岛素抵抗的临床疗效。方法:将216例2型糖尿病胰岛素抵抗患者随机分为对照组108例和治疗组108例,两组患者均按饮食要求,固定每日总热量摄入,并固定运动量,同时采用口服二甲双胍治疗,治疗组在此基础上加服中药代胰降糖方。两组患者分别于治疗前后进行空腹血糖(FPG)、胰岛素(FINS)、糖化血红蛋白(HbAlc)以及血脂[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]检测,并计算胰岛素抵抗指数(IAI)。结果:治疗后对照组总有效率为42.6%,治疗组为74.1%,两组患者总有效率比较有显著性差异(P<0.05)。两组患者治疗后FPG,HbA1c,FINS,IAI,TG,TC水平明显下降,与治疗前比较有显著性差异(P<0.05,P<0.01),治疗后组间比较也有显著性差异(P<0.05,P<0.01);两组患者治疗后HDL-C水平均有升高,治疗组与本组治疗前比较有显著性差异(P<0.05),对照组与本组治疗前比较无显著性差异,治疗后两组间比较也无显著性差异。结论:代胰降糖方联合西药二甲双胍治疗糖尿病胰岛素抵抗,疗效显著,值得在临床上推广使用。

Objective：To observe the curative effect of combined use of TCM and western medicine for insulin resistance in in type 2 diabetes mellitus （T2DM）. Methods：216 cases of T2DM were divided into control group of 108 cases and treatment group of 108 cases. All cases were given the same diet and same exercises with Metformin. Patients in the treatment group were given additional Daiyi Jiangtang capsule. FPG FINS,HbAlc and blood fat of all the patients were detected before and after treatment. IAI was calculated. Results ：The total curative effect was 42.6% in control group and 74.1% in treatment group after treatment. The difference between the two groups was significant （P〈0.05）. FPG, HbAlc, FINS, IAI, TG,TC decreased remarkably after treatment in both groups （P〈0.05,P〈0.01）and the difference between groups was significant as well （P〈0.05,P〈0.01）. HDL-C increased in treatment groups after treatment obviously （P〈0.05）,while that in the control group didn＇t increase significantly（P〈0.05）. The difference between groups was not significant after treatment. Con- clusion：It is more effective to improve the insulin resistance by combine use Daivi Jiangtang capsule with Metformin.