消渴平合剂改善初发2型糖尿病患者胰岛β细胞功能的临床观察

Observation on Improvement of Islet β-Cell Function in Recent-onset Type 2 Diabetes by Xiaokeping Mixture

目的观察消渴平合剂改善初发2型糖尿病患者胰岛β细胞功能的疗效。方法将90例初发2型糖尿病患者随机分为3组,分别给予口服降糖药物(格列吡嗪或格列齐特缓释片,A组30例,后脱落1例)、胰岛素(B组30例,后脱落2例)及胰岛素加消渴平合剂(C组30例,后脱落2例)治疗12周,观察治疗前后临床症状、空腹血糖(FBG)、餐后2 h血糖(P2hPG)、糖化血红蛋白(HbA1c)、空腹及餐后0.5,1,2,3 h C肽、胰岛素抵抗指数及胰岛β细胞功能指数。结果 3组患者治疗后,临床症状和FBG、P2hPG、HbA1c、空腹C肽、HOMA-IS均较治疗前有统计学差异(P<0.05),其中C组治疗后较A、B组有统计学差异(P<0.05)。A组患者C肽分泌峰值仍然较低而且后延,而B、C组患者餐后1 h C肽有明显升高,表明两组患者胰岛β细胞功能均有不同程度改善和恢复,但C组患者的效果最好。结论对初发2型糖尿病患者,消渴平合剂具有一定程度的降低血糖和保护胰岛β细胞功能的作用,与胰岛素联用具有协同和增效作用。

OBJECTIVE To observe the effect of Xiaokeping mixture on improvement of islet β-cell function in recent-onset type 2 diabetes.METHODS Ninty recent-onset type 2 diabetic patients were randomly divided into 3 groups（Group A,B,C）,Group A was given glipizide or gliclazide sustained-release tablets（30 patients,1 patient dropped out）,Group B was given insulin（30 patients,2 patients dropped out）,Group C was given insulin combinate Xiaokeping mixture（30 patients,2 patients dropped out）.The changes in clinical syndromes FBG,P2hPG,HbA1c,C peptide and HOMA-IR,HOMA-IS were observed before and after treatment.RESULTS After treatment,clinical symptom,FBG,P2hPG,HbA1c,fasting C peptide and HOMA-IS were improved parentally comparing with pre-treatment（P0.05）,Group C has significant difference comparing with Group A and B（P0.05）.The secretive peak value of C peptide in Group A was still low and delayed,while in Group B and C,C-peptide at 1 hour was significantly increased and indicated a certain degree of improvement and recovery of islet β-cell function.The improving effect in Group C was better.CONCIUSION To recent-onset type 2 diabetes,Xiaokeping mixture can decrease glucose and protect islet β-cell function,and shows synergistic and enhancing action when combined use with insulin.