天芪降糖胶囊对糖耐量减低患者的疗效和机制

The therapeutic efficacy of tianqi capsule in intervention of patients with impaired glucose tolerance

目的观察天芪降糖胶囊预防糖耐量减低(IGT)患者进展为2型糖尿病的疗效。方法以口服75g葡萄糖耐量试验(OGTT)确诊的IGT患者168例,其中男74例,女94例。随机分为对照组74例,天芪降糖胶囊治疗组94例,两组均进行相同的生活方式干预。对照组予以安慰剂胶囊口服,1次5粒,3次/d;治疗组采用天芪降糖胶囊1次5粒,3次/d;每3个月作1次OGTT及胰岛素释放试验,同时测身高、体重,观察1年。结果天芪降糖胶囊治疗组糖尿病转化率明显低于对照组(22.47%vs40.00%,P<0.05),而逆转为正常糖耐量比率明显高于对照组(50.56%vs24.29%,P<0.05);天芪组HOMA-IR较对照组显著降低(1.87±0.71vs2.20±0.71,P<0.05)。结论天芪降糖胶囊可能通过改善IGT人群胰岛素抵抗,延缓其向2型糖尿病转化。

Objective To evaluate the effects of tianqi capsule in preventing the conversion of impaired glucose tolerance （IGT） to type 2 diabetes in prediabetic patients. Methods Total 168 individuals with IGT were diagnosed by 75g OGTT （WHO 1999）, with their age of 25-70 years and BMI of 18. 8-30 kg/m^2. They were randomized into 2 groups： control group （n=74） and tianqi group （n= 94）. All patients received lifestyle interventions. The control group was treated with placebo capsule 5 pills 3 times a day, while tianqi group was allocated to take tianqi capsule 5 pills 3 times a day. BMI and 75g OGTT and insulin release test were determined once every 3 months for 1 year. The primary end-point was the development of type 2 diabetes diagnosed by 75g OGTI＇. Results At the end of the study, the IGT-to-DM conversion rate in tianqi group was significantly lower than in control group （22. 47% vs 40. 00%, P〈0. 05）, and the IGT-to-NGT conversion rate in Tianqi group was higher than in control group （50. 56% vs 24. 29%, P〈0. 05）. Compared with control group, HOMA-IR in Tianqi group remarkably decreased （1.87 ±0. 71 vs 2. 20 ±0. 71, P〈0. 05）. Conclusions Tianqi capsule has a beneficial effect on delaying the conversion of IGT to type 2 diabetes, possibly due to improving insulin sensitivity.