肥胖T2DM肝胃郁热证患者胰岛素分泌特点研究

Study on Insulin Secretion's Characteristic of Stagnation of Liver Qi and Stomach Heat of Obesity Type 2 Diabetes

目的:研究肥胖T2DM的主要证型肝胃郁热证患者的胰岛素分泌特点,为探讨肝胃郁热证的科学内涵做一粗浅尝试。方法:通过胰岛素耐量实验,将肥胖T2DM肝胃郁热患者与正常组和肥胖组比较,检测0点、30min1、20min免疫反应性胰岛素(IRI)、真胰岛素(TI)和胰岛素原(PI)。结果:同对照组相比,肥胖2型糖尿病肝胃郁热证患者胰岛素分泌低钝,延迟,早时相分泌远低于正常者;Homa-β细胞功能指数、胰岛素抵抗指数存在显著差异。结论:肥胖2型糖尿病肝胃郁热证患者胰岛素分泌的数量、质量及胰岛素分泌的时相性都存在明显的病理改变,证实胰岛β细胞功能减退及胰岛素抵抗双重因素导致该患者群血糖居高不下。同时本研究提示采用真胰岛素评估β细胞功能结果更真实。

Objective：Study on the insulin secretion＇s characteristic of stagnation of liver Qi and stomach heat of obesity type 2 diabetes was made to reveal pathological mechanism of TCM syndrome.Methods：We selected the patients of obese T2DM as subjects,observe the features of insulin-secretion through insulin tolerable test by contrast with normal person and obese person,observe the change of IRI、TI、PI in zero point、 30 minute point、 120 minute point.Results：The patients of stagnation of liver Qi and stomach heat of obesity type 2 diabetes＇s insulin-secretion is low and delayed and especially in early-phase of insulin secretion,fasting PI of subjects is double than normal contrast group＇s,and subjects＇ insulin secretion index and insulin sensitivity index are poor.Conclusion：Distinctive difference exists in the quality and quantity of insulin-secretion between the patients of stagnation of liver Qi and stomach heat of obesity type 2 diabetes and normal contrast group,it is the true reason that insulin resistance（IR）and impaired β-cell function makes subjects blood sugar very high,and it＇s feasible to evaluate β-cell function by true insulin.