2型糖尿病胰岛素抵抗的中医辨证治疗临床观察

Insulin Resistance of Type 2 Diabetes Mellitus Diagnosis and Treatment of Traditional Chinese Medicine Clinical Observation

目的:为探讨胰岛素抵抗的中医病机特点和中药治疗效果,本研究选择2型糖尿病胰岛素抵抗病例进行了中医辨证施治的临床观察。方法:根据中医辨证原则对病例辨证分型,按证型对140例2型糖尿病患者采取分组治疗,随机选取20例患者为对照组,给予西药(二甲双胍)治疗,其余120例患者在西药基础上按证型分别加用相应中药汤剂,各组均8周为1个疗程,1个疗程后比较疗效。结果:全部病例主要辨为阴虚燥热型、湿热(痰浊)困脾型、气阴两虚型、瘀阻脉络型。两组患者治疗后各指标较治疗前均有显著变化,观察组指标变化程度均大于对照组,组内比较,阴虚燥热型和瘀阻脉络型疗效显著好于其他两型,P<0.05,差异有统计学意义。结论:2型糖尿病胰岛素抵抗的病机主要有阴虚燥热、湿热(痰浊)困脾、气阴两虚、瘀阻脉络等,中药治疗2型糖尿病胰岛素抵抗疗效肯定,临床应结合中医辨证施治。

Objective. to explore the pathogenesis of insulin resistance of traditional Chinese medicine and traditional Chinese medi cine treatment effect characteristics, this study choice insulin resistance of type 2 diabetes cases by differentiation of the traditional Chinese medicine clinical observation. Methods ： according to the principle of TCM syndrome differentiation of cases syndrome differ- entiations, press card type to 140 cases of type 2 diabetes patients take group therapy, 20 patients were randomly selected as control group, give western medicine （metformin） treatment, the rest of the 120 patients in the western medicine according to the card type respectively based on traditional Chinese medicine combined with corresponding treatmentresult, each byte is 8 weeks for a period of treatment, a course effect comparison. Results：all cases for the main cause Yin scorching type, hot and humid （phlegm turbidity） trapped spleen deficiency of both qi and Yin is the type, type, blood stasis resistance o~ context. Two groups of patients after treat- ment of each index is before treatment significantly change, the observation group index variations are larger than the control group, the group is within, Yin scorching type and stasis resistance vein type rernarkable curative effect is better than other two model. T= 2. 844, 2. 763, P^0.05 for significant difference. Conclusion ： insulin resistance of type 2 diabetes mellitus main pathogenesis is Yin scorching, hot and humid （phlegm turbidity） trapped spleen deficiency of both qi and Yin,, blood stasis resistance context, tradi- tional Chinese medicine treatment for type 2 diabetes have certain curative effect of insulin resistance, clinical should combine tradi- tional Chinese medicine by differentiation.