艾塞那肽联合小檗碱对初发2型糖尿病患者早期胰岛素分泌的影响

Effects of Exenatide combinated with Berberine therapy on early phase insulin secretion in the patients with new onset type 2 diabetes mellitus

目的探讨艾塞那肽联合小檗碱对初发2型糖尿病患者早期胰岛素分泌的影响,以及对胰岛β细胞功能的保护机制。方法将48例初发2型糖尿病患者随机分为治疗组和对照组各24例。治疗组予以艾塞那肽联合小檗碱治疗,对照组仅予以格列苯脲治疗,疗程均为12周。于治疗前、后分别行75g口服葡萄糖耐量试验(OGTT),测定空腹、服糖后30min、服糖后120min血糖(FPG、P30PG、P120PG)和血胰岛素(FISN、P30ISN、P120ISN)以及三酰甘油(TG)、C反应蛋白(CRP)水平,并计算胰岛素敏感指数(ISI)。结果治疗组治疗后P30INS水平高于治疗前,其他观察指标低于治疗前;对照组治疗后P30INS水平高于治疗前,FPG、P30PG、P120PG水平低于治疗前,差异均有统计学意义(P<0.01)。治疗组治疗后P120PG、FINS、P120INS、TG、CRP、ISI水平低于对照组,P30INS水平高于对照组,差异均有统计学意义(P<0.05和P<0.01)。结论艾塞那肽联合小檗碱治疗初发2型糖尿病,在明显降低血糖的同时,能提高早期胰岛素分泌,保护和恢复胰岛β细胞功能,疗效更确切。

Objective To explorer the effects of exenatide combinated with berberine therapy on early phase insulin secretion in the patients with new onset type 2 diabetes mellitus（T2DM）,as well as protection mechanism on pancreatic islet beta cell function.Methods 48 cases with new onset T2DM were divided randomly into therapy group and control group（n=24）,the therapy group was given Exenatide combinated with Berberine therapy,and the control group was given Glibenclamide therapy for 12 weeks.75g oral glucose tolerance test（OGTT） was conducted in the each group,the change of fasting plasma glucose（FPG）,fasting plasma insulin（FINS）,30 and 120 min plasma glucose and insulin levels after oral glucose intake.Triglyceride（TG） and C-reactive protein（CRP） levels before and after treatment were also determined.And insulin sensitivity index（ISI） was calculated.Results After treatment P30INS in the therapy group was higher than those before treatment,the other observed indexes were lower than that before treatment;P30INS in control group was higher than those before treatment,FFPG、P30PG、P120PG were lower than that before treatment,and the differences were statistically significant（P 0.01）.After treatment P120PG、FINS、P120INS、TG、CRP、ISI in the therapy group were lower than those in the control group,P30INS was higher than that in the control group,and the differences were statistically significant（P0.05 and P0.01）.Conclusion Exenatide combinated with Berberine therapy not only can significantly decrease plasma glucose,but also can significantly increase early phase insulin secretion and improve islet β-cell function in the patients with new onset T2DM.