以血糖分层观察益糖康对并有糖调节受损的代谢综合征临床观察

Clinical Observation of Yitangkang's Curative Effect on Metabolic Syndrome Complicated with Impaired Glucose Regulation Grouped in the Perspective of Different Blood Glucose Levels

目的:(1)观察具有益气健脾、养阴清热功用的中药复方益糖康对并有糖调节受损(IGR)的代谢综合征(MS)患者各项指标的影响;(2)观察益糖康对不同血糖分层的并有IGR的MS患者的临床疗效。方法:试验选取2007年12月—2010年12月由辽宁中医药大学、辽宁省中医药研究院、山东中医药大学附属医院、北京中医药大学东直门医院、辽阳糖尿病专科医院五个中心收治的患者,共计完成试验165例,均为痰热互结型并有IGR的MS患者。根据治疗前的血糖情况将患者分为空腹血糖异常(IFG)组(7.0>空腹血糖(FPG)≥6.1 and餐后2h血糖(2hPG)<7.8),餐后血糖异常(IGT)组(FPG<6.1 and 11.1>2hPG≥7.8)和IFG+IGT(7.0>FPG≥6.1 and 11.1>2hPG≥7.8)3组。给予益糖康配合综合治疗12周,测量其FPG、2hPG、糖化血红蛋白(HBA1C)、血脂、血压、体重指数(BMI)。结果:从血糖角度分层,IFG组BMI;IGT组LDL-C、收缩压(SBP)、舒张压(DBP);IFG+IGT组FPG、2hPG、SBP、DBP的改善与安慰剂组相比,经t检验均具有显著性差异(P<0.05)。结论:(1)痰热互结型并有IGR的MS患者的血糖以IFG+IGT型为主。(2)益糖康治疗后对TC的影响主要以IFG+IGT患者为主;对BMI的影响主要以IFG患者为主。其还可以改善IFG+IGT患者的HDL-C和LDL-C;IGT组的LDL-C水平。

Objective ： 1. To observe the influences on indexes of the Metabolic Syndrome （MS） complicated with Impaired Glucose Regulation （IGR）patients of Chinese Medicine prescription Yitangkang, which can benefit qi and fortify the spleen, and nourish yin and clear heat. 2. To observe Yitangkang＇s curative effect on patients with MS complicated with IGR grouped by their blood glucose levels. Methods ：Select patients from December 2007 to December 2010 in the five centers, including Liaoning University of Traditional Chinese Medicine （TCM）, Medical Research Institute of Liaoning Province, Affiliated Hospital of Shandong University of TCM, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine and Liaoyang diabetes hospitals. Experiment 165 cases of patients with MS complicated IGR in phlegm - heat binding pattern. Group the patients into 3 groups including impaired fasting glucose （IFG） group （ 7.0 〉 FPG ≥ 6.1 and 2hPG 〈 7.8 ）, impaired glucose tolerance （IGT） group （ FPG 〈 6.1 and 11.1 〉 2hPG I〉7.8 ）, and IFG -IGT concurrence group （7.0 〉 FPG 〉16.1 and 11.1 〉 2hPG/〉7.8 ）. Treat them with Yitangkang and comprehensive treatments for 12 weeks and hence test their indexes including FPG, PG at 2 hours after meal, HBA1 C, blood lipoid, blood pressure, BMI, routine examinations of blood, urine, and feces, and liver and kidney functions. Results ： For BMI in IFG group;LDL- C,SBP and DBP in IGT group;and FPG,2hPG,SBP and DBP in IFG -IGT concurrence group,there were significant differences（P 〈 0. 05 ）according to t -test between the indexes of treatment group and placebo group if grouped by blood glucose levels. Conclusion ： 1. The blood lipid of MS complicated with IGR in phlegm - heat binding pattern mainly belongs to IFG - IGT concurrence pattern. 2. By taking Yitangkang, the patients can be well - improved with the effect on TC mainly oc- curring in IFG - IGT concurrence group and that on BMI mainly occurring in IFG group. Yitangkang can improve patients＇HDL - C and LDL - C levels in IFG - IGT group as well as LDL - C levels in IGT group.