加味升降散对T2DM并血脂异常患者调脂作用临床研究

Clinical Study on the Lipid-reducing Effect of Jiaweishengjiang Powder on T2DM and Dyslipidemia Patients

目的:观察加味升降散对2型糖尿病(T2DM)并血脂异常患者调脂作用临床观察。方法:将90例T2DM合并血脂异常患者,随机分为3组,加味升降散治疗组、血脂平对照组和空白对照组,每组各30例。3组均治疗2个月,治疗前后观察临床表现、血脂、游离脂肪酸、胰岛素等水平。结果:(1)治疗组治疗后血脂各项指标治疗前后自身比较(P均<0.05),其中甘油三酯治疗前后相比有明显差异(P<0.01)。治疗组其中医证候的改善以及综合疗效有优于血脂平对照组之趋势。(2)治疗组治疗前后游离脂肪酸水平自身比较有明显差异(P<0.01)。(3)治疗组胰岛素水平自身比较有差异(P均<0.05)。经治疗后有7例患者其高胰岛素血症得到不同程度改善。(4)试验过程中,治疗组有2例患者在治疗初期出现轻度腹泻,考虑与大黄有关,其中1例减少大黄剂量,1例继续原方治疗,腹泻症状均消失。结论:(1)中医升清降浊、化痰利湿、活血化瘀法治疗T2DM合并血脂异常有效。(2)本研究发现加味升降散对游离脂肪酸可能有一定的调节作用。(3)本研究发现加味升降散对T2DM患者胰岛素抵抗、高胰岛素血症可能有一定改善作用。(4)本方对于T2DM患者的调脂治疗安全有效。

Objective: To observe the lipid-reducing effect of Jiaweishengjiang Powder on T2DM and dyslipidemia patients.Methods: 90 TZDM and dyslipidemia patients were randomly divided into three groups,i.e.Jiaweishengjiang Powder group,lipids level control group and blank control group,30 patients per group.The patients of the 3 groups were treated for 2 months,and their clinical manifestations,blood lipids,free fatty acids and insulin level were observed before and after the treatment.Results:(1) The lipid indicators of the treatment group showed a significant difference(P<0.05) in its self-comparison in which the triglyceride of the patients showed more significant difference(P<0.01) before and after the treatment.TCM syndrome improvement and the integrated efficacy of the treatment group were superior to that of the lipids level control group.(2) The self-comparison of free fatty acid levels of the treatment group was significant difference(P<0.01) before and after the treatment.(3) The self-comparison of the insulin levels of the treatment group was differences(P<0.05).The hyperinsulinemia of 7 patients improved after the treatment at varying degrees.(4) In the test procedure,2 patients of the treatment group had mild diarrhea early in the treatment,probably related to rhubarb.One patient was treated with reduced rhubarb dose and another kept the original treatment.Their diarrhea symptoms disappeared.Conclusions:(1) TCM turbid-expelling,phlegm-reducing and activating boold circulation treatment has an extraordinary effect on the treatment of T2DM and dyslipidemia patients.(2) The study discovers Jiaweishengjiang Powder has a certain regulatory effect on the free fatty acids.(3) The study discovers Jiaweishengjiang Powder has a certain improvement for the insulin resistance and hyperinsulinemia of T2DM patients.(4) The prescription is safe and effective for the lipid-lowering of T2DM patients.