消抗丸联合胰岛素对LADA患者胰岛B细胞功能的影响

Effects of Xiaokang Pills Combined with Insulin on the Function of Pancreatic Islet B Cells in Patients with Latent Autoimmune Diabetes Mellitus

目的:观察消抗丸联合胰岛素对成人隐匿性自身免疫性糖尿病(LADA)患者胰岛B细胞功能的影响。方法:将64例LA-DA患者采用随机数字表法均分为胰岛素组(对照组)和消抗丸联合胰岛素组(治疗组)。对照组患者仅皮下注射胰岛素治疗,治疗组患者在胰岛素皮下注射的基础上加服消抗丸水煎剂。分别在入组前和入组3个月后检测两组患者的空腹血糖、糖化血红蛋白(HbAlc)、空腹血胰岛素(FINS)、75g葡萄糖负荷后即刻及2h血糖和C肽,比较其胰岛B细胞功能指标(ΔCP2h/ΔBS2h)及胰岛素抵抗指数(HOMA-IR)。结果:与治疗前比较,两组患者各项指标均有显著改善。两组患者治疗后HbAlc比较,差异无统计学意义(P>0.05);治疗组患者ΔCP2h/ΔBS2h、FINS、HOMA-IR均较对照组患者改善更为显著(P<0.01)。两组患者治疗中均未见明显不良反应发生。结论:消抗丸联合胰岛素具有改善LADA患者胰岛B细胞功能和减少胰岛素抵抗的作用。

OBJECTIVE： To investigate the effects of Xiaokang pills combined with insulin on the function of pancreatic islet B cells in patients with latent autoimmune diabetes mellitus in adults （LADA）. METHODS： 64 LADA patients were randomly as- signed into insulin group and Xiaokang pills combined with insulin group. Insulin group were treated with hypodermic injection of insulin alone, and Xiaokang pills combined with insulin group received water decoction of Xiaokang pills orally on the basis of in- sulin group. Before admission and 3 months later, fasting blood glucose, glycated hemoglobin （HbA^c） , fasting blood insulin （FINS）, plasma glucose and C peptide at fasting and 2 hours after taking 75 g glucose were detected in 2 groups, and index of pancreatic islet B cell function （ACP2 JABS2 h）, FINS and insulin resistance index （HOMA-IR） were compared between 2 groups. RESULTS： Compared with before treatment, all the above-mentioned indexes were improved after treatment in both groups. There was no statistical significance in HbAlc between 2 groups after treatment （P〉0.05） ; ACP2 h/ABS2 h of treatment group was im- proved significantly, compared with control group （P〈0.01） ; FINS and HOMA-IR were dropped significantly in treatment group （P〈0.01）. There was no ADR in the treatment in 2 groups. CONCLUSION： Xiaokang pills combined with insulin could improve the function of islet β-cell and reduce insulin resistance in LADA patients.