针刺对2型糖尿病患者胰岛素抵抗及脂肪细胞因子水平的影响

Effect of Acupuncture on Insulin Resistance and Adipocytokines in Patients with Type 2 Diabetes Mellitus

目的探讨针刺对2型糖尿病患者血糖控制、胰岛素抵抗及脂肪细胞因子水平的影响。方法采用单纯随机数字表法将202例肥胖2型糖尿病患者分为干预组102例与对照组100例。测量身高、体质量计算体质指数(BMI),抽血查空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、瘦素、脂联素、胰岛素抵抗指数(HOMA-IR)水平。两组患者均进行常规治疗,干预组进行3个疗程的针刺治疗。随访1年后复查上述指标,对比两组间各项指标变化。结果干预前两组间各项指标间差异无统计学意义(P>0.05)。干预组经过针刺干预并随访1年后与对照组比较,FPG〔(6.6±1.9)mmol/L比(7.3±2.6)mmol/L〕、2 hPG〔(8.7±2.0)mmol/L比(11.0±2.8)mmol/L〕、HbA1c〔(6.7±2.1)%比(7.2±2.1)%〕、BMI〔(25.9±2.7)kg/m2比(27.1±3.3)kg/m2〕、HOMA-IR〔(0.8±0.3)比(0.9±0.4)〕及瘦素水平〔(7.9±2.6)ng/ml比(9.8±2.4)ng/ml〕均低于对照组,差异有统计学意义(P<0.05);脂联素水平高于对照组〔(6.4±3.7)%比(4.5±3.1)%〕,差异有统计学意义(P<0.05)。结论针刺可调节肥胖2型糖尿病患者瘦素、脂联素水平,改善胰岛素抵抗。

Objective To investigate the impact of acupuncture on the levels of blood glucose control, insulin resist- anee and adipocytokines in patients with type 2 diabetes mellitus. Methods Totally 202 fat diabetic patients were according to the random number table divided as trim group （ n = 102） and control group （ n = 100） . The levels of the body height, body mass index （BMI） , fasting plasma glucose （FPG）, 2 -hour plasma glucose （2 hPG）, glycosylated hemoglobin （HbAI~）, leptin, adiponectin, and HOblA insulin resistance index （HOMA -IR） were determined. The patients in the two groups were given rou- tine treatment, but those in the trial group were given additional acupuncture for 3 course. All the indexes were rechecked after a year＇s follow up, and the changes in the two groups were compared. Results No statistically significant difference between the two groups was found for all the indexes （ P 〉 0. 05 ） . However, after the intervention, the values in the two groups of FPG [ （6.6±1.9）mmol/Lvs. （7.3±2.6） mmol/L], 2 hPG [ （8.7±2.0） mmol/L vs. （11.0±2.8） mmol/L], HbAIo [（6.7±2.1）% vs. （7.2±2.1）%3, BMI [（25.9±2.7） kg/m：vs. （27.1±3.3） kg/m2], HOMA-IR [（0.8±0.3） vs. （0. 9±0.4） ）, and leptin [ （7.9±2. 6） ng/ml vs. （9. 8 ＋2.4） ng/ml ] revealed statistically significant lower in the tri- al group than in the control group （P 〈0. 05）, but the values of adiponectin [ （6. 4±3.7）% vs. （4. 5±3.1）% ] showed sig- nificant higher in the trial group than in the control group （ P 〈 0.05 ）. Conclusion Acupuncture could regulate the levels of leptin and adiponectin, and improve insulin resistance.