2型糖尿病患者证型与血清超敏C-反应蛋白、白细胞介素-6水平及胰岛素分泌指数的相关性研究

Study on the relationship of the syndrome of patients with type 2 diabetes and hs-CRP, IL-6 and insulin se- cretion index

目的比较不同中医证型2型糖尿病患者血清超敏C-反应蛋白（hs—CRP）、白细胞介素石（IL-6）水平、胰岛素分泌指数（HOMA—β）、胰岛素抵抗指数（HOMA—IR）等指标的变化。方法收集初发2型糖尿病患者63例，按中医证型分为痰热互结、气阴两虚、阴阳两虚三组，另设20例健康体检者为对照组，测定各组研究对象血清hs—CRP、IL-6及空腹血糖、胰岛素水平。结果对照组hs—CRP、IL-6、胰岛素抵抗指数水平均低于糖尿病各中医证型组，差异有统计学意义（t=6．948，P〈0．05）。各证型组间胰岛素抵抗指数差异无统计学意义。对照组胰岛素分泌指数与痰热互结组比较差异无统计学意义（t=4．832，P〉0．05）。各中医证型组间IL-6差异有统计学意义（t=4．985，P〈0．05）。HOMA-B在各中医证型组间的差异有统计学意义（t=5．043，P〈0．05），从高到低依次为痰热互结组〉气阴两虚组〉阴阳两虚组。结论IL-6的变化与中医证型有关，中医证型变化的过程中伴随着胰岛功能的变化，IL-6、胰岛素分泌指数可作为中医辨证分型的参考依据。

Objective To compare the changes of hs-CRP,IL-6 level, insulin secretion index （HOMA-β）, insulin resistance index （HOMA-IR） in the different TCM Hou of type 2 diabetic patients. Methods 63 newly diag- nosed type 2 diabetic patients were selected. According to the TCM syndrome, they were divided into combination of phlegm and heat, deficiency of both qi and yin, yin and yang deficiency three groups. 20 healthy people were selected as control group. The serum hs-CRP, IL-6 and fasting blood glucose, insulin were measured. Results The levels of hs-CRP, IL-6 and insulin resistance index were lower than the other three groups, there were significant differences （t = 6. 948 ,P 〈0.05 ）. There was no significant difference in insulin secretion index between the control group and the combination of phlegm and heat gruop（t =4. 832 ,P 〉0.05）. There were significant differences in IL-6 level and HOMA-β among different syndromes groups（ t = 4. 985,5. 043, P 〈 0.05 ）. HOMA-β from high to low was the combi- nation of phlegm and heat group 〉 deficiency of both qi and yin group 〉 yin and yang deficiency group. Conclusion The change of IL-6 correlates with TCM syndromes, and the change of TCM syndrome with the change of islet func- tion. IL-6 and insulin secretion index can be used as reference of TCM type.