黄芪联合二甲双胍对初诊2型糖尿病患者胰岛素抵抗及血浆胰淀素水平的影响

The effects of astragalus combined with metformin on insulin resistance and plasma amylin level in newly diagnosed type 2 diabetic patients

目的 观察黄芪联合二甲双胍对初诊2型糖尿病患者胰岛素抵抗及血浆胰淀素（Amylin）水平的影响.方法 纳入初诊2型糖尿病患者88例,按随机数字表法将患者分为A组（生活方式干预组）30例,B组（二甲双胍治疗组）30例,C组（黄芪联合二甲双胍治疗组）28例.A组给予控制饮食,增加运动,控制血压、血脂等治疗;B组在生活方式干预组基础上加用二甲双胍治疗;C组在B组基础上加用黄芪治疗,疗程均为8周,比较三组治疗前后空腹血糖（FPG）、糖化血红蛋白（HbA1c）、甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HIDL-C）、低密度腊蛋白胆固醇（LDL-C）、空腹血糖（FPG）;糖化血红蛋白（HbA1c）;空腹胰岛素（F-Ins）、胰岛素抵抗指数（Homa-IR）、β细胞功能指数（Homa-β）及Amylin水平.结果 三组经过治疗后,FPG均明显下降（t值分别为-2.696、-4.029、-3.995,P均＜0.05）,且B、C两组的降糖效果优于A组（t值分别为-2.245、-3.493,P均＜0.05）;C组F-Ins下降较A组明显（t=-2.305,P＜0.05）;B、C两组均能降低Homa-IR（t值分别为-2.599、-3.813,P＜0.05）,且C组降低的幅度要优于B组（t=-2.334,P＜0.05）;B、C两组均能提高Homa-β（t值分别为2.303、2.384,P均＜0.05）及Amylin水平（t值分别为2.341、3.045,P均＜0.05）.结论 黄芪联合二甲双胍可改善初诊2型糖尿病患者的胰岛素抵抗,并提高Homa-β水平.

Objective To understand the effect of astragalus on insulin resistance and plasma amylin levels in newly diagnosed type 2 diabetic patients.Methods 88 patients of newly diagnosed type 2 diabetes were randomly divided into three groups：Group A （lifestyle intervention group） contained 30 patients,Group B （metformin treatment group） also contained 30 Patients,and Group C （astragalus and metformin treatment group） contained 28 Patients.Patients in group A were intervened with the control of diet,blood pressure and lipids level; patients in group B were additionally treated with metformin on the basis of group A; patients in group C were additionally treated with metformin and astragalus on the basis of group A.The course for both treatments were 8 weeks.Various clinical and biochemical parameters were detected before and after the treatment in all three groups and enzyme-linked immunosorbent assay was adopted for the detection of plasma amylin.Results Fasting blood glucose levels were significantly decreased after treataent in the three groups （t=-2.696、-4.029、-3.995,P＜0.05） ; insulin resistance index reduced in group B and group C （t=-2.599、-3.813,P＜0.05）,the difference between group C and group B was statistically significant （t=-2.334,P＜0.05） ;treatments of group B and group C could improve the beta cell function index （t=2.303、2.384,P＜0.05）,and they also could increase the plasma amylin level （t=2.341、3.045,P＜0.05）.Conclusion Astragalus and metformin can improve insulin resistance index and increase plasma amylin levels in newly diagnosed type 2 diabetic patients.