黄连素对2型糖尿病湿热困脾证患者胰高血糖素样肽的影响

Effects of berberine on glucagon-like peptide in patients with type 2 diabetes mellitus(syndrome of dampness-heat disturbing spleen)

目的:探讨黄连素对2型糖尿病湿热困脾证患者的血糖、胰岛素抵抗及胰高血糖素样肽-1(glucagon-like-peptide-1,GLP-1)的影响。方法:纳入2型糖尿病湿热困脾证患者60例,随机分为对照组和黄连素组,每组各30例。两组患者均给予西医常规治疗,黄连素组患者在西医常规治疗的基础上加用黄连素口服,两组疗程均为12周。评价两组患者的临床疗效,检测两组患者的空腹血糖(FBG)、糖化血红蛋白(HbAlc)、胰岛素(FINS)及GLP-1水平,计算胰岛素抵抗指数(HOMA-IR)。结果:治疗后,黄连素组、对照组的临床总有效率分别为92.86%、72.41%,黄连素组疗效优于对照组(P<0.01)。治疗后,两组患者的FBG、HbAlc、FINS、HOMAIR水平较治疗前均明显降低(P<0.05),GLP-1水平较治疗前明显升高(P<0.05);且黄连素组患者的FBG、HbAlc、FINS、HOMA-IR水平低于对照组(P<0.05),GLP-1水平高于对照组(P<0.05)。结论:黄连素结合西医常规疗法治疗2型糖尿病湿热困脾证患者,可改善患者的临床症状,并能通过升高GLP-1水平控制血糖,改善胰岛素抵抗。

Objective: To explore the effects of berberine on blood glucose,insulin resistance and glucagon-like peptide-1( GLP-1)in patients with type 2 diabetes mellitus( syndrome of dampness-heat disturbing spleen). Methods: Sixty patients of type 2 diabetes mellitus with syndrome of dampness-heat disturbing spleen were selected and randomly divided into the control group and the berberine group,30 cases in each group. All patients were treated with routine western medicine,and the patients in the berberine group were orally treated with berberine on the basis of routine western medicine,with a course of 12 weeks. The clinical efficacy was evaluated,the levels of fasting blood glucose( FBG),glycated hemoglobin( HbAlc),fasting insulin( FINS) and GLP-1 were detected,and the insulin resistance index( HOMA-IR) was calculated. Results: After treatment,the total clinical effective rates of the berberine group and the control group were 92.86% and 72.41% respectively,and the efficacy of the berberine group was better than that of the control group( P<0.01). After treatment,the levels of FBG,HbAlc,FINS and HOMA-IR in both groups were significantly decreased compared with treatment before( P<0.05),the level of GLP-1 was significantly increased( P<0.05); and the levels of FBG,HbAlc,FINS and HOMA-IR in the berberine group were lower than those in the control group( P<0.05),and the level of GLP-1 in the berberine group was higher than that in the control group( P<0.05). Conclusion: Berberine combined with routine western medicine can improve the clinical symptoms of patients of type 2 diabetes mellitus with syndrome of dampness-heat disturbing spleen,and control the level of blood glucose and improve insulin resistance by raising the level of GLP-1.