盐酸小檗碱对T2DM合并高脂血症患者血清NO水平及SOD活性的影响

Effects of berberine on T2DM and high lipid serum NO level in patients with hyperlipidemia and the activity of SOD

目的:探讨2型糖尿病(T2DM)合并高脂血症患者氧化应激水平的变化及盐酸小檗碱对患者血清一氧化氮(NO)水平和超氧化物歧化酶(SOD)活性的影响。方法:采用前瞻性随机病例对照研究,选择80例T2DM合并高脂血症的患者分为常规治疗组(A组,n=40)及小檗碱治疗组(B组,n=40),同时选择体检健康的20例(C组,n=20)作为对照组。A组给予口服降糖药控制血糖、钙离子拮抗剂控制血压等治疗;B组在常规治疗组的给药基础上联用盐酸小檗碱片(0.2mg,3次/d),口服,治疗时间为3个月。检测治疗前后的血清中一氧化氮(NO)、超氧化物歧化酶(SOD)、超敏C反应蛋白(hs-CRP)、内皮素(ET-1)、丙二醛(MDA)、血清总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、餐后2h血糖(2h PBG)及相关生化指标。结果:与C组比较,两组T2DM合并高脂血症患者的血清炎症因子、血脂水平升高,NO及SOD水平降低(P<0.01)。随访治疗3个月后,A组血清2h PBG、TC、TG、hs-CRP、MDA、ET-1水平比治疗前均有明显降低,NO、SOD水平比治疗前明显升高(P<0.05);与同期A组比较,B组变化幅度更为显著,差异有统计学意义(P<0.01)。结论:盐酸小檗碱显著改善了T2DM合并高脂血症患者的糖、脂代谢异常和胰岛素抵抗,降低了患者的氧化应激水平,提高了血清NO水平及SOD活性,增加了NO合成,减少了NO破坏。可见盐酸小檗碱具有较好的抗炎、抗氧化应激反应及改善血管内皮功能的作用。

Objective：to investigate the effects of type 2 diabetes mellitus （T2DM） and berberine hydrochloride in patients with changes and oxidative stress level in hyperlipidemia on serum Nitric oxide （NO） level and Superoxide dismutase （SOD） activity.Methods：A prospective randomized controlled study cases, 80 cases of T2DM were divided into conventional treatment group（group A, n=40） and berberine treated group （group B, n=40） and 20 cases of normal people as control group （group C, n=20）. A group were given oral hypoglycemic drugs to control blood sugar, calcium antagonists, control of blood pressure; B group in the conventional treatment group on the basis of administration by Berberine Hydrochloride Tablets（0.2, 3/d）, oral, treatment time is 3 months.Comparing the group of serum nitric oxide and treated in（NO）, superoxide dismutase（SOD）, high sensitive C reactive protein（hs-CRP）, endothelin（ET-1）, malondialdehyde（MDA）, serum total cholesterol（TC）, triglyceride（TG）, fasting blood glucose（FPG）, 2h blood glucose after the meal （2 h PBG） and the changes of the related biochemical indexes. Results compared with C group, T2DM and hyperlipidemia in patients with elevated serum inflammatory factors, serum lipid levels, NO and SOD levels decreased （P〈0.01）; follow-up treatment serum 3 months after 2 h PBG, TC, TG, hs-CRP, MDA and ET-1 levels were significantly lower than that before treatment, NO, SOD levels than before treatment in Ming Dynasty Xian Shenggao （P〈0.05）. Compared with A group, B group, the amplitude of variation is more significant, the difference was statistically significant （P〈0.01）. Conclusion：berberine hydrochloride significantly improves T2DM and hyperlipidemia in patients with glucose and lipid metabolism and insulin resistance, lower the level of oxidative stress in patients with increased serum NO levels and SOD activity, increased NO synthesis, reduce NO damage. Visible, berberine hydrochloride has good anti inflammation and oxidative stress reaction and improve endothelial function.