糖脉康颗粒对2型糖尿病患者胰岛素敏感性的临床疗效观察

Clinical efficacy of Tangmaikang particles on insulin sensitivity in treatment of type 2 diabetes

目的评价糖脉康颗粒对2型糖尿病患者胰岛素敏感性的影响。方法将120例2型糖尿病患者随机分为对照组60例和试验组60例。对照组予以常规的降糖、降压、调脂等治疗;试验组在常规治疗基础上,加用糖脉康颗粒15 g·d-1口服,每天3次,2组疗程均为3个月。观察2组治疗前后餐后血糖、糖化血红蛋白、空腹胰岛素水平、胰岛素敏感性、低密度脂蛋白、三酰甘油、内皮素-1及临床症状的变化,以及不良反应发生率。结果试验组总有效率88.33%明显优于对照组75.00%(P<0.05)。治疗后,2组患者的空腹胰岛素水平、胰岛素敏感性、餐后血糖及糖化血红蛋白较治疗前均明显改善(P<0.05),且试验组治疗后的改善幅度明显优于对照组(P<0.05)。2组患者的临床症状均较治疗前明显改善(P<0.05),且试验组优于对照组(P<0.05)。治疗后,2组三酰甘油水平均无明显改善(P>0.05)。治疗后,试验组低密度脂蛋白以及内皮素-1水平较治疗前明显降低(P<0.05),对照组则不明显(P>0.05)。合并早期糖尿病肾病的治疗后,试验组内皮素-1较治疗前显著降低(P<0.05),对照组则不明显(P>0.05),组间比较差异有统计学意义(P<0.05)。2组在治疗期间均未发生不良反应。结论糖脉康在安全有效治疗2型糖尿病的同时能改善胰岛素敏感性,减轻胰岛素抵抗,降低内皮素-1水平,尤其是降低糖尿病肾病患者的内皮素-1水平。

Objective To observe the effect of Tangmaikang particles on insulin sensitivity in the treatment of type 2 diabetes.Methods A total of 120 patients with type 2 diabetes were selected, randomly divided into control group （ n=60） and treatment group （ n=60）.Patients in control group received routine hypoglycemic, hypotensive and lipid adjusting treatment, while patients in treatment group were given Tangmaikang par-ticles 15 g· d-1 on the basis of conventional treatment.The treatment lasted for 3 months.The data of postprandial plasma sugar （ PPG） , gly-cosylated hemoglobin （ HbA1 c ） , fasting insulin （ FINS ） , insulin sensi-tivity （ HOMA-IS ） , low density lipoprotein （ LDL -C ） , triglyceride （TG）, endothelin -1（ ET-1） and the change of clinical symptoms in two groups before and after treatment were observed as well as the inci-dence of adverse reactions in 2 groups.Results The total effective rate was 88.33% in treatment group, better than control group （75.00%） .After treatment, the data of FINS, HOMA -IS, PPG, HbA1c were all significantly improved in two groups（ P〈0.05 ） , and treatment group improved more obviously than control group （ P〈0.05 ） .Symptoms in two groups were both improved compared with before treatment（ P〈0.05） , and the treatment group was better than control group（ P〈0.05）.But the TG level wasn′t significantly decreased in two groups（ P〉0.05）.After treatment, LDL-C and ET-1 level in treatment group were significantly decreased （ P〈0.05 ） , and the control group was not obvious （P〉0.05）.After the treatment for early diabetic nephropathy, ET -1 in treatment group was significantly lower （P〈0.05）, and the control group was not obvious （P〉0.05）.There was no adverse reactions found during treat-ment.Conclusion Tangmaikang particles are safe and effective for type 2 diabetes, which also can improve insulin sensibility, reduce insulin resistance and ET-1 level, especially can reduce the ET-1 level of patients with diabetic nephropathy.