参芪降糖胶囊对2型糖尿病合并血脂异常患者糖、脂代谢的影响

Study on Effect of Shenqi Jiangtang Capsule on Sugar and Lipid Metabolism of Patients with Type 2 Diabetes Combined with Dyslipidemia

目的:探讨参芪降糖胶囊对2型糖尿病合并血脂异常患者糖、脂代谢的调节作用和对血清肿瘤坏死因子-α(TNF-α),脂联素(APN),瘦素(LP),超敏C-反应蛋白(hs-CRP)的影响。方法:106例患者随机按数字表法分为观察组54例和对照组52例。两组均采用盐酸二甲双胍片和阿卡波糖片控制血糖,对照组采用阿托伐他汀片,20 mg·d-1,睡前服用;观察组服用参芪降糖胶囊,3粒/次,3次/d。两组疗程均为12周。检测治疗前后空腹血糖(FBG),餐后2 h血糖(PBG),糖化血红蛋白(Hb Alc),并计算胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),载脂蛋白A(Apo A),载脂蛋白B(Apo B),TNF-α,APN,LP,hs-CRP水平;并进行安全性评价。结果:经Ridit分析,观察组血脂疗效与对照组相比较,差异无统计学意义;治疗后观察组Hb A1c,HOMA-IR低于对照组,ISI高于对照组(P<0.05);治疗后两组TC,TG,LDL-C和Apo B水平较治疗前下降,HDL-C和Apo A上升(P<0.01),治疗后观察组LDL-C水平高于对照组(P<0.05),其他指标组间比较差异均无统计学意义;治疗后观察组TNF-α,LP,hs-CRP水平低于对照组,APN水平高于对照组(P<0.05)。结论:参芪降糖胶囊对糖尿病合并脂代谢异常患者的糖、脂代谢均有一定的调节作用,还能改善HOMA-IR,调节炎症因子,且副作用少。

Objective： To discuss the effect of Shenqi Jiangtang capsule in regulating sugar and lipid metabolism of patients with type 2 diabetes combined with dyslipidemia and on the levels of serum tumor necrosis factor-α（ TNF-α）,adiponectin（ APN）,leptin（ LP）,hypersensitive c-reactive protein（ hs-CRP）. Method：Totally 106 patients were randomly divided into the observation group（ 54 cases） and the control group（ 52cases）. Both groups were given Metformin Hydrochloride tablets and Acarbose Tablets to control blood sugar. The control group took Atorvastatin tablets（ 20 mg·d-1,taking before sleeping）. The observation group took Shenqi Jiangtang capsule（ 3 pieces / time,tid）. Both groups were treated for 12 weeks. Before and after the treatment,the levels of fasting blood glucose（ FBG）,2 hours postprandial blood glucose（ PBG） and glycosylated hemoglobin（ Hb Alc） were detected. The insulin resistance index（ HOMA-IR） and insulin sensitivity index（ ISI）,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterol（ LDL-C）,high density lipoprotein cholesterol（ HDL-C）,apolipoprotein A（ Apo A）,apolipoprotein B（ Apo B）,TNF-α,APN,LP,hs-CRP were calculated. A safety evaluation was conducted. Result： According to the Ridit analysis,there was no significantly statistical difference in the blood lipid efficacy between the observation group and the treatment group. After the treatment,the levels of Hb A1 c,HOMA-IR in the observation group were lower than that in the control group,with higher ISI than that in the control group（ P 〈 0. 05）. The levels of TC,TG,LDL-C and Apo B in both groups declined but HDL-C and Apo A levels increased compared with that before the treatment（ P 〈 0. 01）. The LDL-C level in the observation group was higher than that in the control group（ P 〈 0. 05）,with no statistical difference in other indexes in the inter-group comparison. And the observation group showed lower TNF-α,LP,hs-CRP levels but higher APN than that in the control group（ P 〈 0. 05）. Conclusion： Shenqi Jiangtang capsule has a certain effect in regulating sugar and lipid metabolism and inflammatory factors of patients with diabetes combined with dyslipidemia and improving HOMA-IR,with few side effects.