α-硫辛酸联合疏血通对2型糖尿病患者胰岛功能的影响

The effect of alpha lipoic acid and Shuxuetong on islet function in patient with type 2 diabetes mellitus

目的观察α-硫辛酸联合疏血通对2型糖尿病(T2DM)患者氧化应激水平及胰岛素抵抗的影响。方法收集该院内分泌科2012年2月至2014年2月治疗的T2DM患者90例,分为疏血通治疗组(A组)、α-硫辛酸治疗组(B组)和α-硫辛酸联合疏血通治疗组(C组),每组30例。计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、胰岛素敏感指数(HOMAISI)。黄嘌呤氧化酶法测定超氧化物歧化酶(SOD),硫代巴比妥酸法测定丙二醛(MDA),IL-6和TNF-α表达使用ELISA法检测。结果治疗前A、B、C 3组SOD、MDA、IL-6、TNF-α、HOMA-IR、HOMA-ISI和HOMA-β差异无统计学意义(P>0.05)。治疗后各组上述指标与治疗前比较差异均有统计学意义(P<0.05或P<0.01)。其中SOD、HOMA-ISI和HOMA-β在C组显著高于B组(P<0.05),B组又显著高于A组(P<0.05);MDA和HOMA-IR在C组显著低于B组(P<0.05);B组又显著低于A组(P<0.05)。IL-6和TNF-α在C组显著低于A组和B组(P<0.01),A组与B组间差异无统计学意义(P>0.05)。结论α-硫辛酸联合疏血通可以显著改善T2DM患者氧化应激状态,抑制炎性反应,改善胰岛素抵抗,提高患者对胰岛素的敏感性,有利于T2DM的临床治疗。

Objective To explore the effect of alpha lipoic acid and Shuxuetong on oxidative stress and insulin resistance in patient with type 2 diabetes mellitus（T2DM） and to guide the clinical therapy for T2DM. Methods Totally 90 cases of T2DM pa tients were sellected from Hainan Province Nongken Hospital. The patients were divided into Shuxuetong group（group A,n= 30）, alpha lipoic acid group（group B, n = 30） and alpha lipoic acid and Shuxuetong group （group C, n = 30）. HOMA-IR, HOMA-A3, and HOMA-ISI was calculated. SOD was determined by xanthine oxidase method. MDA was detected by Thiobarbituric acid method. The expression of IL-6 and TNF-α was determined by ELISA analysis. Results Before treatment, SOD, MDA, IL-6, TNF-α, HOMA-IR, HOMA-ISI,and HOMA-β was no significant difference among the three groups（P〈0.05）. After treatment, all of which was significantly changed（P〈0.05 and P〈0.01）. SOD, HOMA-ISI and HOMA-13 in group C was significantly higher than that in group B（P〈0.05） ,and which was significantly higher in group B than that in group A （P〈0.05）. MDA and HOMA-IR in group C was significantly lower than that in group B（P〈0. 05） ,and which was significantly lower in group B than that in group A （P〈 0.05）. IL-6 and TNF-α in group C was lower than that in group A and group B（P〈0.01） ,and which was no significant difference between group A and group B（P〉0.05）. Conclusion Alpha lipoic acid combined with Shuxuetong injection can significantly improve the oxidative stress state of T2DM patients,inhibit the inflammatory reaction,improve insulin resistance and patientrs sensitivity to insulin. Which＇was contribute to clinical treatment for T2DM.