绞股蓝对糖尿病伴高脂血症患者的心肌保护作用及其机制

Protective effect of gynostemma on myocardium in diabetes associated with hyperlipemia and its mechanism

目的探讨绞股蓝对糖尿病伴高脂血症患者的心肌保护作用及其机制。方法选取浙江省宁海中医院内分泌科收治的2型糖尿病伴高脂血症患者178例,按随机数字表法分组,对照组89例予以糖尿病基础治疗+阿托伐他汀,研究组89例在对照组基础上予以绞股蓝治疗,检测比较2组间心肌损伤指标、血糖水平、血脂水平、血清细胞因子水平及血清氧化应激反应指标。结果与对照组比较,研究组治疗后血清天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)水平较低,治疗后空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2h postprandial blood glucose,2h PG)、糖化血红蛋白(Hb A1c)水平较低,治疗后血清总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白(low-density lipoprotein cholesterol,LDL-C)水平较低,高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平较高,治疗后血清血清脂联素(adiponectin,ADPN)水平较高,肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-18(interleukin-18,IL-18)水平较低,治疗后血清丙二醛(malondialdehyde,MDA)、活性氧(reactive oxygen species,ROS)水平较低,谷胱甘肽过氧化物酶(glutathione Peroxidase,GSH-Px)、超氧化物歧化酶(superoxide dismutase,SOD)水平较高,具有统计学意义(P<0.05)。结论绞股蓝能够明显减轻糖尿病伴高脂血症患者的心肌损伤,起到心肌保护作用,其作用机制可能为降低血糖、血脂水平,抑制炎症细胞因子参与的炎症反应,提高机体抗氧化能力,减轻氧化应激损伤。

Objective To investigate the protective effect of gynostemma on myocardium and its mechanism in patients with diabetes associated with hyperlipemia. Methods 178 patients with type 2 diabetes mellitus with hyperlipidemia from the department of endocrinology in our hospital were selected and divided into two groups,89 cases in the control group treated with basic treatment of diabetes ＋ atorvastatin,89 cases in the experiment group received gynostemma on the basis of the control group,myocardial injury index,blood glucose level,blood lipid level,serum cytokine levels and serum oxidative stress response indexes were detected and compared after the treatment. Results Compared with the control group,serum levels of aspartate aminotransferase（ AST）,creatine kinase（ CK）,CK-MB,lactate dehydrogenase（ LDH） were lower in the experiment group after treatment,fasting plasma glucose（ FPG）,2h postprandial blood glucose（ 2h PG）,Hb A1 c level were lower after treatment,serum levels of total cholesterol（ TC）,triglycerides（ TG）,low-density lipoprotein cholesterol（ LDL-C） were lower,high-density lipoprotein cholesterol（ HDL-C） level was higher after treatment,serum level of adiponectin（ ADPN） was higher,tumor necrosis factor-alpha（ TNF-α）,interleukin-6（ IL-6）,interleukin-18（ IL-18） levels were lower after treatment,serum levels of malondialdehyde（ MDA）,reactive oxygen species（ ROS） were lower,glutathione peroxidase（ GSH-Px）,superoxide dismutase（ SOD） levels were higher after treatment,with significant difference（ P〈0. 05）. Conclusion Gynostemma can significantly reduce the cardiac muscle damage of patients with diabetes associated with hyperlipemia,plays a role in myocardial protection,the mechanism may be to reduce blood glucose and blood lipid levels,inhibit the inflammatory reaction caused by inflammatory cytokines,improve the antioxidant capacity of the body and reduce oxidative stress damage.