自拟健脾理气祛瘀方改善糖耐量减低患者胰岛素抵抗的疗效观察

Efficacy of self-designed Jianpiliqiquyufang in improving insulin resistance in patients with impaired glucose tolerance

目的探讨自拟健脾理气祛瘀方改善糖耐量减低患者胰岛素抵抗的疗效。方法选择2014年1月至2016年1月期间梅州市中医医院内科诊治的150例糖耐量减低患者为研究对象,根据随机数表法随机分为观察组和对照组,每组75例,对照组予二甲双胍治疗,观察组联合应用自拟健脾理气祛瘀方治疗,疗程均为3个月。比较两组患者治疗前后的空腹血糖(FPG)、餐后2 h血糖(2 h PG)及胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMAIS)水平。结果治疗后,观察组和对照组患者的FPG、2 h PG、HOMA-IR分别为(5.68±0.48)mmol/L、(8.35±2.15)mmol/L、(2.46±0.62)和(6.05±0.62)mmol/L、(9.13±2.08)mmol/L、(2.91±0.57),均较治疗前的(6.51±0.26)mmol/L、(10.48±2.68)mmol/L、(3.81±0.97)和(6.62±0.31)mmol/L、(10.53±2.49)mmol/L、(3.78±0.79)显著降低,HOMA-IS为(21.98±1.98)和(18.64±8.64),均较治疗前的(15.39±5.39)和(16.38±6.38)显著提高,且观察组明显优于对照组,差异均有统计学意义(P<0.05)。结论自拟健脾理气祛瘀方治疗糖耐量降低可以改善胰岛素抵抗,提高胰岛素敏感性。

Objective To study the effect of self-designed Jianpiliqiquyufang in improving insulin resistance in patients with impaired glucose tolerance status. Methods From January 2014 to January 2016, 150 patients with impaired glucose tolerance treated in Department of Endocrinology of our hospital were selected as the research objects, according to the random number table method, which were divided into observation group（n=75） and control group（n=75）. The control group was treated with metformin treatment, and the observation group received self-designed Jianpiliqiquyufang plus metformin treatment. The course of treatment was 3 months. Fasting plasma glucose（FPG）, 2 h-postprandial plasma glucose（2 h PG） and insulin resistance index（HOMA-IR）, islet beta cell function index（HOMA-IS） levels were compared between the two groups. Results After treatment, the FPG, 2 h PG, HOMA-IR, HOMA-IS respectively were（5.68±0.48） mmol/L,（8.35±2.15） mmol/L,（2.46±0.62）,（21.98±1.98） in the observation group and（6.05±0.62） mmol/L,（9.13 ±2.08） mmol/L,（2.91±0.57）,（18.64±8.64） in the control group, compared with（6.51±0.26） mmol/L,（10.48±2.68） mmol/L,（3.81±0.97）,（15.39±5.39） in the observation group and（6.62±0.31） mmol/L,（10.53±2.49） mmol/L,（3.78±0.79）,（16.38±6.38） in the control group before treatment. The levels in the observation group were significantly better than those in the control group（P〈0.05）. Conclusion Self-designed Jianpiliqiquyufang can reduce insulin resistance, improve insulin sensitivity in impaired glucose tolerance.