加味六君子汤对脾虚痰湿证2型糖尿病患者胰岛β细胞功能的影响

Effect of Modified Liujunzi Decoction on Syndrome of Spleen Deficiency and Phlegm Stagnation in Patients with Type 2 Diabetes Mellitus

目的探讨加味六君子汤联合西药改善脾虚痰湿证2型糖尿病患者胰岛β细胞功能的作用。方法将72例患者随机分为治疗组和对照组各36例,均进行饮食调整及适量运动。2组均给予盐酸二甲双胍缓释片,每次0.5 g(2周后每次1.0 g),每日2次,口服;阿卡波糖片,每次50 mg,每日3次,口服。治疗组在上述基础上加用加味六君子汤,每次200 m L,每日3次,口服。均3个月为1个疗程。观察2组治疗前后血糖、C肽、胰岛素(INS)、糖化血红蛋白(Hb A1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、服糖30 min胰岛素净增值/葡萄糖净增值(ΔI30/ΔG30)。结果与治疗前比较,2组治疗后空腹血糖(FBG)、服糖30 min血糖(30 min PBG)、2 h PBG、Hb A1c、空腹胰岛素(FINS)、空腹C肽、HOMA-IR均降低,治疗组30 min INS、30 min C肽、ΔI30/ΔG30升高,差异有统计学意义(P<0.05);治疗后2组FBG、30 min PBG、2 h PBG、Hb A1c、空腹C肽、FINS、30 min INS、30 min C肽、HOMA-IR、ΔI30/ΔG30比较,差异有统计学意义(P<0.05)。结论加味六君子汤联合西药改善脾虚痰湿证2型糖尿病患者胰岛β细胞功能的疗效优于单纯西药。

Objective To observe the effects of modified Liujunzi Decoction on improving isletβ-cell function ofpatients with the syndrome of spleen-deficiency and phlegm-stagnation of type2diabetes mellitus.Methods Totally72patients were selected and divided into treatment group and control group randomly,with36cases in each group.Both groups were under diet adjustment and appropriate exercise and were given metformin hydrochloricle tablets,0.5g each time(1.0g each time after2weeks),twice a day;acarbose,50mg each time,three times a day.Thetreatment group was given modified Liujunzi Decoction additionally,200mL each time,three times a day,orally.Thecourse of treatment of the two groups was three months.Blood glucose,C peptide,INS,HbA1c,HOMA-IR,HOMA-βandΔI30/ΔG30after30minutes of glucagon loading was recorded.Results Compared with beforetreatment,FBG,30min PBG,2h PBG,HbA1c,FINS,fasting C-peptide,and HOMA-IR decreased in both groups,and the30min INS,30min C peptide,andΔI30/ΔG30increased in the treatment group,with statistical significance(P<0.05).After treatment,there was statistical significance in FBG,30min PBG,2h PBG,HbA1c,fasting C-peptide,FINS,30min INS,30min C peptide,HOMA-IR,andΔI30/ΔG30between the two groups(P<0.05).Conclusion ModifiedLiujunzi Decoction combined with Western medicine can better improve isletβ-cell function of patients with thesyndrome of spleen-deficiency and phlegm-stagnation of type2diabetes mellitus than Western medicine merely.