并提汤加减治疗2型糖尿病临床疗效及对胰岛功能的影响

Clinical Efficacy of Modified Bingtitang in Treatment of Type 2 Diabetes Mellitus and Effect on Pancreas Islet Function

目的:探讨并提汤加减治疗2型糖尿病(T2DM)临床疗效及对患者胰岛功能的影响。方法:将108例T2DM患者按照随机数字表法分为对照组和治疗组,每组54例。对照组给予糖尿病饮食、适量运动、控制血糖等糖尿病常规治疗,治疗组在对照组治疗基础上应用并提汤加减口服。比较两组患者治疗前后血糖、胰岛功能相关指标、中医证候积分、血清视黄醇结合蛋白4(RBP4),Betatrohin水平,并比较治疗总有效率。结果:治疗后治疗组空腹血糖(FPG),糖化血红蛋白(Hb A1c),血糖变异系数(CV-FPG),胰岛素抵抗指数(HOMA-IR)低于对照组(P<0.01),胰岛素分泌指数(HOMA-IS),30 min胰岛素增值(I30)和血糖增值(G30)之比(ΔI30/ΔG30)高于对照组(P<0.01),各项中医证候积分低于对照组(P<0.01);血清RBP4水平低于对照组(P<0.01),Betatrohin水平高于对照组(P<0.01),治疗组总有效率高于对照组(P<0.05)。结论:在常规治疗基础上,应用并提汤加减可有效控制血糖,改善胰岛功能,缓解中医证候,治疗T2DM效果确切,其机制可能与调节血清RBP4,Betatrohin水平有关。

Objective:To investigate the clinical efficacy of modified Bingtitang in treatment of type 2 diabetes mellitus(T2 DM)and its effect on pancreas islet function.Method:A total of 108 patients with T2 DM were divided into two groups according to the digital number table method,with 54 cases in each group.The control group were given routine therapy of diabetic diet,proper exercise and blood sugar control,while the treatment group were orally given traditional Chinese medicine(TCM)and modified Bingtitang in addition to the therapy of the control group.The blood sugar,pancreas islet function-related indexes,TCM syndrome score,serum retinol binding protein 4(RBP4)and Betatrohin levels were compared between two groups before and after treatment.The total effective rate was also compared.Result:After treatment,the fasting blood glucose(FPG),glycated hemoglobin(HbA1 c),blood glucose variation coefficient(CV-FPG),insulin resistance index(HOMA-IR)of the treatment group were lower than those of control group(P<0.01),while the ratio of insulin secretion index(HOMA-IS),30-minute insulin increment(I30)and blood glucose proliferation(G30)to(ΔI30/ΔG30)of treatment group were higher than those of the control group(P<0.01).The TCM score and the serum RBP4 level were lower than those of control group(P<0.01),while Betatrohin level was higher than that of the control group(P<0.01),and the total effective rate was higher than that of control group(P<0.05).Conclusion:In addition to the routine treatment,modified Bingtitang can effectively control blood sugar,improve pancreas islet function,and alleviate TCM syndromes,with a significant effect on T2 DM.Its mechanism may be related to the regulation of serum RBP4 and Betatrohin levels.