益气养阴活血汤对2型糖尿病患者胰岛β细胞功能、血脂和血液流变学的影响

Effects of Qi-invigorating Yin-nourishing Blood-activating Decoction on Hemorheology,Blood Lipids and IsletβCell Function in Type Two Diabetes Mellitus Patients

目的:观察益气养阴活血法对2型糖尿病患者胰岛β细胞功能、血脂和血液流变学的影响。方法:将100例2型糖尿病患者,随机分为观察组和对照组,每组50例。对照组给予西医基础治疗,观察组在对照组基础上给予益气养阴活血法治疗,4周为1疗程,连服3个疗程。观察两组临床疗效、中医证候积分、血糖指标、胰岛β细胞功能指标、血脂指标及血液流变学指标的变化。结果:观察组中医证候治疗有效率、临床治疗有效率显著高于对照组(P<0.05);两组治疗后中医症状积分、空腹血糖、餐后两小时血糖、糖化血红蛋白水平显著降低,观察组治疗后以上指标均低于对照组(P<0.05);两组治疗后胰岛素抵抗指数和β细胞功能指数水平显著降低(P<0.05),观察组治疗后以上指标均低于对照组(P<0.05)。两组治疗后血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯水平显著改善,观察组治疗后以上指标改善情况显著优于对照组(P<0.05);两组治疗后血液流变学指标全血黏度、血浆黏度、红细胞聚集指数、纤维蛋白原水平均显著降低,观察组低于对照组(P<0.05)。结论:益气养阴活血汤可显著改善患者血糖紊乱状态,提高胰岛β细胞功能,降低血脂水平、血液黏稠度,改善血液流变学指标。

Objective:To observe the method of Qi-invigorating Yin-nourishing blood-activating on hemorheology,blood lipids and isletβcell function in type two diabetes mellitus(T2DM)patients.Methods:All 100 patients were randomized into the observation group(50 cases)and the control group(50 cases),the control group accepted basic therapy of Western medicine,and the observation group were treated by the method of Qiinvigorating Yin-nourishing blood-activating on the foundation of basic therapy of Western medicine,four weeks were one course,for three courses.To record clinical effects of both groups;to investigate the changes of TCM syndrome integrals,blood glucose indexes,the indicators of isletβcell function,the indexes of blood lipid and hemorheological indexes before and after treating.Results:The observation group was higher than the control group in therapeutic effective rate of TCM syndrome and clinical therapeutic effective rate notably(P<0.05);after treating,TCM syndrome integrals,the levels of FPG,2hPG and HbA1c lowered notably in both groups,the above indexes of the observation group were lower than these of the control group(P<0.05);the levels of HOMA-IR and HOMA-βin both groups lowered notably after treating(P<0.05),the observation group was lower than the control group in the above indexes after treating(P<0.05).After treating,the levels of TC,HDL-C,LDL-C and TG of both groups improved notably,the improvements of the above indexes of the observation group were superior to these of the control group after treating(P<0.05);the levels of hemorheology indexes,whole blood viscosity,plasma viscosity,erythrocyte aggregation index and fibrinogen of both groups lowered significantly after treating,the observation group was lower than the control group in these indexes above after treating(P<0.05).Conclusion:On the foundation of basic therapy of Western medicine for T2DM patients,its combination with the method of Qiinvigorating Yin-nourishing blood-activating could remarkably improve blood glucose disorder and isletβcell function,reduce the levels of blood lipid,improve hemorheology and blood viscosity.