健脾渗湿方对2型糖尿病黎明现象患者胰岛β细胞功能的影响

Effect of Jianpi Shenshi Decoction on pancreatic β cell in type 2 diabetes mellitus with dawn phenomenon

目的探讨健脾渗湿方对2型糖尿病黎明现象的有效性及其对患者胰岛β细胞功能的影响。方法采用前瞻性随机对照研究,选取2020年8月至12月广东省中医院内分泌科收治的90例2型糖尿病伴黎明现象患者为研究对象。按照随机数字表法分为两组,每组45例。对照组在原降糖治疗基础上加服二甲双胍片,研究组在原降糖治疗基础上加服健脾渗湿方,治疗3个月。监测空腹血糖(FBG)、餐后2 h血糖(2hBG)、睡前血糖、凌晨血糖、血糖变异系数(CV)、糖化血红蛋白(HbA_(1c))水平;采用稳态评估模型测定胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)衡量胰岛β细胞功能。结果治疗3个月,对照组FBG、2hBG、CV低于治疗前;研究组FBG、2hBG、睡前血糖、CV低于治疗前,差异有统计学意义(P<0.05)。治疗3个月,研究组FBG、2hBG和CV低于对照组,差异有统计学意义(P<0.05)。治疗3个月,两组HbA_(1c)低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗3个月,两组HOMA-IR低于治疗前,HOMA-β高于治疗前,差异有统计学意义(P<0.05);研究组HOMA-IR低于对照组,HOMA-β高于对照组,差异有统计学意义(P<0.05)。结论健脾渗湿方可改善2型糖尿病伴黎明现象患者的胰岛β细胞功能,利于维持晨间血糖的稳定性。

Objective To investigate the effect of Jianpi Shenshi Decoction on type 2 diabetes mellitus with dawn phenomenon and its effect on the function of pancreatic β cell.Methods A prospective randomized controlled study was conducted to select 90 patients with type 2 diabetes mellitus complicated with dawn phenomenon from August to December 2020 in the Department of Endocrinology,Guangdong Provincial Hospital of Traditional Chinese Medicine.They were divided into two groups according to the random number table method,with 45 cases in each group.The control group was treated with Metformin in addition to the original hypoglycemic treatment,while study group was treated with Jianpi Shenshi Decoction in addition to the original hypoglycemic treatment,and the treatment lasted for three months.The fasting blood glucose(FBG),2 h-postprandial blood glucose(2 hBG),blood glucose before sleeping,blood glucose in the morning,coefficient of variation(CV),and haemoglobin A_(1c)(HbA_(1c)) levels were monitored;the HOMA insulin resistance index(HOMA-IR) and homeostasis model assessment-β(HOMA-β) were measured by homeostasis assessment model to evaluate pancreatic β cell function.Results After three months of treatment,FBG,2 hBG,and CV in control group were lower than those before treatment;FBG,2 hBG,blood glucose before sleeping,and CV in study group were lower than those before treatment,and the differences were statistically significant(P < 0.05).After three months of treatment,FBG,2 hBG,and CV in study group were lower than those in control group,and the differences were statistically significant(P < 0.05).After three months of treatment,HbA_(1c)in both groups were lower than those before treatment,and study group was lower than control group,and the differences were statistically significant(P < 0.05).After three months of treatment,HOMA-IR in both groups were lower than those before treatment,and HOMA-β in both groups were higher than those before treatment,and the differences were statistically significant(P < 0.05).HOMA-IR in study group was lower than that in control group,and HOMA-β was higher than that in control group,and the differences were statistically significant(P < 0.05).Conclusion Jianpi Shenshi Decoction can improve the function of pancreatic β cell of type 2 diabetes mellitus patients with dawn phenomenon,which is beneficial to maintain the stability of morning blood glucose.