降糖补肾方对糖耐量低减患者干预治疗的影响

Effect of Jiangtang Bushen Recipe in Intervention Treatment of Patients with Impaired Glucose Tolerance

目的 观察饮食、运动和中药 (降糖补肾方 )干预对预防糖耐量低减 (impairedglucosetolerance,IGT)人群进展为 2型糖尿病 (type 2diabetesmellitus,T2DM)的作用。方法 按WHO 1999年诊断标准确诊的IGT患者 5 1例 ,随机分为对照组 2 6例和中药干预组 2 5例 ,对照组参加糖尿病宣传教育课程和饮食、运动治疗 ,中药干预组在此基础上加服中药降糖补肾方 ,参试者均在 3、6、12个月复查葡萄糖耐量试验 (oralglucosetolerancetest,OGTT)及体重指数、血脂、空腹胰岛素等 ,观察时间 1年。 结果 5 1例参试者有 6例(11 7% )退出 ,对照组 1年后与干预前比较 ,空腹胰岛素、空腹血糖无明显变化 (P >0 0 5 ) ,总胆固醇、甘油三酯轻度降低 ,但差异无显著性 (P >0 0 5 ) ,OGTT 2h后血糖、体重指数下降明显 (P <0 0 5 )。中药干预组空腹血糖无明显变化 (P >0 0 5 ) ,但空腹胰岛素、总胆固醇、甘油三酯、体重指数、OGTT 2h后血糖均明显降低 ,差异有显著性 (P <0 0 1)。观察期结束 ,转变为糖尿病者对照组 3例 (13 6 % ) ,中药干预组为 1例(4 3% ) ,χ2 检验显示 ,两组IGT转化糖尿病率差异无显著性 (P >0 0 5 ) ;但中药干预组正常糖耐量 (normalglucosetolerance ,NGT)年转化率明显优于对照组 (χ2 =8 31,P <0 0 1)。

Objective To evaluate the intervention effect of diet, exercise and Jiangtang Bushen Recipe (JBR, a Chinese herbal recipe) in preventing the progress of patients with impaired glucose tolerance (IGT) to diabetes mellitus (DM) type 2. Methods Fifty-one patients with IGT, with their diagnosis conformed to the diagnosis standard of WHO, 1999,were randomly divided into the control group (n=26) and the TCM group (n=25). Patients in the control group attended to the educational course for DM and received dietotherapy and kinetotherapy, and to those in the TCM group, under these treatments, JBR was given additionally. Oral glucose tolerance test (OGTT), body weight index (BWI), levels of blood lipids and fasting insulin of all the patients were examined after 3 months, 6 months and 12 months of treatment. The total observation time was 1 year. ResultsExcept the 6 cases out of the 51 patients (11.7%),on whom the observation discontinued, in the control group, as compared with before treatment, levels of fasting insulin and fasting blood glucose after treatment were not changed significantly (P>0.05),also insignificant difference was shown in levels of total cholesterol (TC) and triglyceride (TG), though the two indexes lowered slightly after treatment (P>0.05),but significant difference was shown in comparison of OGTT/2h, blood glucose and BWI (P<0.05). While in the TCM group, fasting blood glucose was changed insignificantly (P>0.05),but there was significant difference in comparison of fasting insulin, TC, BWI, OGTT/2h and plasma glucose levels (P<0.01) respectively before and after treatment. At the end of the study, the cumulative cases with conversion to diabetes were 3 (13.6%) in the control group, and 1 (4.3%) in the TCM group, χ 2 test showed insignificant difference in comparison of diabetes conversion rate between the two groups (P>0.05), however, the TCM group showed a better year conversion rate of normal glucose tolerance than that in the control group (χ 2=8.31,P<0.01). Conclusion TCM intervention is possibly effective in delaying the conversion of IGT to DM type 2,and plays integrative effeciency in impelling IGT patients to health. The favorable education and treatment of DM controlling, including dieto- and kineto-therapy may also be advantageous in IGT intervention, but could not be effective in blocking the advance of IGT.