清肝泻心汤对2型糖尿病胰岛素抵抗相关因素影响的研究

目的 探讨清肝泻心汤对2型糖尿病患者血清多种脂肪细胞因子水平变化的影响及其与胰岛素抵抗的关系.方法 按随机数字表法将60例患者分为2组并进行均衡性检测,治疗组30例采用清肝泻心汤治疗,对照组30例采用文迪雅(马来酸罗格列酮)治疗2个月.用ELISA法检测并比较治疗前后两组的抵抗素、脂联素、瘦素、肿瘤坏死因子-α、白介素-6水平.检测并比较治疗前后两组的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、C反应蛋白、胰岛素抵抗指素.结果 治疗组及对照组均能降低T-Cho及TG水平,但2组治疗前后及两组间比较无差异(P＞0.05),2组治疗后能升高HDL-C水平及降低LDL-C水平(P＜0.05),但2组比较无明显差异性(P＞0.05).在改善胰岛素抵抗疗效方面,2组治疗后均能升高胰岛素敏感性指数,胰岛素抵抗明显改善,但两组间差值比较差异不显著(P＞0.05).2组治疗后血清抵抗素水平明显降低(P＜0.01),脂联素水平明显升高(P＜0.01),但2组间差值比较差异不显著(P＞0.05).治疗后治疗组能明显降低瘦素、肿瘤坏死因子-α、C反应蛋白、白介素-6水平(P＜0.01),对照组能明显降低C反应蛋白、白介素-6水平(P＜0.01),治疗前后有显著差异(P＜0.01),两组间比较有显著性差异(P＜0.01).结论 清肝泻心汤及文迪雅治疗2型糖尿病均能降低患者血清抵抗素水平、升高脂联素水平,这些脂肪细胞因子的改变可能与2型糖尿病患者胰岛素抵抗的改善有关.

Effect of Clearing Liver and Purging the Heart Decoction on insulin resistance in patients with type 2 diabetes

Objective To investigate the serum level of adipocytokines before and after the treatment of Clearing Liver and Purging the Heart Decoction in type 2 diabetes patients, and to explore the relationship between serum adipocytokine concentrations with insulin resistance. Methods Sixty patients of type 2 diabetes were randomly divided into treated group (30 cases) and control group (30 cases).The treated group were treated with Clearing Liver and Purging the Heart Decoction for 2 months, and the control were given with rosiglitazone mesylate (Avandia, 4 mg/d) for 2 months. Their serum levels of adiponectin and resistin before and after the treatment were measured with ELISA method. Their T-Cho, TG, HDL-C, LDL-C, blood sugar, C-P levels as well as insulin resistance levels were measured. Results The levels of T-Cho and TG, in the 2 groups were decreased, but no significant difference was observed between the before and after treatment or between the 2 groups. Levels of HDL-C and LDL-C were significantly increased and reduced respectively in 2 groups after than before treatment (P<0.05), and blood sugar was reduced in 2 groups (P<0.01), but no significant difference was observed in these 3 indexes between the 2 groups. HbA1c was reduced too in 2 groups (P<0.01), with the treated groups more significant (P<0.01). Levels of FINS and C-P were significantly reduced in 2 groups (P<0.01), and IAI was increased, but no significant difference was observed between the 2 groups. After treatment, serum levels of resistin was reduced and adiponectin was increased in 2 groups (P<0.01), no significant difference was observed between the 2 groups. Conclusion Serum level of resistin is decreased and that of adiponectin increased after treatment of the Clearing Liver and Purging the Heart Decoction or avandia. All these changes of adipocytokine are well correlated with insulin resistance.