2型糖尿病论文：2型糖尿病 胰岛素抵抗 祛胰抵方 TNF-α .docVIP

2型糖尿病论文：2型糖尿病 胰岛素抵抗 祛胰抵方 TNF-α 【中文摘要】观察以益气养阴、活血祛痰法为组方原则的自拟方(祛胰抵方)联合西药二甲双胍对2型糖尿病胰岛素抵抗(IR)气阴两虚兼有血瘀痰滞型的临床疗效,对照治疗前后血清TNF-α、胰岛素敏感指数(ISI)、FPG、FINS、2hPG等指标的变化,从而分析探讨中西药联合治疗2型糖尿病IR的临床疗效。方法：将60例2型糖尿病胰岛素抵抗患者随机分为2组,在基础治疗相同的前提下,对照组给予二甲双胍片500mg,每日三次口服；治疗组给予祛胰抵方中药汤剂,每日一剂,水煎两次共取药汁200ml,早晚两次分服,并加以二甲双胍片500mg,每日三次口服。疗程8周。观察两组患者治疗前后血清TNF-α、胰岛素敏感指数(ISI)、空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、血脂分析(TC、TG、HDL-C、LDL)、中医临床症状积分的变化。结果：治疗组可明显降低气阴两虚兼有血瘀痰滞型2型糖尿病胰岛素抵抗患者血清TNF-α水平,提高胰岛素敏感性；改善血糖、糖化血红蛋白指标、血脂、中医症候积分,且优于对照组；通过观测治疗前后血常规、尿常规、便常规、肝功、肾功、心电图等指标,显示治疗期间两组患者各指标均在正常范围内,未见异常变化。结论：本研究证实,在治疗2型糖尿病患者胰岛素抵抗符合中医气阴两虚兼有血瘀痰滞型方面,祛胰抵方联合西药疗法明显优于单独使用西药疗法,可以明显地降低TNF-α并升高ISI,增加胰岛素敏感性；降低FPG、FINS、2hPG、HbAlc;能明显降低患者TG、TC、LDL并升高HDL-C以改善脂代谢紊乱；改善2型糖尿病患者的中医症候积分,改善临床症状；且无明显不良反应及毒副作用,安全性较好,值得临床推广应用。 【英文摘要】:To observe qu yi di fang, which is selfside-provided on yiqi yangyin huoxue qutan principle of law, combined with western medicine metformin efficacy in the treatment of serum TNF-α, insulin sensitivity index (ISI), FPG, FINS,2hPGand other indicators of the changes, which analysis of the combined treatment of type 2 diabetes medicine clinical effect of IR on insulin resistance (IR) in type 2 diabetes of both Qiyinliangxu phlegm stagnation blood stasis。Methods:60 patients with insulin resistance of type 2 diabetes were randomly divided into two groups, On the premise of same basic, therapy group give metformin slice 500mg, three times daily; The treatment group gives qu yi di fang Chinese medicine, water frying twice total take a medicine juice 200ml, sooner or later, two times daily. and metformin slice 500mg, three times daily,8 weeks as one period of treatment.Observe both groups of patients before and after the treatment of tumor necrosis factor-α(TNF-α), insulin sensitivity index (ISI),fasting plasma glucose (FPG) and fasting insulin (FINS),2-hour plasma glucose (2hPG), glycated hemoglobin Alc (HbAlc), lipid analysis (TC and TG, HDL-c, LDL),Chinese medicine clinical symptom scores.Results:treatment grou