糖尿病脾虚证应健脾益气法的临床疗效观察和胃肠激素研究.pdfVIP

2.实验研究 目的：本研究旨在通过对糖尿病、糖尿病脾虚证、脾虚证模型大鼠的胃肠激素及 其相关性的研究，探讨糖尿病状态下脾虚证的病理生理意义，揭示脾虚证的本质，探 讨病证之间的互动关系。 研究方法：建立糖尿病、糖尿病脾虚证、脾虚证大鼠模型后处死，观察各组血糖、 胰高血糖素样肽-1 （glucagon-likepeptide1 ，Glp-1 ）、胰岛素（insulin,Ins ）、胰高血糖 素（glucagon,Gln ）、抑胃肽（gastric inhibitory polypeptide,GIP ）、胃泌素（gastrin,Gas ） 等指标的差异。 结果：经统计学分析，脾虚组的 GLP-1 明显高于糖尿病组和糖尿病脾虚组,糖尿 病组与糖尿病脾虚组之间未见明显差异,正常组与其他各组之间均未见明显差异。糖 尿病组和糖尿病脾虚组的 Ins 明显高于正常组和脾虚组,糖尿病组与糖尿病脾虚组、脾 虚组与正常组之间无明显差异。脾虚组的 Gln 明显低于糖尿病组和糖尿病脾虚组,糖 尿病脾虚组明显高于正常组,糖尿病组与糖尿病脾虚组之间、正常组与脾虚组及糖尿 病组差异无统计学意义。四组的GIP 无显著性差异，但脾虚组明显低于糖尿病脾虚组。 糖尿病组和糖尿病脾虚组 Gas 明显高于脾虚组；糖尿病组和糖尿病脾虚组高于正常 组，其差异具有统计学意义；糖尿病组与糖尿病脾虚组之间差异无统计学意义；脾虚 组与正常组之间无明显差异。糖尿病大鼠 GLP-1 与血糖呈负相关，与 GIP 呈正相关。 结论：GLP-1 降低和 Gas 升高可能是糖尿病及糖尿病脾虚证的病理实质的组成部 分；脾虚证及糖尿病脾虚证时机体具有自我调节的能力；糖尿病及糖尿病脾虚证与单 纯脾虚证之间具有明显差异，提示临床上应先辨病后辨证，在疾病诊断明确的情况下 进行辨证论治。 关键词 胃肠激素；脾虚证；糖尿病脾虚证；自我调节 Clinical Observation applied Strengthening the Spleen and Replenishing Qi of Diabetes of Deficiency Spleen and Study on Gastrointestinal Hormones Specialty: Internal Medicine of Traditional Chinese Medicine Author:Zhang Jing Tutor:Prof.Sun Fenglei Abstract This paper including clinical research and experimental study two parts. 1. Clinical research Objective: This study aimed to explore the role of spleen in the pathogenesis of type 2 diabetes, and Strengthening the Spleen and Replenishing Qi clinical efficacy of treatment of type 2 diabetes spleen deficiency, and reveal the clinical features of type 2 diabetes patients with spleen deficiency syndrome to prove that the Jian Pi Jiang Tang Yin is effective prescription for the treatment of type 2 diabetes. Methods: In this study, selected from the clinical type 2 diabetes 60 cases, 30 cases were randomly divided into two groups, the treatment group and control group (