肥胖T2DM肝胃郁热证患者胰岛素分泌特点研究

目的:研究肥胖T2DM的主要证型肝胃郁热证患者的胰岛素分泌特点,为探讨肝胃郁热证的科学内涵做一粗浅尝试。方法:通过胰岛素耐量实验,将肥胖T2DM肝胃郁热患者与正常组和肥胖组比较,检测0点、30min1、20min免疫反应性胰岛素(IRI)、真胰岛素(TI)和胰岛素原(PI)。结果:同对照组相比,肥胖2型糖尿病肝胃郁热证患者胰岛素分泌低钝,延迟,早时相分泌远低于正常者;Homa-β细胞功能指数、胰岛素抵抗指数存在显著差异。结论:肥胖2型糖尿病肝胃郁热证患者胰岛素分泌的数量、质量及胰岛素分泌的时相性都存在明显的病理改变,证实胰岛β细胞功能减退及胰岛素抵抗双重因素导致该患者群血糖居高不下。同时本研究提示采用真胰岛素评估β细胞功能结果更真实。

Study on Insulin Secretion’s Characteristic of Stagnation of Liver Qi and Stomach Heat of Obesity Type 2 Diabetes

Objective:Study on the insulin secretion’s characteristic of stagnation of liver Qi and stomach heat of obesity type 2 diabetes was made to reveal pathological mechanism of TCM syndrome.Methods:We selected the patients of obese T2DM as subjects,observe the features of insulin-secretion through insulin tolerable test by contrast with normal person and obese person,observe the change of IRI、TI、PI in zero point、 30 minute point、 120 minute point.Results:The patients of stagnation of liver Qi and stomach heat of obesity type 2 diabetes’s insulin-secretion is low and delayed and especially in early-phase of insulin secretion,fasting PI of subjects is double than normal contrast group’s,and subjects’ insulin secretion index and insulin sensitivity index are poor.Conclusion:Distinctive difference exists in the quality and quantity of insulin-secretion between the patients of stagnation of liver Qi and stomach heat of obesity type 2 diabetes and normal contrast group,it is the true reason that insulin resistance(IR)and impaired β-cell function makes subjects blood sugar very high,and it’s feasible to evaluate β-cell function by true insulin.