雷公藤多甙在迟发性自身免疫糖尿病早期治疗中的作用观察

目的观察雷公藤多甙在成人迟发性自身免疫糖尿病（latent autoimmune diabetes in adult,LADA）早期治疗的疗效.方法将糖尿病患者随机分两组：治疗组和对照组,对照组40例给予胰岛素治疗,而治疗组40例在胰岛素治疗的基础上加用雷公藤多甙,观察两组糖尿病患者的真胰岛素和C肽水平、谷氨酸脱羧酶抗体（glutamic acid decarboxylase antibody,GADAb）、胰岛细胞抗体（ICA）及临床特点.结果两组酮症发作情况、体重指数、肝肾功能等方面差异无显著性（P＞0.05）;治疗组6个月时GADAb、ICA阳性率下降（P＜0.01）,空腹及餐后2h C肽增加（P＜0.01）,餐后2h真胰岛素亦增加;1年时GADAb、ICA阳性率下降更加明显（P＜0.01）,空腹及餐后2h C肽和真胰岛素水平进一步增加.结论对于LADA患者,早期进行雷公藤多甙治疗比单纯胰岛素治疗更有利于缓解自身免疫的损害和胰岛功能的恢复.

Effect of Multi-glycosides of Tripterygii on Latent Autoimmune Diabetes in Adults in Early Stage

Objective To observe the effect of multi-glycosides of tripterygii (MT) on latent autoimmune diabetes of adults (LADA) in early stage. Methods The diabetic patients were divided randomly into the control group treated with insulin alone and the treated group treated with insulin and MT. Levels of insulin, C-peptide, glutamic acid decarboxylase antibody (GADAb) and islet cell antibody (ICA) were detected and clinical features of the disease were observed. Results There was no difference between the control group and the treated group in body mass index (BMI), the occurrence of diabetic keto-acidosis and the function of liver and kidney (P>0.05). After 6 months' treatment, the positive rate of GADAb and ICA decreased, plasma levels of fasting and 2 hrs post-prandial C-peptide and also 2 hrs post-prandial true insulin in the treated group increased (P<0.01), while all the above indexes improved more significantly after 1 year's treatment (P<0.01). Conclusion Compared treatment of insulin with multi-glycosides of tripterygii in early stage of LADA has better effects in relieving autoimmune injury and recovering function of pancreatic island than insulin alone.