三黄降糖方对Ⅱ型糖尿病患者外周胰岛素抵抗的影响

目的：观察三黄降糖方（即加味桃核承气汤）对Ⅱ型糖尿病患者外周胰岛素抵抗的影响。方法：９５例Ⅱ型糖尿病患者随机分为中药组和西药组，中药组以三黄降糖方的水煎剂和片剂同时使用；西药组用美吡达治疗。两组疗程均主４－６个月，治疗前后进行标准馒头餐试验，并计算外周胰岛素敏感度（ＳＩ）、胰岛素释放率（ＩＲＧ）及胰岛素敏感性指数。结果：（１）中药组改善外周胰岛素抵抗疗效的部有效率主７９．２％（其中逆转率２６．４％

Effect of sanhuang jiangtang recipe on insulin peripheral resistance in type II diabetics]

OBJECTIVE: To observe the effect of Sanhuang Jiangtang recipe (SHJT) on insulin peripheral resistance in type II diabetics. METHODS: Ninety-five patients with type II diabetics were randomly divided into two groups. Fifty-three cases of SHJT group were given orally decoction and tablets of SHJT for 4-6 months. The efficacy was compared with that of 42 cases treated with Glipizide as the control. Before and after treatment standard steamed bread meal test was performed to measure the insulin peripheral sensitivity, insulin release to glucose and insulin sensitivity index. RESULTS: (1) The total effective rates of improving insulin peripheral resistance and reducing blood sugar in SHJT group were 79.2% and 80.1%, which was equivalent to levels in the control group, but SHJT recipe was more effective in relieving symptoms of Qi deficiency and signs of blood stasis. (2) In SHJT group, the insulin peripheral sensitivity and insulin sensitivity index were significantly increased (P < 0.05 and P < 0.01), meanwhile the fasting blood sugar and blood sugar area were reduced (P < 0.05), but the change of insulin release to glucose was blunted. (3) The lowering of blood sugar in SHJT group was significantly negative correlated with the changing of degree of insulin peripheral sensitivity and index of insulin sensitivity (P < 0.01 and P < 0.05), but not with that of insulin area. CONCLUSIONS: It suggested that the treatment of SHJT recipe might decrease insulin peripheral resistance (partial reversal) by means of reducing hyperinsulinemia and improving insulin sensitivity.