通脑精胶囊治疗急性脑梗死胰岛素抵抗的临床研究

观察通脑精胶囊改善急性脑梗死(ACI)神经功能缺损及胰岛素抵抗(IR)的作用.将64例ACI患者随机分为治疗组34例和对照组30例,分别给予通脑精胶囊和尼莫地平3周,观察治疗前后神经功能缺损、空腹及餐后2 h血糖、胰岛素(Ins)、胰岛素敏感指数(ISI)和血脂的变化,并与健康对照组19例比较.结果表明治疗前两组患者空腹Ins及餐后2 h血糖、Ins含量明显高于健康对照组(P<0.01),且ISI明显降低(P<0.01);治疗后治疗组的空腹Ins、餐后2 h血糖及餐后2 h血清Ins均明显降低(P<0.05,P<0.01),ISI则显著升高(P<0.05),并在降低空腹Ins水平及提高ISI方面明显优于对照组(P<0.05,P<0.01),治疗组脂质紊乱也有明显改善.提示脑梗死急性期患者并发明显的IR状态,通脑精胶囊不仅具有明显改善ACI神经功能缺损的作用,而且还具有改善脑梗死急性期IR状态及伴发的脂质代谢紊乱作用.

Clinical Study on the Treatment of Acute Cerebral Infarction and Insulin Resistance by Naotongjing Capsules

The effects of Naotongjing Capsules (NC) against the neurological deficit and insulin resistance caused by acute cerebral infarction (ACI) were studied. 64 Patients were randomly divided into the treating group (34 cases) and treating control group (30 cases), and the former was given NC and the latter, nimodipine, respectively for 3 weeks. Some criteria, such as the severity of neurological deficit, the levels of blood sugar (empty stomach and 2 hours after meal), level of insulin (Ins), insulin sensitivity index (ISI) and the level of blood lipid, were measured before and after the administration. The results showed that before the administration, the level of Ins (empty stomach), and the levels of blood sugar and Ins (2 hours after meal) were markedly higher (P < 0.01), and the value of ISI was markedly lower (P < 0.01) in the patients of the above-mentioned two groups, compared with those in the healthy subjects in the normal control group; after the administration, the level of Ins (empty stomach) and the levels of blood sugar and Ins (2 hours after meal) were markedly decreased (P < 0.05, P<0.01), the value of ISI was markedly increased (P < 0.05), and the lipid metabolic disturbance was markedly relived in the patients in the treating group; NC showed better effects for decreasing the level of Ins (empty stomach) and increasing the value of ISI, compared with nimodipine (P < 0.05, P < 0.01). The results suggest that NC not only may relieve the severity of ACI neurological deficit significantly, but also may control the insulin resistance accompanied by lipid metabolic disturbance in the acute stage of cerebral infarction .