针药结合对糖尿病胃轻瘫患者空腹血浆Ghrelin水平的影响

目的：通过观察糖尿病合并胃轻瘫症状患者空腹血浆Ghrelin水平的变化,探讨血浆Ghrelin与糖尿病胃轻瘫的关系及针药结合治疗对其的影响。方法：糖尿病无胃轻瘫症状患者35例为对照组;糖尿病合并胃轻瘫症状患者70例随机分为针药结合治疗组35例,莫沙比利治疗组35例。检测和比较针药结合治疗组和莫沙比利治疗组治疗28d前后血浆Ghrelin以及平均血糖（MBG）、平均血糖波动幅度（MAGE）、低血糖次数等指标的改变。结果：糖尿病胃轻瘫组患者的空腹血浆Ghrelin水平明显低于糖尿病无胃轻瘫组（P〈0.05）,其平均血糖（MBG）、平均血糖波动幅度（MAGE）、低血糖次数也明显高于糖尿病无胃轻瘫组（P〈0.05）;治疗28d后两治疗组平均血糖（MBG）、平均血糖波动幅度（MAGE）、低血糖次数均较治疗前有明显降低（P〈0.05）,空腹血浆Ghrelin水平高于治疗前水平（P〈0.05）,其中针药结合治疗组上述各指标的变化均大于莫沙比利治疗组（P〈0.05）。结论：①糖尿病胃轻瘫患者存在血浆Ghrelin水平低下,可能与血糖波动等多因素有关;②针药结合治疗较单纯莫沙比利能更有效改善糖尿病胃轻瘫症状及减少血糖波动,其机制可能是通过增加血浆Ghrelin水平来发挥其作用。

The Effect of Acupuncture Combined with Drugs on Fasting Plasm Ghrelin Levels in Patients with Diabetic Gastroparesis

Objective：To observe the change of fasting plasm ghrelin levels in patients with diabetic gastroparesis and to investigate the relationship between ghrelin and diabetic gastroparesis and the effect of acupuncture combined with drugs on them.Methods：35 diabetic patients without gastroparesis symptoms were considered as a control group,while 70 diabetic patients with gastroparesis symptoms were randomly divided into acupuncture-medicine therapy group and mosapride group,each group had 35 cases.Changes of plasm ghrelin levels,the mean blood glucose（MBG）,mean amplitude of glycemic excursions（MAGE） and the number of hypoglycemia were measured and compared between two groups after treatment 4 weeks.Results：Levels of fasting plasm ghrelin in diabetic patients with diabetic gastroparesis were lower than those of control group without gastroparesis symptoms（P〈0.05）,and the level of MBG,MAGE and the number of hypoglycemia were higher than those of control group（P〈0.05）.After 4 weeks treatment,the level of MBG,MAGE and the number of hypoglycemia were significantly lower than those before treatment（P〈0.05）,while the level of plasm ghrelin was higher than before treatment（P〈0.05）.The changes of these incides mentioned above of acupuncture-medicine therapy group were more than that of mosapride group（P〈0.05）.Conclusion：Levels of plasm ghrelin are lower in diabetic gastroparesis patients,which may be related many factors such as blood glucose fluctuations.Acupuncture-medicine therapy is more effective than mosapride treatment in improving symptoms of diabetic gastroparesis and reducing blood sugar fluctuations,which exerts its effect possibly by increasing the plasma ghrelin levels.