加味二阴煎对2型糖尿病血糖波动的影响

目的:探讨加味二阴煎对2型糖尿病(T2 DM)血糖波动的影响及对氧化应激和血管内皮功能的作用。方法:将86例T2 DM患者随机按数字表法分为对照组和观察组各43例。对照组服用瑞格列奈片,1~2 mg,3次/d,餐前15 min口服;甘精胰岛素注射液,睡前皮下注射。观察组在对照组治疗的基础上服用加味二阴煎,1剂/d。两组疗程均为12周。进行治疗前后动态血糖监测,包括血糖水平的标准差(SDBG)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)及餐后血糖波动均值(MPPGE)等指标;检测治疗前后空腹血糖(FBG)、空腹胰岛素(FINS)、餐后2 h血糖(2 hPBG)及糖化血红蛋白(HbAlc),计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌功能指数和胰岛素敏感指数(ISI);检测治疗前后血丙二醛(MDA)、超氧化物歧化酶(SOD)、血清脂联素(APN)、血管性血友病因子(vWF)和一氧化氮(NO)水平。结果:观察组治疗后FBG,2 hPG,HbA1c,HOMA-IR低于对照组,HOMA-IS和ISI高于对照组(P<0.01);观察组治疗后SDBG,MAGE,MODD及MPPGE均低于对照组(P<0.01);治疗后观察组APN和NO水平高于对照组(P<0.01),vWF水平低于对照组(P<0.01);治疗后观察组SOD水平高于对照组(P<0.01),MDA水平低于对照组(P<0.01)。结论:加味二阴煎能降低T2 DM患者血糖,调节日内血糖波动,稳定血糖,改善β细胞分泌功能,提高机体胰岛素敏感性;还能减轻氧化应激和血管内皮损伤,延缓糖尿病及其并发症的发生。

Influence of Eryin Decoction Jiawei to Glucose Fluctuation of Patients with Type Two Diabetes Mellitus

Objective: Discuss influence of modified Eryin decoction jiawei to glucose fluctuation and impact on oxidative stress and function of vascular endothelium in treating type two diabetes mellitus(T2 DM). Method: Eighty-six patients with T2 DM were randomly divided into control group (43 cases) and observation group (43 cases) by random number table.Patients in control group received repaglinide tablets,1-2 mg/time,3 times/day,and took it at the fifteenth minute before meal.and patients got subcutaneous injection of insulin glargine injection before sleeping.Based on the treatment of control group,patients in observation group added modified Eryin decoction jiawei,1 dose/day.Course of treatment in two groups were both 12 weeks.Before and after treatment,continuous glucoses which including standard deviation of blood glucose level(SDBG),mean amplitude of glycemic excursions(MAGE),mean of daily differences(MODD), and mean postprandial glucose excursion (MPPGE) were monitored;and fasting blood-glucose(FBG),fasting insulin(FINS),two hours' postprandial blood glucose(2h PBG) and glycosylated hemoglobin(HbAlc) were detected,and indexes of homeostasis model assessment of insulin resistance(HOMA-IR),secretion function of pancreas islet B cell and insulin sensitivity(ISI) were calculated.and Levels of methane dicarboxylic aldehyde(MDA),superoxide dismutase(SOD),adiponectin(APN),von willebrand factor(vWF) and nitric oxide(NO) were detected. Result: After treatment,indexes of FBG,2 hPG,HbA1c and HOMA-IR in observation group were lower than those in control group,but indexes of HOMA-IS and ISI were higher than those in control group(P<0.01).and SDBG,MAGE,MODD and MPPGE in observation group were lower than those in control group(P<0.01).levels of APN and NO in observation group were higher than those in control group(P<0.01),but level of vWF was lower than in control group(P<0.01). And level of SOD in observation group was higher than in control group(P<0.01),but level of MDA was lower than in control group(P<0.01). Conclusion: Eryin decoction jiawei can reduce blood glucose of patients with T2 DM,Regulate intraday glucose fluctuation,keep stability of blood glucose,ameliorate secretion function of pancreas islet B cell and improve bodies' insulin sensitivity.And it can also relieve oxidative stress and damage of vascular endothelium, delay the onset of diabetes and its complications.