丹蛭降糖胶囊对2型糖尿病合并肥胖患者胰岛素抵抗及脂毒性改善作用

目的 观察具有益气活血功效中药复方制剂丹蛭降糖胶囊对2型糖尿病(type 2 diabetes mellitus,T2DM)合并肥胖患者胰岛素抵抗、脂毒性相关指标的改善效果.方法 选取T2DM合并肥胖患者80例,随机分为对照组及治疗组各40例,均给予降低血糖、调节血脂的基础治疗,治疗组在常规治疗上加用中药复方制剂丹蛭降糖胶囊口服,疗程为4周,观察治疗前后患者空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2-hour postprandial blood glucose,2hPG)、胰岛素抵抗指数(homeostasis model assessment of in-sulin resistance,HOMA-IR)、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL)、低密度脂蛋白胆固醇(low density lipoprotein choles-terol,LDL)、载脂蛋白(apolipoprotein,APO)、尿酸(uric acid,UA)等指标变化的情况.结果 治疗4周后门诊随访,两组患者FPG、2hPG、HOMA-IR、TG、APO-B、UA水平均较治疗前明显降低,HDL明显升高(P<0.05);其中治疗组治疗后FPG、HOMA-IR、TG、UA、APO-B水平较对照组下降更为明显(P<0.05).结论 丹蛭降糖胶囊能显著降低T2DM合并肥胖症患者的HOMA-IR、TG、UA水平,有效改善肥胖型T2DM患者胰岛素抵抗及脂毒性状态,从而有力防控糖尿病进展.

Effect of Danzhi Jiangtang Capsule in Improving Insulin Resistance and Lipotoxicity in Patients with Type 2 Diabetes Mellitus and Obesity

Objective To investigate the effect of Danzhi Jiangtang Capsule, a traditional Chinese medicine (TCM) compound formulation with Qi-tonifying and blood-activating functions, in improving related indices of insulin resistance and lipotoxicity in patients with type 2 diabetes mellitus (T2DM) and obesity. Methods A total of 80 patients with T2DM and obesity were randomly divided into treatment group and control group, with 40 patients in each group. The patients in the control group were given conventional hypoglycemic and lipid-lowering therapy, and those in the treatment group were given oral administration of the TCM compound formulation Danzhi Jiangtang Capsule in addition to the treatment in the control group; the course of treatment was 4 weeks for both groups. The two groups were compared in terms of the changes in fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, apolipoprotein B (APO-B), and uric acid (UA) after treatment. Results During follow-up at the outpatient service after 4 weeks of treatment, both groups had significant reductions in FPG, 2hPG, HOMA-IR, TG, APO-B, and UA and a significant increase in HDL-C (P<0.05), and compared with the control group, the treatment group had significantly greater reductions in FPG, HOMA-IR, TG, UA, and APO-B (P<0.05). Conclusion In patients with T2DM and obesity, Danzhi Jiangtang Capsule can significantly reduce HOMA-IR, TG, and UA, effectively improve insulin resistance and lipotoxicity, and thus prevent and control the progression of diabetes.