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目的观察中药联合胰岛素泵(CSII)治疗2型糖尿病(T2DM)的临床效果,精确评价联合用药对胰岛β细胞功能和胰岛素抵抗(IR)的作用。方法对10例初诊T2DM患者(联合组)采用中药联合CSII治疗,匹配空腹血糖值相同者(对照组)单纯CSII治疗,疗程1个月,检测血糖(PG)、糖化血红蛋白(HbA1C),高葡萄糖钳夹评价胰岛β细胞功能和IR情况。结果①治疗后2组双相胰岛素分泌均有升高,其联合组2相(2PH)胰岛素分泌均值和最大值高于对照组,差异有显著统计意义,P<0.05;②联合组胰岛素敏感指数(ISI)升高,t=-4.837,P=0.001;对照组ISI变化不显著,t=-1.655,P=0.132;2组ISI净升高值存在显著差异,t=4.364,P=0.002。结论中药联合CSII治疗T2DM可获得良好血糖控制,其机理可能是通过恢复胰岛β细胞对葡萄糖刺激的敏感性和改善IR而实现的。
Objective To observe the clinical effect of combined traditional Chinese medicine and insulin pump (CSII) on type 2 diabetes mellitus (T2DM) and to evaluate accurately the effect of combination therapy on pancreatic β cell function and insulin resistance (IR). Methods A total of 10 newly diagnosed T2DM patients (combined group) were treated with CSII combined with CSII and matched with fasting blood glucose (CSII) group for one month. The duration of treatment was 1 month. The levels of blood glucose (PG), glycosylated hemoglobin (HbA1C) Pliers were used to assess pancreatic β-cell function and IR. Results ① After treatment, the biphasic insulin secretion increased in both groups, and the mean and maximum of 2PH insulin secretion in the combined group were higher than those in the control group (P <0.05); ② The insulin sensitivity index (ISI), t = -4.837, P = 0.001. There was no significant difference in the ISI of the control group (t = -1.655, P = 0.132). There was a significant difference in the net increase of ISI between the two groups (t = 4.364, P = 0.002) Conclusion Chinese medicine combined with CSII treatment of T2DM can get good glycemic control, the mechanism may be through the restoration of pancreatic β-cell sensitivity to glucose stimulation and improve the IR achieved.