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目的评价糖脉康颗粒对2型糖尿病患者胰岛素敏感性的影响。方法将120例2型糖尿病患者随机分为对照组60例和试验组60例。对照组予以常规的降糖、降压、调脂等治疗;试验组在常规治疗基础上,加用糖脉康颗粒15 g·d-1口服,每天3次,2组疗程均为3个月。观察2组治疗前后餐后血糖、糖化血红蛋白、空腹胰岛素水平、胰岛素敏感性、低密度脂蛋白、三酰甘油、内皮素-1及临床症状的变化,以及不良反应发生率。结果试验组总有效率88.33%明显优于对照组75.00%(P<0.05)。治疗后,2组患者的空腹胰岛素水平、胰岛素敏感性、餐后血糖及糖化血红蛋白较治疗前均明显改善(P<0.05),且试验组治疗后的改善幅度明显优于对照组(P<0.05)。2组患者的临床症状均较治疗前明显改善(P<0.05),且试验组优于对照组(P<0.05)。治疗后,2组三酰甘油水平均无明显改善(P>0.05)。治疗后,试验组低密度脂蛋白以及内皮素-1水平较治疗前明显降低(P<0.05),对照组则不明显(P>0.05)。合并早期糖尿病肾病的治疗后,试验组内皮素-1较治疗前显著降低(P<0.05),对照组则不明显(P>0.05),组间比较差异有统计学意义(P<0.05)。2组在治疗期间均未发生不良反应。结论糖脉康在安全有效治疗2型糖尿病的同时能改善胰岛素敏感性,减轻胰岛素抵抗,降低内皮素-1水平,尤其是降低糖尿病肾病患者的内皮素-1水平。
Objective To evaluate the effects of Tangmailang granules on insulin sensitivity in type 2 diabetic patients. Methods 120 patients with type 2 diabetes were randomly divided into control group (60 cases) and experimental group (60 cases). The control group was given routine hypoglycemic, antihypertensive, lipid-lowering and other treatment; the experimental group on the basis of conventional treatment, plus the Tangmai Kang granules 15 g · d-1 orally, 3 times a day, 2 courses were 3 months . The changes of postprandial blood glucose, glycosylated hemoglobin, fasting insulin, insulin sensitivity, low density lipoprotein, triglyceride, endothelin - 1 and clinical symptoms in two groups before and after treatment were observed. The incidence of adverse reactions was also observed. Results The total effective rate of the experimental group was 88.33% which was significantly better than that of the control group (75.00%, P <0.05). After treatment, the fasting insulin level, insulin sensitivity, postprandial blood glucose and HbA1c in both groups were significantly improved (P <0.05), and the improvement rate in the experimental group was significantly better than that in the control group (P <0.05 ). The clinical symptoms in both groups were significantly improved (P <0.05), and the experimental group was better than the control group (P <0.05). After treatment, no significant improvement was found in triglyceride levels in both groups (P> 0.05). After treatment, the levels of LDL and ET-1 in the experimental group were significantly lower than those before treatment (P <0.05), but not in the control group (P> 0.05). After the treatment of early diabetic nephropathy, the level of endothelin-1 in the experimental group was significantly lower than that before treatment (P <0.05), but not in the control group (P> 0.05). The difference between the two groups was statistically significant (P <0.05). No adverse reactions occurred in the two groups during the treatment. Conclusions Tang Maikang can improve insulin sensitivity, reduce insulin resistance and reduce endothelin-1 level, especially reduce the level of endothelin-1 in patients with diabetic nephropathy, which is safe and effective in the treatment of type 2 diabetes mellitus.