中西药对2型糖尿病胰岛素拮抗激素干预的临床对比观察

发布时间：2018-07-31 16:53

【摘要】：1目的以理论研究和临床实验的方式,观察服用中西药前后2型糖尿病患者空腹血糖、餐后2小时血糖、糖化血红蛋白、血清胰岛素、C肽以及胰岛素拮抗激素胰高血糖素、甲状腺素T3、T4的变化,通过对比研究数值的变化,验证酸甘健运、清养化浊中药对2型糖尿病患者体内胰岛素拮抗激素干预的优势,比较中西药在干预2型糖尿病胰岛素拮抗激素上的区别,指导中医辨证施治。2方法2.1理论研究通过理论研究说明2型糖尿病患者体内存在胰岛素拮抗激素的变化,了解中医对于2型糖尿病患者的病因病机的认识,分析说明通过中西药物的干预,在治疗2型糖尿病,起到降糖作用的同时,可以干预患者体内的胰岛素拮抗激素。2.2临床研究将60例明确诊断为2型糖尿病的患者,随机分成两组,西药组和中药组,每组各30例,西药组给予二甲双胍联合格列齐特缓释片口服降糖治疗,中药组在西药组的基础上给予酸甘健运、清养化浊中药颗粒剂配方冲服降糖治疗,两组统一疗程为2个月。治疗前后分别检测两组患者空腹血糖、餐后2小时血糖、糖化血红蛋白、血清胰岛素、C肽以及胰岛素拮抗激素胰高血糖素、甲状腺素T3、T4的变化。对比分析中西药对于2型糖尿病患者胰岛素拮抗激素的干预效果,分别计算两组药物治疗的总有效率。3结果3.1理论研究结果理论研究证明了2型糖尿病患者体内的胰岛素拮抗激素会发生一定的变化,其中胰高血糖素相对于正常来说均有所升高,而在一定阶段,甲状腺素T3水平相对正常有所降低、T4则无明显的差异,在此基础上,通过中医对于2型糖尿病的病因和病机的认识,辩证论治,可以干预2型糖尿病的治疗,影响患者体内胰岛素拮抗激素的变化,而中西药在干预2型糖尿病体内的胰岛素拮抗激素时存在明显的差异效果。3.2临床研究结果临床研究观察表明,经酸甘健运、清养化浊法配方的中药治疗2个月后的中药组有效率为73.3%,而二甲双胍联合格列齐特缓释片组治疗的西药组总有效率为56.7%,结果表明中药组疗效优于西药组(P0.05),酸甘健运、清养化浊中药组和西药组治疗后患者的FPG、2hPG、HbA1c、INS、GC、C-Peptide、T3比治疗前均有改善(P0.05-P0.01),而与西药组相比GC、T3有显着性差异(P0.05);酸甘健运、清养化浊中药组和西药组治疗后GC较治疗前有明显降低(P0.05),与西药组相比各项指标均有显着性差异(P0.05);酸甘健运、清养化浊中药组和西药组治疗后T3较治疗前有明显升高(P0.05),与西药组相比各项指标均有显着性差异(P0.05);酸甘健运、清养化浊中药组治疗后与治疗前及西药组同期相比均有明显改善(P0.05)。中西药对于2型糖尿病患者体内胰岛素拮抗激素均有干预作用,酸甘健运、清养化浊中药对于2型糖尿病患者体内胰岛素拮抗激素的干预作用优于传统降糖西药。4.结论酸甘健运、清养化浊中药对2型D M患者体内胰岛素拮抗激素的干预效果优于传统西药。传统西药通过调节患者的脂质代谢水平,减少糖尿病患者胰岛素抵抗现象,增加患者机体靶器官和组织细胞对于胰岛素的敏感性,降低患者血糖,保存胰岛B细胞的功能,解除大脑皮质在紧张时患者体内的各种升高血糖激素分泌的水平,通过此种方式,去达到降低血糖和干预2型糖尿病患者胰岛素拮抗激素的水平,增强疗效。酸甘健运、清养化浊中药通过中医辨证论治,采用中医对于2型糖尿病的辨证分型,活血化瘀、健脾调肝、清养化浊,干预患者体内的胰岛素拮抗激素的水平,改善患者的中医临床症状,为2型糖尿病胰岛素抵抗患者新的标本兼治之法,由此组成的酸甘健运、清养化浊中药在治疗效果上明显的优于西药,具有良好的治疗2型糖尿病降低血糖的作用。
[Abstract]:1 Objective To observe the fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, serum insulin, C peptide, insulin antagonist glucagon, thyroxine T3, T4, and the changes in the comparative study of the value of glycemic glycemia in patients with type 2 diabetes mellitus before and after taking Chinese and Western medicine. The advantages of traditional Chinese medicine on insulin antagonistic hormone intervention in type 2 diabetes patients, compare the difference between Chinese and Western medicine in the intervention of insulin antagonist of type 2 diabetes, guide the theory of TCM syndrome differentiation and treatment.2 2.1 theory study to explain the changes of glucagon antagonist hormone in the body of type 2 diabetes mellitus, and understand the 2 of Chinese medicine to 2 The understanding of the etiology and pathogenesis of type 2 diabetic patients shows that, through the intervention of Chinese and Western drugs, in the treatment of type 2 diabetes, as well as hypoglycemic action, the clinical study of insulin antagonist hormone in the patient's body can be intervened in 60 cases with type 2 diabetes, which are randomly divided into two groups, the western medicine group and the traditional Chinese medicine group, each group of 30 cases. The western medicine group was treated with metformin and Gliclazide Sustained-release Tablets oral hypoglycemic treatment. The traditional Chinese medicine group was given acid Gan Jian Yun on the basis of the western medicine group. The prescription of traditional Chinese medicine granules was taken to reduce sugar treatment. The two groups were treated for 2 months. Before and after treatment, two groups of patients with empty abdominal blood glucose, 2 hours postprandial blood sugar, glycated hemoglobin, blood were tested. The changes in insulin, C peptide, insulin antagonist glucagon, thyroxine T3, and T4. Comparison and analysis of the intervention effects of Chinese and Western drugs on insulin antagonist in type 2 diabetic patients, the total effective rate of two groups of drug treatment was calculated, and the results of the 3.1 theoretical study on the results of the 3.1 theoretical study proved the islets of type 2 diabetic patients. There is a certain change in the hormone antagonistic hormone, in which glucagon is higher than normal, and at a certain stage, the level of thyroxine T3 is lower than that of normal, and there is no obvious difference in T4. On this basis, the dialectical treatment of TCM on the etiology and pathogenesis of type 2 diabetes can interfere with type 2 diabetes. The effect of the treatment on insulin antagonistic hormone changes in the patient's body, and the effect of Chinese and Western Medicine on the insulin antagonist in type 2 diabetes mellitus there is a significant difference effect.3.2 clinical research results of the clinical research results showed that the effective rate of Chinese traditional medicine group after 2 months treatment was 73.3%, and two of the Chinese medicine group treated by the acid Gan Jian Yun decoction. The total effective rate of the western medicine group treated with metformin combined with Gliclazide Sustained-release Tablets group was 56.7%. The results showed that the effect of the Chinese medicine group was better than the western medicine group (P0.05), the acid Gan Jian transportation, the FPG, 2hPG, HbA1c, INS, GC, C-Peptide, T3 of the patients after treatment were improved (P0.05-P0.01) after treatment (P0.05-P0.01), and T3 was compared with the western medicine group (GC, T3). The sex difference (P0.05), the acid Gan Jian transportation, the clearing turbid Chinese medicine group and the western medicine group were significantly lower than before the treatment (P0.05), and compared with the western medicine group, there were significant differences (P0.05). The acid Gan Jian Yun, the clear raising turbid Chinese medicine group and the western medicine group were significantly higher than the treatment group (P0.05) after treatment (P0.05). Compared with the western medicine group, all the indexes were significantly higher than those in the western medicine group. Compared with the same period of the treatment group before treatment and Western medicine group (P0.05), there were significant improvement (P0.05). Chinese and Western medicine had the intervention effect on insulin antagonist hormone in type 2 diabetes patients. The intervention of acid Gan Jian, Qingyang turbid Chinese medicine on insulin antagonist hormone in type 2 diabetic patients The effect is better than traditional glycemic western medicine.4. conclusion acid Gan Jian transportation. The effect of traditional Chinese medicine on insulin antagonistic hormone in type 2 D M patients is better than traditional western medicine. Traditional western medicine can reduce the insulin resistance in diabetic patients by regulating the lipid metabolism level of the patients and increase the target organs and tissue cells of the patients. Sensitivity, reducing blood sugar, preserving the function of islet B cells and relieving the level of glucocorticoid secretion in the cerebral cortex during tension, through this way, to reduce blood sugar and interfere with the level of insulin antagonist hormone in type 2 diabetic patients and enhance the curative effect. TCM syndrome differentiation and treatment, using TCM syndrome differentiation of type 2 diabetes, activating blood to dissipate blood stasis, invigorating the spleen and regulating the liver, raising the level of insulin antagonistic hormone in the patient's body, improving the clinical symptoms of the patients, is a new method of treating the patients with type 2 diabetes insulin resistance. The treatment effect is obviously superior to western medicine, and has good effect on treating type 2 diabetes and reducing blood sugar.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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