雷公藤多甙治疗LADA的初步临床观察

摘要

Objective To study the effects of tripterygium on the islet cell function and immunological parametersin patients with late onset autoimmune diabetes mellitus in adults (LADA). Methods Randomly divided into twogroups. Test group ( n = 9) involved in patients with tfipterygium and oral hypoglycemic agents (OHA), control group( n =9)with OHA alone. Results ①Compared to control group at 6 months, postprandial blood glucose of test groupwas decreased and postprandial C-peptide of rest group was higher. CD4+ cell of test group was decreased ( P <0. 05)；CD4+/CDs+ was decreased in test group at 3 months. ②ICA(+) of 2 patients become negative while no one in controlgroup after 3 months ( P <0. 05). ③ΔC-peptide was correlated with CD4+/CD8+ ( γ = -0. 36, P <0. 05). ConclusionThe results suggested that tripterygium played a role in cellular immunity regulation with decrease in the titer of isletcell antibody and tendency to improve islet cell function in early LADA patients.%目的探讨雷公藤多甙治疗对成人隐匿性自身免疫性糖尿病(LADA)早期患者胰岛β细胞功能及免疫学指标的影响。方法把18例患者随机分为两组，试验组(n=9)用雷公藤多甙加口服降糖药，对照组(n=9)仅口服降糖药。结果①与对照组比较，6个月后试验组餐后血糖降低，餐后C肽上升，CD4+细胞下降(P<0．05)；而3个月CD4+／CD8+降低(P<0．05)。②试验组有2例ICA(阳性)转阴，对照组无一例转阴(P<0．05)。③ΔCP与CD4+／CD8+呈负相关(P<0．05)。结论初步提示雷公藤多甙对LADA早期患者细胞免疫有调节作用，可在短期内降低胰岛细胞抗体水平，有改善胰岛β细胞功能的趋势。