目的 观察加味建瓴汤对原发性高血压患者胰岛素抵抗及血清白细胞介素-6 (IL-6)水平的影响,并探讨其可能的作用机制.方法 选择符合纳入标准的原发性高血压伴胰岛素抵抗患者60例,采用随机、单盲、对照试验设计分为治疗组和对照组各30例.对照组给予依那普利10 mg/次,每日1次口服,治疗组在西药治疗基础上予加味建瓴汤150 mL/次,每日2次口服,疗程为3周.观察2组患者治疗前后空腹血糖、血浆胰岛素水平、中医症状、血清IL-6水平变化,并计算胰岛素敏感指数.结果 治疗组较对照组经治疗后空腹血糖、空腹胰岛素水平明显降低,胰岛素敏感指数明显改善,血清IL-6水平明显下降(P＜0.01或P＜0.05)；治疗组中医症状疗效明显优于对照组(P＜0.01).结论 加味建瓴汤能显著降低血糖、血浆胰岛素水平,改善临床症状和减轻胰岛素抵抗.降低血清IL-6水平,抑制炎症反应,可能是其改善胰岛素抵抗的机制之一.%Objective To study the curative effect of Jiawei Jianling Tang on insulin resistence and the interleukin-6 (IL-6) level of essential hypertension (EH) patients, and investigate its action mechanism. Methods Sixty EH patients according with the diagnosis criteria were divided into two groups at random, single-blind, controlled trial. Each group had 30 patients. The control group were treated with enalaprilat (10 mg, Qd), while the treatment group was treated with Jiawei Jianling Tang (150 mL, Bid) on the basis of western medicine. The course of treament was three weeks. The fast plasma glucose (FPG), plasma insulin level, TCM symptoms and serum level of IL-6 of two groups were measured before and after treatment, the insulin sensitivity index (ISI) was assessed. Results After treatment, the level of FPG, FINS and IL-6 were remarkably reduced in the treatment group, the level of ISI in treatment group were improved more significantly than control group (P<0.01 or P<0.05). The treatment effect of TCM symptoms in the treatment group was ameliorated better than the control group (P<0.01). Conclusion Jiawei Jianling Tang can lower the level of FPG and insulin, improve the clinical symptoms and the degree of insulin resistance of EH patients. Jiawei Jianling Tang can lower IL-6 level and inhibit inflammatory reaction, which may be one of the mechanisms to reducing the insulin resistance.
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