2型糖尿病常见中医证型与胰岛素抵抗及胰岛功能的关系研究

摘要

目的 研究2型糖尿病常见中医证型与胰岛素抵抗及胰岛功能的关系.方法 选取2型糖尿病患者60例, 按照中医证候诊断结果分为气阴两虚组、湿热困脾组和血瘀脉络组, 每组20例.测定空腹血糖 (FPG) 及空腹胰岛素 (FIN) 水平, 计算腰臀比 (WHR) 和体重指数 (BMI), 计算胰岛素抵抗指数 (HOMA-IR) 及胰岛素分泌指数 (HOMA-β), 比较各个证型组之间是否存在差异.结果 湿热困脾组的FIN明显高于气阴两虚组及血瘀脉络组 (P＜0.05);湿热困脾组的WHR及BMI明显高于气阴两虚组及血瘀脉络组 (P＜0.05);湿热困脾组的HOMA-IR明显高于气阴两虚组及血瘀脉络组 (P＜0.05);血瘀脉络组的HOMA-β明显低于气阴两虚组及湿热困脾组 (P＜0.05).结论 湿热困脾证患者体重超标及腹型肥胖程度严重, 湿热困脾证患者胰岛素抵抗程度严重, 血瘀脉络证患者胰岛功能较差.%Objective To study the relationship between TCM syndrome and insulin resistance and pancreatic islet function in type 2 diabetes mellitus.Methods Sixty patients with type 2 diabetes mellitus were divided into three groups according to the results of TCM syndrome diagnosis, including qi and yin deficiency group, damp-heat trapped spleen group and blood stasis choroid group, with 20 cases in each group.The levels of FPG and FIN were measured, the WHR and BMI, the HOMA-IR and HOMA-β were calculated, and the differences between different syndrome groups were compared.Results The FIN of damp-heat trapped spleen group was significantly higher than that of qi and yin deficiency group and blood stasis choroid group (P＜0.05), and the WHR and BMI of damp-heat trapped spleen group were significantly higher than those of qi and yin deficiency group and blood stasis choroid group (P＜0.05).The HOMA-IR of damp-heat trapped spleen group was significantly higher than that of qi and yin deficiency group and blood stasis choroid group (P＜0.05), and the HOMA-β of blood stasis choroid group was significantly lower than that of qi and yin deficiency group and damp-heat trapped spleen group (P＜0.05).Conclusion The degree of overweight and abdominal obesity was serious in the patients with damp-heat trapped spleen syndrome, the degree of insulin resistance was serious in the patients with damp-heat trapped spleen syndrome, and the function of pancreatic islet was poor in the patients with blood stasis choroid syndrome.