摘要
目的:探究健脾清化方对气阴两虚型2型糖尿病患者肠促胰岛素效应的影响。方法:将符合纳入标准的18例患者随机分为试验组和对照组,每组9例。在维持糖尿病饮食及运动方案的基础上,试验组采用中药健脾清化方治疗,对照组采用二肽基肽酶-Ⅳ(DPP-Ⅳ)抑制剂治疗,干预4周,观察两组患者治疗前后口服葡萄糖耐量试验(OGTT)各时点(0 min,糖负荷后30、60、120、180 min)的总胰高血糖素样肽-1(TGLP-1)、活性胰高血糖素样肽-1(AGLP-1)、总葡萄糖依赖性促胰岛素释放肽(TGIP)、DPP-Ⅳ、血糖(PG)、糖化血清蛋白(GSP)以及安全性指标的水平。结果:治疗后,试验组TGLP-1(糖负荷30 min)、TGIP(糖负荷180 min)水平较前升高(P<0.05),DPP-Ⅳ(空腹及糖负荷120、180 min)活性、GSP水平较前下降,DPP-Ⅳ曲线下面积(AUC)减少(P<0.05);对照组AGLP-1(糖负荷60、120、180 min)水平较前升高(P<0.05),AUC增加(P<0.05),DPP-Ⅳ活性及TGLP-1(糖负荷30 min)、GSP水平较前下降,DPP-ⅣAUC减少(P<0.05)。治疗后组间比较,试验组TGLP-1(糖负荷30 min)水平显著高于对照组(P<0.05);对照组AGLP-1(糖负荷60 min及AUC)、TGIP(空腹及糖负荷180 min)水平高于试验组(P<0.05),DPP-Ⅳ(空腹、糖负荷30、60、120 min)活性及AUC低于试验组(P<0.05);两组PG、GSP及安全性指标差异无统计学意义。结论:健脾清化方通过提高TGLP-1及TGIP水平、降低DPP-Ⅳ活性,改善气阴两虚型2型糖尿病患者肠促胰岛素效应,作用机制与DPP-Ⅳ抑制剂比较存在差异。
Objective:To investigate the influence of Jianpi Qinghua Formula on the incretin effect in type 2 diabetic patients of qi and yin deficiency type.Methods:Eighteen patients who met the inclusion criteria were randomly divided into two group:the experimental group and the control group.Each group contained 9 patients.Based on the maintenance of diabetic diet and exerciseplan,the experimental group was treated with Chineseherbal medicine Jianpi Qinghua Formula and the control group was treated with DPP-Ⅳ inhibitor for 4 weeks.After conducting oral glucose tolerance test(OGTT),the patients in both group were observed about their TGLP-1,AGLP-1,TGIP,DPP-Ⅳ,PG,GSP,and safety index levels before and after treatment at each time point of glucose load(0 min,30 min,60 min,120 min,180 min).Results:After treatment,TGLP-1(glucose load 30 min)and TGIP(glucose load 180 min)levels increased in the experimental group(P<0.05),DPP-Ⅳ(fasting and glucose load 120 and 180 min)activity and GSP levels decreased,and the area under the curve(AUC)of DPP-Ⅳdecreased(P<0.05).AGLP-1(glucose load 60,120,180 min)levels increased,AUC increased(P<0.05),DPP-Ⅳactivity and TGLP-1(glucose load 30 min)and GSP levels decreased,and DPP-Ⅳ AUC decreased(P<0.05)in the control group.In comparison between groups after treatment,TGLP-1(glucose load 30 min)levels were significantly higher in the experimental group than in the control group(P<0.05);AGLP-1(glucose load 60 min and AUC)and TGIP(fasting and glucose load 180 min)levels were higher in the control group than in the experimental group,and DPP-Ⅳ(fasting,glucose load 30,60 and 120 min)activity and AUC were lower than in the experimental group(P<0.05).The levels of PG,GSP and safety items were not significantly different between the two groups.Conclusion:Jianpi QingHua Formula increased the level of TGLP-1 and TGIP,and decreased the activity of DPP-Ⅳ,and improved Incretin effect in type 2 diabetic patients of qi and yin deficiency type.The mechanism of action is different from that of DPP-Ⅳ
作者
闫子惠
徐舒雨
刘亚华
陈清光
陆灏
YAN Zi-hui;XU Shu-yu;LIU Ya-hua;CHEN Qing-guang;LU Hao(Department of Endocrinology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Diabetes Research Institute,Shuguang Hospital Affliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Pudong New Area Jin Yang Community Health Service Center,Shanghai 200136,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2022年第12期7059-7063,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(No.82074381)
上海市科学技术委员会科研计划项目(No.21S21900700)
上海市临床重点专科(No.shslczdzk05401)
上海市中医临床重点实验室(No.20DZ2272200)
中医糖尿病专科联盟建设[No.ZY(2018-2020)-FWTX-4011]。
