中西藥對2型糖尿病胰島素拮抗激素干預(yù)的臨床對比觀察
發(fā)布時間：2018-07-31 16:53
【摘要】：1目的以理論研究和臨床實驗的方式,觀察服用中西藥前后2型糖尿病患者空腹血糖、餐后2小時血糖、糖化血紅蛋白、血清胰島素、C肽以及胰島素拮抗激素胰高血糖素、甲狀腺素T3、T4的變化,通過對比研究數(shù)值的變化,驗證酸甘健運、清養(yǎng)化濁中藥對2型糖尿病患者體內(nèi)胰島素拮抗激素干預(yù)的優(yōu)勢,比較中西藥在干預(yù)2型糖尿病胰島素拮抗激素上的區(qū)別,指導(dǎo)中醫(yī)辨證施治。2方法2.1理論研究通過理論研究說明2型糖尿病患者體內(nèi)存在胰島素拮抗激素的變化,了解中醫(yī)對于2型糖尿病患者的病因病機(jī)的認(rèn)識,分析說明通過中西藥物的干預(yù),在治療2型糖尿病,起到降糖作用的同時,可以干預(yù)患者體內(nèi)的胰島素拮抗激素。2.2臨床研究將60例明確診斷為2型糖尿病的患者,隨機(jī)分成兩組,西藥組和中藥組,每組各30例,西藥組給予二甲雙胍聯(lián)合格列齊特緩釋片口服降糖治療,中藥組在西藥組的基礎(chǔ)上給予酸甘健運、清養(yǎng)化濁中藥顆粒劑配方?jīng)_服降糖治療,兩組統(tǒng)一療程為2個月。治療前后分別檢測兩組患者空腹血糖、餐后2小時血糖、糖化血紅蛋白、血清胰島素、C肽以及胰島素拮抗激素胰高血糖素、甲狀腺素T3、T4的變化。對比分析中西藥對于2型糖尿病患者胰島素拮抗激素的干預(yù)效果,分別計算兩組藥物治療的總有效率。3結(jié)果3.1理論研究結(jié)果理論研究證明了2型糖尿病患者體內(nèi)的胰島素拮抗激素會發(fā)生一定的變化,其中胰高血糖素相對于正常來說均有所升高,而在一定階段,甲狀腺素T3水平相對正常有所降低、T4則無明顯的差異,在此基礎(chǔ)上,通過中醫(yī)對于2型糖尿病的病因和病機(jī)的認(rèn)識,辯證論治,可以干預(yù)2型糖尿病的治療,影響患者體內(nèi)胰島素拮抗激素的變化,而中西藥在干預(yù)2型糖尿病體內(nèi)的胰島素拮抗激素時存在明顯的差異效果。3.2臨床研究結(jié)果臨床研究觀察表明,經(jīng)酸甘健運、清養(yǎng)化濁法配方的中藥治療2個月后的中藥組有效率為73.3%,而二甲雙胍聯(lián)合格列齊特緩釋片組治療的西藥組總有效率為56.7%,結(jié)果表明中藥組療效優(yōu)于西藥組(P0.05),酸甘健運、清養(yǎng)化濁中藥組和西藥組治療后患者的FPG、2hPG、HbA1c、INS、GC、C-Peptide、T3比治療前均有改善(P0.05-P0.01),而與西藥組相比GC、T3有顯著性差異(P0.05);酸甘健運、清養(yǎng)化濁中藥組和西藥組治療后GC較治療前有明顯降低(P0.05),與西藥組相比各項指標(biāo)均有顯著性差異(P0.05);酸甘健運、清養(yǎng)化濁中藥組和西藥組治療后T3較治療前有明顯升高(P0.05),與西藥組相比各項指標(biāo)均有顯著性差異(P0.05);酸甘健運、清養(yǎng)化濁中藥組治療后與治療前及西藥組同期相比均有明顯改善(P0.05)。中西藥對于2型糖尿病患者體內(nèi)胰島素拮抗激素均有干預(yù)作用,酸甘健運、清養(yǎng)化濁中藥對于2型糖尿病患者體內(nèi)胰島素拮抗激素的干預(yù)作用優(yōu)于傳統(tǒng)降糖西藥。4.結(jié)論酸甘健運、清養(yǎng)化濁中藥對2型D M患者體內(nèi)胰島素拮抗激素的干預(yù)效果優(yōu)于傳統(tǒng)西藥。傳統(tǒng)西藥通過調(diào)節(jié)患者的脂質(zhì)代謝水平,減少糖尿病患者胰島素抵抗現(xiàn)象,增加患者機(jī)體靶器官和組織細(xì)胞對于胰島素的敏感性,降低患者血糖,保存胰島B細(xì)胞的功能,解除大腦皮質(zhì)在緊張時患者體內(nèi)的各種升高血糖激素分泌的水平,通過此種方式,去達(dá)到降低血糖和干預(yù)2型糖尿病患者胰島素拮抗激素的水平,增強(qiáng)療效。酸甘健運、清養(yǎng)化濁中藥通過中醫(yī)辨證論治,采用中醫(yī)對于2型糖尿病的辨證分型,活血化瘀、健脾調(diào)肝、清養(yǎng)化濁,干預(yù)患者體內(nèi)的胰島素拮抗激素的水平,改善患者的中醫(yī)臨床癥狀,為2型糖尿病胰島素抵抗患者新的標(biāo)本兼治之法,由此組成的酸甘健運、清養(yǎng)化濁中藥在治療效果上明顯的優(yōu)于西藥,具有良好的治療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.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1
本文編號：2156213
[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.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1
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