【摘要】 目的观察盐酸小檗碱治疗2型糖尿病的临床疗效及其可能的作用机制。方法选择在上海市徐汇区中心医院2007年10月—2010年1月确诊为2型糖尿病的门诊或住院患者100例。随机分成治疗组(49例)和对照组(51例),治疗组予盐酸小檗碱0.3g,每日3次,口服2个月,已用其他降糖药者原药剂量不变。对照组除不予盐酸小檗碱治疗外,其余治疗方案同治疗组。检测两组患者在实验结束后的脂联素(AN)、肿瘤坏死因子(TNF)-α及游离脂肪酸(FFA)水平。结果两组治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)均较治疗前显著降低(P值分别<0.05、0.01)。治疗后,治疗组的FPG、2hPG、HbA1c、空腹胰岛素(FINS)、HOMA-IR、ISI与对照组的差异均有统计学意义(P值分别<0.05、0.01)。与对照组比较,治疗组的AN水平显著升高(P<0.01),TNF-α、FFA水平均显著降低(P值均<0.05)。结论盐酸小檗碱对2型糖尿病胰岛素抵抗有一定的临床疗效,其机制可能是增强2型糖尿病患者AN的分泌,抑制TNF-α、FFA的致炎作用。更多还原

【Abstract】 Objective To explore the clinical efficiency and potential mechanism of berberine hydrochloride on type 2 diabetes mellitus.Methods A total of 100 cases with type 2 diabetes mellitus,who were outpatients or hospitalized from October 2007 to January 2010 in our hospital,were enrolled in this study and then were randomized into treatment group(A group,49 cases) and the control group(B group,51 cases).Berberine hydrochloride was orally administered in the patients of A group at the dose of 0.3 g tid for 2 months.No other change was made to their ordinary hypoglycemic prescription.The control group received same treatment regime without berberine hydrochloride.At the end of treatment,serum levels of adiponectin,tumor necrosis factor-alpha(TNF-α),and free fatty acid in both groups were measured.Results Both group A and the control group had significantly decreased serum level of fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),hemoglobin A1c(HbA1c),and reduced homeostasis model of assessment-insulin resistance(HOMA-IR) and insulin sensitivity index(ISI) after the treatment(P<0.05,0.01).Significant differences were found in FPG,2hPG,HbA1c,FINS,HOMA-IR and ISI between the A group and the control after treatment(P<0.05 or 0.01).Compared to the control,A group has higher serum level of adiponectin(P<0.01) and lower levels of TNF-α and free fatty acids(FFA,P<0.05).Conclusion Berberine hydrochloride shows good efficiency in treatment of type 2 diabetes mellitus,which might be through improving the secretion of adiponectin and inhibiting the phlegmonosis induced by TNF-α and FFA.更多还原