【作者】 赵昱； 仝小林； 刘素宾； 陈良； 王霞；

【Author】 zhaoyu,The general hospital of CAAC, Beijing 100083; Tong Xiaolin, GuangAnMen Hospital, China Academy of Traditional Chinese Medicine, Beijing 100053;Liu SuBin, First Hospital of BJMU, Beijing 100034;Chen Liang, Beijing University of Chinese, Beijing 100029;Wang Xia, Beijing Jishuitang Hospital,Beijing 100035.

【机构】 北京民航总医院； 中国中医科学院广安门医院； 北京大学第一医院； 北京中医药大学； 北京积水潭医院；

【摘要】 目的:探讨复方开郁清胃颗粒对不同血糖水平患者胰岛β细胞功能的影响以及不同浓度葡萄糖、血糖水平和β细胞功能之间的关系;方法:将受试者根据口服葡萄糖耐量试验(OGTT)2小时血糖(PBG)分为3组。第1组:7.8《PBG<11.1mmol/L;第2组::11.1《PBG<16.7mmol/L;第3组:PBG>16.7mmol/L。观察62例糖代谢异常患者在开郁清胃颗粒治疗前后体重及腰臀围、血糖、血脂、胰岛素敏感指数等指标的变化并用口服葡萄糖耐量试验(OGTT)数据(0’、30’、60’、120’、180’5点)评估β细胞功能:计算Homaβ细胞功能指数(HBCI)、糖负荷30分钟胰岛素增值与30分钟血糖增值的比值(?I30/?G30)及胰岛素曲线下面积(INSAUC);结果:①第1组、第2组患者在开郁清胃颗粒治疗前后体重及腰臀围、血糖、血脂明显改善,胰岛素敏感指数增加,而各点胰岛素(lNS)水平呈下降趋势,Homaβ细胞功能指数(HBCI)及反映β细胞早相分泌的指标?I30/?G30升高,胰岛素曲线下面积(INSAUC)减小。②第3组患者血糖、血脂下降,胰岛素敏感指数增加,而各点胰岛素(lNS)水平无明显变化,Homaβ细胞功能指数(HBCI)、?I30/?G30略有升高,而胰岛素曲线下面积(INSAUC)前后对照无统计学意义;结论:当PBG<16.7mmol/L开郁清胃颗粒通过降糖、降脂、增加胰岛素敏感性改善糖代谢异常患者β细胞功能,特别是对β细胞早相分泌较好的改善作用与糖负荷后两小时血糖的显著降低密切相关。当PBG>16.7mmol/L时,高浓度葡萄糖抑制胰岛素分泌,表现出葡萄糖毒性作用,β细胞功能受损明显,开郁清胃颗粒通过降糖减毒使β细胞功能有所恢复。更多还原

【Abstract】 Objective: To study the effect of Kaiyu Qingwei granule on the beta-cell function with different blood glucose levels’ patient,and and discuss relationship of different plasma glucose levels、bloody glucose and beta-cell function; Methods: subjects were divided into three groups by 2 h postprandial plasma glucose( PPG) ,the first group,7.8《PBG<11 .1 mmol/ L,the second group,11.1《PBG<16.7m mol/L,the third group,PBG>16.7 m mol/L. we surveyed the difference of body’s weights before and after clinical experiment, bloody glucose, fat of blood cholesterol, insulin sensibility index. Oral glucose tolerance test( OGTT)(0’、30’、60’、120’、180’five point) were conducted, then Boma β-cell function index( HBCI),Early-phase Insulin Secretion index(?I30/?G30)and insulin area undercurve(INSAUC) were calculated;Results: ①Kaiyu Qingwei granule curtails the first group and the second group patient’s bloody glucose, improves cholesterol, lessens the body weights, increases insulin sensibility index 、HBCI、?I30/?G30,decreases INSAUC and insulin of different time point. ②Kaiyu Qingwei granule curtails the third group patient’s bloody glucose, improves cholesterol, increases HBCI、?I30/?G30 a little,while INSAUC and insulin of different time point have no change; Conclusion: when PBG<16.7m mol/L, Kaiyu Qingwei granule improves beta-cell function ,especiall improves beta-cell function of Early-phase Insulin Secretion by curtailing bloody glucose 、lessening the body’s weights and increasing of insulin sensibility. when PBG>16.7 m mol/L,high-level glucose restrains beta-cell secreation insulin, indicating glucose toxicity does a lot of damage to beta-cell function,Kaiyu Qingwei granule improves beta-cell function a little by decreasing glucose toxicity.更多还原