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目的研究复方番石榴制剂对超重肥胖2型糖尿病患者胰岛素抵抗的影响。方法选取广州中医药大学附属中山医院诊治的超重肥胖2型糖尿病患者120例,将入组患者随机分为2组,治疗组予复方番石榴制剂联合二甲双胍肠溶片,对照组予二甲双胍肠溶片,两组均用药12周,于治疗前、治疗12周后分别记录其空腹血糖(FBG)、餐后2h血糖(P2BG)、糖化血红蛋白(Hb A1c)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、脂联素(APN)、C-反应蛋白(CRP)、空腹胰岛素(FINS)等指标,根据公式计算患者胰岛素分泌指数(HOMA-β),并对以上指标进行统计学分析。结果治疗组治疗后FBG、P2BG、Hb A1c、TC、TG、LDL-C、CRP较治疗前明显下降(P<0.05);两组比较,治疗12周后治疗组患者的FBG、P2BG、Hb A1c、TC、TG、LDL-C与对照组比较有显著性差异(P<0.05),但CRP与对照组比较无显著性差异(P>0.05);治疗后,两组的FINS、HOMA-β、APN均有一定程度的上升,治疗组治疗前后比较,差异有统计学意义(P<0.05),两组治疗后比较,差异亦有统计学意义(P<0.05)。结论复方番石榴制剂联合二甲双胍具有较好的降糖、降脂作用,且能改善胰岛素抵抗。其对脂联素水平的调控可能是纠正胰岛素抵抗的重要机制。
Objective To study the effects of compound guava preparations on insulin resistance in overweight and obese type 2 diabetic patients. Methods 120 cases of overweight and obesity type 2 diabetes diagnosed and treated in Zhongshan Hospital Affiliated to Guangzhou University of Chinese Medicine were randomly divided into two groups. The treatment group was treated with guava preparations combined with metformin enteric-coated tablets and the control group with metformin enteric-coated tablets (FBG), 2h postprandial blood glucose (P2BG), Hb A1c, cholesterol (TC) and triglyceride (TG) were recorded before treatment and 12 weeks after treatment, ), LDL-C, HDL-C, APN, CRP and FINS were calculated according to the formula Secretion index (HOMA-β), and the above indicators for statistical analysis. Results After treatment, FBG, P2BG, Hb A1c, TC, TG, LDL-C and CRP in treatment group were significantly decreased compared with those before treatment (P <0.05); FBG, P2BG, Hb A1c TC, TG, LDL-C had significant difference compared with the control group (P <0.05), but there was no significant difference between the CRP and the control group (P> 0.05). After treatment, the FINS, HOMA- APN increased to a certain extent. There was significant difference between the two groups before and after treatment (P <0.05). There was also significant difference between the two groups after treatment (P <0.05). Conclusion Compound guava preparation combined with metformin has good hypoglycemic and lipid-lowering effects, and can improve insulin resistance. Its regulation of adiponectin level may be an important mechanism to correct insulin resistance.