目的 观察补肾抗衰片治疗肾虚痰瘀型2型糖尿病胰岛素抵抗的临床疗效。方法 选取2013年7月—2014年9月在天津中医药大学第一附属医院就诊的肾虚痰瘀型2型糖尿病胰岛素抵抗患者80例, 随机分为对照组和治疗组, 每组40例。对照组给予常规治疗方案。治疗组在对照组治疗基础上口服补肾抗衰片, 6片/次, 3次/d。两组均连续治疗8周。观察两组患者的临床疗效, 同时比较两组治疗前后空腹血糖(FBG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbA1c)、空腹胰岛素及胰岛素抵抗指数(IRI)的变化。结果 治疗后, 对照组和治疗组总有效率分别为85.0%、97.5%, 两组比较差异具有统计学意义(P<0.01)。治疗后, 治疗组FBG、2hPBG、HbA1c、空腹胰岛素、IRI均明显下降, 与同组治疗前比较差异有统计学意义(P<0.05), 且治疗后治疗组这些观察指标明显低于对照组(P<0.05)。结论 补肾抗衰片治疗肾虚痰瘀型2型糖尿病胰岛素抵抗具有较好的临床疗效, 不仅能改善患者糖代谢, 还能增加胰岛素敏感性, 改善胰岛素抵抗, 为临床治疗肾虚痰瘀型2型糖尿病胰岛素抵抗提供理论支持。

Objective To investigate the efficacy of Bushen Kangshuai Tablets in treatment of type 2 diabetes mellitus with insulin resistance of kidney deficiency and stagnant phlegm syndrome. Methods Patients (80 cases) with type 2 diabetes mellitus with insulin resistance of kidney deficiency and stagnant phlegm syndrome in First Affiliated Hospital of Tianjin University of TCM from July 2013 to September 2014 were randomly divided into control and treatment groups. Each group had 40 cases. Patients in control group were given conventional treatment. Patients in treatment group were po administered with Bushen Kangshuai Tablets on the basis of control group, 6 tablets/time, three times daily. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and the changes of FBG, 2hPBG, HbA1c, fasting insulin, and IRI in two groups were compared. Results The efficacies in the control and treatment groups were 85.0% and 97.5%, respectively, and there were differences between two groups (P < 0.05). After treatment, FBG, 2hPBG, HbA1c, fasting insulin and IRI in treatment group were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Bushen Kangshuai Tablets has the good clinical effect in treatment of type 2 diabetes mellitus with hyperlipidemia of kidney deficiency and stagnant phlegm syndrome, and not only can improve glucose metabolism, but also can increase insulin sensitivity, and can improve insulin resistance, which can provide theoretical support for clinical treatment of type 2 diabetes mellitus with insulin resistance of kidney deficiency and blood stasis syndrome.

国家自然科学基金面上项目(30973728)