摘要
目的探讨2型糖尿病患者非糖尿病一级亲属的β细胞功能状态、胰岛素抵抗和中医症证特点。方法以2型糖尿病患者非糖尿病一级亲属68例为观察组,45例性别、年龄、体重指数(BMI)与之匹配的无糖尿病家族史的健康人为对照组,比较两组口服75g葡萄糖耐量试验(OGTT)中空腹血糖(FBG)、2h血糖(2hPG)、空腹胰岛素(FINS)及2h胰岛素(2hINS),并计算比较两组稳态模型胰岛素抵抗指数(HOMAIR)、β细胞功能指数(HOMAβ)、胰岛素敏感指数(ISI),比较两组中医症证,分析一级亲属组症证特点。结果观察组FBG、FINS明显高于对照组(P<0.01),而2hPG和2hINS两组比较差异无显著性(P>0.05)。观察组HOMAIR、HOMAβ显著高于对照组(P<0.05),ISI明显低于对照组(P<0.01)。与对照组比较,一级亲属组舌质紫暗、神疲乏力、脉弦细和腰膝酸软症状多见,辨证属气阴两虚证占51.47%,阴虚证占30.88%,瘀血为主要兼证占61.76%。结论2型糖尿病患者非糖尿病一级亲属具有较高的β细胞分泌功能和低胰岛素敏感性,存在胰岛素抵抗,中医症证特点为气阴两虚,瘀血内阻。
Objective To study the function of pancreatic islet β cells, insulin resistance （IR） and features of TCM symptoms and syndromes in the non diabetic first-grade relatives （ND1GR） of patients with type 2 diabetes mellitus （DM2）. Methods A total of 68 ND1GR of DM2 patients were enrolled in the observed group and 45 healthy subjects with matched sex, age and body mass index （BMI） but without family history of DM were selected into the control group. Levels of fasting blood glucose （FBG）, 2 hrs postprandial glucose （2hPG）, fasting insulin （FINS） and 2 hrs postprandial insulin （2h INS） in all the subjects were measured to calculate and compare the IR and beta-cell function of the homeostatic model analog （HOMA-IR and HOMA-β）, and the insulin sensitive index （ISI）. Moreover, the symptoms manifested in the ND1OR were also observed to analyze the features in them. Results FBG and FINS were obviously higher in the observed group than those in the control group （P〈0.01）, while no significant difference was found in 2hPG or 2h INS （P 〉0.05）. HOMA-IR and HOMA-β were significantly higher （P 〈 0.05 ） and ISI were significantly lower （P 〈 0.01 ） in the observed group than those in the control group. Compared with the control group, the main symptoms such as dark purplish tongue, listlessness, thready and thin pulse, lassitude in loin and legs in the observed group were seen more frequently. In the observed group syndrome of deficiency of Qi and Yin accounted for 51.47% , syndrome of deficiency of Yin for 30.88 % , subjects with syndrome of blood stasis as the main accompanying syn- drome accounts for 61.76 % , Conclusion Higher β cell secretion function and lower insulin sensitivity appear in ND1GR of DM2 patients, suggesting the existence of insulin resistance. The feature of TCM syndrome in them is characterized by deficiency of Qi and Yin with inner obstruction of blood stasis.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2005年第12期1089-1091,共3页
Chinese Journal of Integrated Traditional and Western Medicine
基金
深圳市科技局课题(No.200405158)
关键词
2型糖尿病
一级亲属
β-细胞功能状态
中医症证
type 2 diabctes mellitus
first-gradc relatives
condition of β cell function
traditional Chinese medicinal symptoms and syndromes
作者简介
通讯作者：董彦敏，Tel：0755-81370968，E-mail：freebirddym@21cn.com
