摘要
目的比较2型糖尿病肥胖与非肥胖患者血流变学指标,探讨两组患者的血液流变学特性,并观察中药麻痛液对其的影响。方法符合1999年糖尿病诊断标准的住院2型糖尿病77例,根据有无肥胖,将所有糖尿病患者分为肥胖组与非肥胖组,用放射免疫分析法测定2组的空腹胰岛素,血脂、血糖测定用酶法,并据空腹血糖、空腹胰岛素计算胰岛素敏感性指数ISI=Ln(1/FINS.FBS),血流变学检查用普利生LBY-N6A自清洗旋转式粘度计。所有病例均用中药麻痛液足疗,观察治疗前后血液流变学的变化。结果肥胖组胰岛素敏感性指数低于非肥胖组、空腹血胰岛素、血尿酸、高于非肥胖组,肥胖的糖尿病患者,其血脂及血液流变学变化,TG及TC,均与非肥胖者比较有显著差异,但两组的APOA、APOB、LP(a)、LDL无显著差异。其全血粘度高切、低切均高于非肥胖者,而红细胞压积高于非肥胖者,差异显著。两组麻痛液足疗后血液流变学均有改善(P<0.05),但组间比较无显著性差异。结论肥胖的2型糖尿病患者存在明显的胰岛素敏感性减低、高胰岛素血症、高尿酸血症、高粘血症及脂代谢紊乱,提示改善肥胖本身、降低血粘度以及针对脂毒性的治疗在2型糖尿病综合治疗中的重要地位;中药麻痛液足疗能明显改善糖尿病患者的血液流变性,是一种安全有效的辅助治疗方法,值得临床推广。
Objective To compare the indices of hemorheology of the two groups of obese type 2 diabetic patients and non--obese type 2 diabetic patients, to explore the characteristics of the Traditional Chinese Medicine of Matong Liquid of the patients in the two groups, and to observe the effect of the Traditional Chinese Medicine of Matong Liquid on hemorheology of a patient, Methods 77 patients with type 2 diabetes in hospital were selected as the subjects for conducting the study, These patients were diagnosed in accordance with 1999 diagnosis standard for diabetes. Based on whether obesity accompanied or not, all the patients were divided into two groups, i.e. , the fatty group and the non--fatty group. For the two groups, fasting insulin was measured by immunoradiometric assay, and plasma glucose and lipid by enzyme assay. Insulin sensitivity index was Calculated with fasting plasma glucose （ FPG and fasting plasma insulin （Fins）, as follows： ISI = Ln （ 1/FINS · FBS）. Hemorheology was examined by LBY--N6A self--cleaning and rotating viscosity meter from Pu Li Sheng Company. All the eases were accepted the foot therapy with the traditional Chinese medicine of Matong liquid, and the Hemorheologieal change before and after the treatment was observed. Results The insulin sensitivity index in the fatty group was lower than that in the nonfatty group. The fasting plasma insulin and the plasma uric acid in the fatty group were higher than those in the non fatty group, respectively. The obese diabetic patients showed a significant difference on plasma lipid level, the Hemorheologieal change, TG and TC compared with the non--obese patients. However, there was no significant difference between the two groups on APOA, APOB, LP（a） and LDL. The measurements of the whole blood high shear viscosity and the whole blood high shear viscosity obtained from the obese diabetic patients were higher than these obtained from the non--obese diabetic patients. But the packed cell volume （PCV） of the obese diabetic patients was higher than that of the non--obese diabetic patients, with a significant difference. After the foot therapy with Matong Liquid, the hemorheology of the patients in the two groups was improved （P 〈0.05）. But, the comparison between the groups showed that there was not a significant difference. Conclusions The obese type 2 diabetic patients showed a significant decrease of insulin sensitivity, hyperinsulinism, hyperuricaemia, hyper--viscosity of blood and lipid metabolic disorder. This suggests that the treatment with the aims of improving obesity per se, lowering blood viscosity and fighting again the toxicity of lipid will play a key role in the complex therapy for type 2 diabetes mellitus. The therapy with the traditional Chinese medicine of Matong liquid can largely improve the hemorheology of the diabetic patients, which is a safe and effective adjuvant useful in the treatment of diabetes and is worthy of being clinically spread.
出处
《现代护理》
2006年第7期592-594,共3页
Modern Nursing
关键词
糖尿病
肥胖症
血脂
血流变学
麻痛液
diabetes mellitus
obesity
blood lipid
hemorheology
Matong Liquid
