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目的比较不同干预方法对糖耐量减低(impaired glucose tolerance,IGT)胰岛素抵抗和胰岛β细胞功能的影响。方法选取深圳市5个区社区健康中心、体检中心、门诊及病房IGT患者382例,按照干预方案分为对照组、饮食加运动组、阿卡波糖组、二甲双胍组和中药组,各组进行相应的干预方案。受试者分别于干预前后测定身高、体重、血糖、胰岛素(INS)、C肽等,并计算体重指数、胰岛素抵抗指数和β细胞功能。结果5年末,饮食运动组胰岛素、F-CP、IR及其他干预组FPG、2hPG、胰岛素、C肽、IR均明显低于干预前(P<0.05),饮食运动组FPG、2hPG、胰岛素、C肽、IR显著低于对照组(P<0.05)。二甲双胍组、阿卡波糖组FPG、2hPG、胰岛素、F-CP、IR显著低于对照组及饮食运动组,且阿卡波糖组P-CP也明显低于对照组及饮食运动组(P<0.05)。中药组FPG、2hPG明显低于对照组,但FPG高于阿卡波糖组和二甲双胍组,2hPG高于阿卡波糖组,差异有统计学意义(P<0.05),F-Ins、P-Ins、F-CP、IR明显低于对照组,但F-Ins和P-Ins及IR显著高于二甲双胍组和阿卡波糖组(P<0.05),中药组P-Ins低于饮食运动组,且有统计学意义(P<0.05)。结论二甲双胍、阿卡波糖、中药及饮食运动都能有效降低IGT患者胰岛素水平、F-CP及IR,但在改善IR方面,二甲双胍及阿卡波糖效果比中药和饮食运动好(P<0.05)。
Objective To compare the effects of different interventions on impaired glucose tolerance (IGT) insulin resistance and pancreatic β-cell function. Methods 382 cases of community health center, medical examination center, outpatient department and ward IGT patients in 5 districts of Shenzhen were selected and divided into control group, diet plus exercise group, acarbose group, metformin group and TCM group according to the intervention program. Corresponding intervention program. Subjects were measured before and after intervention in height, weight, blood glucose, insulin (INS), C-peptide, and calculated body mass index, insulin resistance index and β-cell function. Results At the end of the five-year period, FPG, 2hPG, insulin, C-peptide and IR of insulin group, F-CP group, IR group and other intervention groups were significantly lower than those before intervention (P < Peptide, IR significantly lower than the control group (P <0.05). FPG, 2hPG, insulin, F-CP and IR in metformin group and acarbose group were significantly lower than those in control group and dietary exercise group, and P-CP in acarbose group was significantly lower than that in control group and dietary exercise group <0.05). FPG and 2hPG in Chinese medicine group were significantly lower than those in control group, but FPG was higher than that in acarbose group and metformin group, 2hPG was higher than acarbose group, the difference was statistically significant (P <0.05), F-Ins, P- Ins, F-CP and IR were significantly lower than those in the control group, but F-Ins, P-Ins and IR were significantly higher than those of metformin and acarbose (P <0.05) , With statistical significance (P <0.05). Conclusions Metformin, acarbose, Chinese medicine and dietary exercise can effectively reduce the insulin level, F-CP and IR in patients with IGT, but metformin and acarbose are better than traditional Chinese medicine and diet in improving IR (P <0.05 ).