玉竹提取物胶囊对餐后血糖影响的临床研究

【作者】 梁凡；

【导师】 刘铜华；

【作者基本信息】 北京中医药大学 ， 中医内科学， 2008， 硕士

【摘要】 本论文分为文献综述和临床研究两部分。其中,文献综述包括单味中药治疗糖尿病的研究进展和玉竹的现代研究进展;临床研究为玉竹提取物胶囊对餐后血糖影响的临床研究。单味中药治疗糖尿病的研究进展包括临床研究和实验研究。临床研究主要论述了单味中药在临床中治疗糖尿病的情况;实验研究主要论述了单味中药有效化学成分的研究和作用机制的研究。说明单味中药降糖机理呈现多渠道、多途径的特点,是高效、低毒、又能防治并发症的药物,对于预防和治疗糖尿病都有实际的意义,具有很大的优势和很大的开发研究价值。玉竹的现代研究进展主要论述了常用中药玉竹在古代文献方面的研究;玉竹的性味归经、四气五味和生物学特征;现代医学对玉竹的化学成分、药理作用的研究;玉竹活性成分及其复方在临床糖尿病中的应用。玉竹多糖是玉竹的主要有效成分,运用多糖的降糖作用对预防和治疗糖尿病的意义,及玉竹所具有巨大的开发前景。糖尿病患者餐后血糖的升高是引起胰岛素敏感性降低,加重病情并可能导致严重并发症的主要原因之一,在糖尿病的发病过程中占有重要地位。如何有效的控制餐后高血糖是防治糖尿病及其并发症的一个重要的措施。本课题研究的目的:观察玉竹提取物对餐后血糖的影响探讨其是否具有即时降糖效应以及玉竹的可能降糖机理,为临床应用提供依据和参考。方法:试验一:从病房中选取了60例2型糖尿病患者,随机分为两组,即高剂量组和低剂量组,每组30例患者。高剂量组给予4粒玉竹提取物胶囊(相当于生药玉竹30克),低剂量组给予2粒玉竹提取物胶囊(相当于生药玉竹15克)。在患者空腹血糖控制在12mmol/L以内的前提下,在现有的治疗上,两组患者空腹服用一次玉竹提取物胶囊。试验二:另择30例健康受试者为正常对照组,给予4粒玉竹提取物胶囊(相当于生药玉竹30克)。治疗前后监测患者的一般情况、空腹血糖和餐后2小时血糖。本研究采用SAS8.2统计软件进行统计,计量资料采用t检验,计数资料用X2检验。结果:高剂量组治疗后血糖差值减少,与治疗前比较无显著统计学差异(P>0.05);低剂量组治疗后血糖差值增大,与治疗前比较无显著统计学差异(P>0.05);两组治疗后血糖差值比较无显著统计学差异(P>0.05);正常对照组治疗后血糖差值无明显变化,与治疗前比较无显著统计学差异(P>0.05)。高剂量组有降低2hPG的趋势。结论:高剂量的玉竹提取物胶囊有降低2型糖尿病患者餐后血糖的趋势,尤其是对气阴两虚兼内热型疗效较明显;低剂量的玉竹提取物胶囊没有降低糖尿病患者餐后血糖的趋势;玉竹提取物胶囊对健康受试者的血糖基本没有影响。更多还原

【Abstract】 Review of this paper is divided into two parts and clinical research. The literature review, including single herbs treatment of diabetes research progress and Polygonatum odoratum progress of the modern research, clinical research Polygonatum odoratum extract capsules postprandial blood glucose for diabetes Clinical study of the effects.Single Herb progress in the treatment of diabetic research including clinical research and experimental study. Clinical research focuses on the single Chinese herb in the clinical treatment of diabetes mellitus; experimental study focuses on the single Chinese herb effective research and the chemical constituents of the mechanism of the study. Sheets Herb hypoglycemic mechanism has multi-channel, multi-channel characteristics, is a high-performance, low toxicity, but also the prevention and treatment of complications drugs for the prevention and treatment of diabetes has practical significance, and it is very much the advantages and Research and Development value.Polygonatum odoratum modern research focuses on the progress odoratum used in the ancient Chinese literature studies; Polygonatum odoratum of herbs by the four gas Five and biological characteristics of modern medicine on the chemical composition of Polygonatum odoratum, and the role of pharmacological studies; Polygonatum odoratum active ingredient in the compound and the application of clinical diabetes. Polygonatum odoratum polysaccharide Polygonatum odoratum is the main active ingredient, the use of polysaccharide hypoglycemic effect the prevention and treatment of diabetic significance, and the Yuzhu with great prospects of development.Postprandial glucose in patients with diabetes is the cause of the increased insulin sensitivity decreased, increased illness and could lead to serious complications one of the main reasons, the incidence of diabetes in the process occupies an important position. How effective control postprandial hyperglycemia of diabetes and its complications is an important measure. The purpose of this research: To observe the Yuzhu extract on the impact of postprandial glucose whether it has immediate effect and Yuzhu hypoglycemic possible hypoglycemic mechanism for the clinical application and provide the basis for reference. Methods: Test 1: Select from the wards of the 60 cases of diabetic patients were randomly divided into two groups, namely high-dose group and low dose groups, each with 30 patients. High-dose group were given four Yuzhu extract capsules (equivalent to 30 grams of Health drug Yuzhu), low-dose group were given two Yuzhu extract capsules (equivalent to 15 grams of Health drug Polygonatum odoratum). In patients with impaired fasting glucose control in 12 mmol / L within the premise of the existing treatment, the patients were taking a fasting Yuzhu extract capsules. Test 2: choose another 30 healthy subjects for the control group, for four Yuzhu extract capsules (equivalent to 30 grams of Health drug Polygonatum odoratum). Before and after treatment with monitoring the general situation, fasting plasma glucose and postprandial glucose two hours. This study used statistical software SAS8.2 statistics, the measurement data using t-test, count information with the X2 test. Results: high-dose group after treatment to reduce blood sugar margin, and before treatment showed no significant statistical difference (P> 0.05); low-dose group after treatment margin increased blood sugar, and the treatment showed no significant statistical difference (P> 0.05) after the two groups of blood glucose margin no significant statistical difference (P> 0.05); normal blood sugar control group after treatment had no significant changes in the margin, and the treatment showed no significant statistical difference (P> 0.05). High-dose group decreased 2 hPG trend. Conclusion: high doses of Yuzhu extract capsules have lower blood sugar in diabetic patients with postprandial trend, especially for heat-Qiyinliangxu and more obvious effect of low doses of Yuzhu extract capsules did not lower blood sugar in diabetic patients with postprandial Trends; Yuzhu extract capsule on healthy volunteers did not affect the basic blood sugar.更多还原