| Purpose:To discuss the understanding of traditional Chinese medicine about type2diabetes mellitus complicating metabolic syndrome. Through clinical research, using the TangZhiQing Decoction to treat type2diabetes mellitus complicating metabolic syndrome. To observe the therapeutic efficacy of this decoction in treating type2diabetes mellitus complicating metabolic syndrome by the indexes such as clinical symptoms, BMI, Waist-hip ratio, blood pressure, blood glucose, blood lipid levels, FINS, ISI. Then evaluate its curative effect and safety, so as to guide its clinical application. By experiment research, to explore TangZhiQing effects on type2diabetes mellitus complicated with metabolic syndrome model rats blood lipid levels, insulin resistance and inflammatory cytokines and markers of oxidative stress.Methods:A randomized, controlled trial was conducted.The patients of type2diabetes mellitus complicating metabolic syndrome were randomly classified into two groups according to1:1pair matched.On the basic of normal treatment and western medicine,the patients of treated group were treated by Chinese medicine while the patients of controlled group were treated by normal treatment. Observing for3month and four weeks made up of a course of treatment.The observed indexes included curative effect indexes,such as clinical symptoms, BMI, Waist-hip ratio, blood pressure, blood glucose, blood lipid levels, FINS, ISI and so on.The complete data carries on statistics analysis by the SPSS19.0statistics software. Experiment research:in Fed with high fat and high sugar diet contain PTU based on low dose streptozotocin resulting in type2diabetes mellitus complicating metabolic syndrome rat model. After the successful model rats were divided into model group, TangZhiQing group, pioglitazone group and normal control group. After4weeks the rats were observed the following indicators:blood glucose, blood lipid levels, insulin resistance and inflammatory cytokines and markers of oxidative stress.Results:Clinical research:The diagnosis and included type2diabetes mellitus complicating metabolic syndrome patients with60cases.30cases of treated group, while30cases of controlled group. Prior treatment, the gender, age, course of disease of the two groups patients had no differeces.1.Symptoms and signs improvement:the treated group after treatment had a significant improvement. The symptoms improvement of the treated group was better than the controlled group (P<0.01).2.Blood glucose:the FBG, PBG of treated group and controlled group were significantly lower(P<0.01); After treatment, the FBG of the treated group had a significantly difference than controlled group(P<0.01).The PBG of treated group also had a difference than controlled group (P<0.05), The HbAlc of treated group also had a difference than controlled group (P<0.05).3. Improve lipid level:The TG, TC, LDL-C of the two groups were decreased, the HDL-C of them were elevated, compared with pre-treatment there is a remarkable statistically significant (P<0.01). And the treatment group had an advantage over the control group in TG, TC, HDL-C(P<0.01).4.BMI is lower in patients after treatment of two groups, but the difference had no statistically significant (P>0.05), BMI changes of treated group compared with the controlled group had no significant difference (P>0.05).The the WC, WHR of treatment group were decreased, compared with pre-treatment there is statistically significant (P<0.01). The WC, HC. WHR of control group and the HC of treatment group were not decreased after treatment(P>0.05). The descent of WC, WHR in treatment group had a statistically significant compared with control group(P<0.05).5.Reduce fasting insulin levels, improve insulin resistance:compared with fasting insulin levels and insulin sensitivity index, two groups of patients after treatment fasting insulin are reduced (P<0.05or P<0.01), changes in fasting insulin and insulin sensitivity index in the treated group had a difference than controlled group, the difference statistically significant (P<0.05).6.After treatment in patients with systolic blood pressure, diastolic pressure were decreased significantly, compared with before treatment had significant difference (P<0.01); the treatment group and the control group had no significant differences (p>0.05).7.safety index:The routine blood/urine/feces test, and the liver and kidney function tests of treated group were within the normal range.two groups had no unhealthy response.Experiment research:TangZhiQing group after treatment fasting glucose compared with the model groups with significant differences (p<0.05), compared with before treatment had significant difference (p<0.05). After treatment TangZhiQing group total cholesterol declined, compared with before treatment had significant differences (P<0.05), and compared with model group also had significant differences (p<0.05); After treatment TangZhiQing group rats TG significantly declined, compared with the model groups had significant differences(p<0.05); After treatment TangZhiQing group LDL-C level declined, compared with the model groups had significant differences (p<0.05). TangZhiQing group rats serum SOD and MDA after treatment compared with before treatment had significant difference (P<0.05), compared with the model groups also had significant difference (P<0.05). TangZhiQing group of fasting serum insulin level compared with before treatment had significant difference (P<0.05),compared with the model groups with significant differences (P<0.05). TangZhiQing group after treatment of inflammatory cytokines (CRP, and TNF-α)and model groups and comparison of pioglitazone group, statistically significant differences Conclusion:Through the preliminary clinical study, TangZhiQing Decoction has sure curative effected in treating type2diabetes mellitus complicating metabolic syndrome. From the angle of western medicine, it can reduce blood sugar and HbAlc, reduce blood lipid levels, improve glucose and lipid metabolism and insulin resistance, reduce abdominal obesity.And, most important, be safe and effective.It is worth studying deeply and developing further.Remarkable results have been achieved by TangZhiQing Decoction that control diabetes and improve metabolic syndrome.But because of my ability and conditions limited as a overseas student, there were small number of cases and simple observational items in this study. And further inestigations is required. Experimental study results on TangZhiQing Decoction suggest that TangZhiQing Decoction has lower blood sugar, blood lipids, glucose and lipid metabolism regulation, oxidative stress, improve insulin resistance and anti-inflammatory effect, but due to limitations, this research is still in the whole animal level and outcome measures is relatively simple, requires further in-depth and systematic discussion on molecular mechanism of TangZhiQing Decoction in treatment of diabetes mellitus. |
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