Study On Insulin Resistance Of Type 2 Diabetes Mellitus Treated By

With the development of modernization, lifestyle and diet, the incidence of type 2 diabetes is significantly increased. The pathogenesis of type 2 diabetes involves two aspects:insulin resistance and insulin secretion. The former which is associated closely with complications of diabetes,obesity,dyslipidemia, hypertension,atherosclerosis and other diseasesan is an important cause of the disease. IR has become a hot topic in today’s field of endocrinology.The classic definition of Insulin resistance is insulin with normal dose has less biological effects than the normal effects. Its common causes include obesity, lifestyle (diet, exercise,smoking), hyperglycemia,oxidative stress,inflammation,and so on.The pathogenesis is too complex to been fully elucidated. And it can be generally summarized as the defects of mechanism and functional from insulin in target tissues,cells,the pre-receptors, the post receptors and molecular and the disorders of the regulation of hormones from insulin action.Therapeutic methods of Modern medicine are regulating metabolism the glucose and lipid,increasing insulin sensitivity. It is widely known that the treatment has certain side effects,in addition,there are some limitations in improving the clinical symptoms and the life quality of patients.Much research and experiments with Chinese medicine to improve insulin resistance In recent years confirmed the unique advantages Of Chinese medicine in terms of improving insulin resistance. Professor Louxi En,based on summing up the experience of predecessors and integrating years of clinical experience,propose the major pathogenesis of obese patients with type 2 diabetes and insulin resistance are dampness due to spleen deficiency and phlegm heat inside the body and formulated the tonifying spleen, cleaning heat, reducing phlegm early intervenetion methods which are clinically effective.Objetive:Through observing and comparing the changes of TCM clinical symptom score, glucose, HbA1c, insulin, adiponectin, blood lipids, BMI, IRI and other laboratory parameters before and after the treatment with tonifying spleen, cleaning heat, reducing phlegm to evaluate the clinical efficacy of this early intervention methods;Safety of the particle is evaluated through observation of liver function test (ALT, AST), kidney function test(Cr, BUN),blood and urine routine test. And then lay the theoretical foundation for the promotion of clinical.Methods:68 patient of type 2 diabetes who met the inclusion criteria are randomly divided to treatment or control groups, including 32 patients in the treatment group and 30 patients in the control group effectively.At first they are all received lifestyle intervenetion (including diet control, physical exercise) on the basis of diabetes education, after 2 weeks of basic treatment,the trial observation period comes.The treatment group is given granule of traditional Chinese medicine with the basic treatment, and the control group,with the same basic treatment, is given glucophage. After 12 weeks of clinical treatment, collecting the TCM symptom score, FBG,2hPG, HbAlc, FINS,blood lipids,APN and other laboratory parameters,calculating BMI, IRI index of all the patients before and after treatment and these data are all statistically analyzed.Results:1 The comparison of the efficacy of TCM symptoms:the total effective rate of the treatment group was 87.50%,but in the control group, the total effective rate was 58.33%,there was a statistically significant between the two groups(P< 0.01).2 The comparison of glucose and lipid metabolism before and after treatment:FPG,2hPG, HbA1c of two groups both decreased significantly, the difference was statistically significant (P<0.01). TC, TG, LDL-C of two groups decreased and HDL-C increased,there were a statistically significant(P<0.01或P< 0.05). Between the two groups,the TC and LDL-C reduced more in the treatement groups5and the difference was statistically significant (P<0.01 或 P<0.05).3 The comparison of BMI, ISI, APN before and after treatment:With both treatment methods,BMI index decreased,fasting serum insulin decreased, and IRI index also decreased, and the clinical effect is significant (P<0.01) adiponectin. increased significantly after treatment in the treatment group. (P<0.01).4 During the test, the results of some subjects monitored which include the liver function (ALT, AST),renal function (Cr, BUN), and biood, urine routine were not find any adverse reactions.In conclusion:The early intervention methods of tonifying spleen,cleaning heat, reducing phlegm can significantly improve a variety of clinical symptoms of patients with type 2 diabetes and insulin resistance and improve quality of life, regulate glucose and lipid metabolism, dicreased BMI index, elevated serum adiponectin, eased insulin resistance. It aiso has the character of safe and reliable in clinical application.