目的 探讨白藜芦醇软胶囊对2型糖尿病患者血糖变异及胰岛素抵抗的影响。方法 采用随机数字表法将2型糖尿病80例分为A、B、C、D 4组:每组20例, A、B、C组在基础治疗上加白藜芦醇软胶囊。其中,A组: 250 mg/次,口服,2次/d;B组: 350 mg/次,口服,2次/d;C组:500 mg/次,口服,2次/d,治疗12周;D组为对照组(基础治疗);检测空腹血糖(FPG)、空腹胰岛素(FISN)糖化血红蛋白(HbA₁c)、血脂、胰岛素及三餐2h后血糖,计算MBG、血糖波动参数、胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(ISI)。结果 C组和D组治疗前后各值均数差F各值均数差FPG:[(1.54±0.06) mmol/L vs (0.45±0.01) mmol/L,t=4.562, P=0.037)];FISN:[(4.85±0.35) pmol/ml vs (0.76±0.13)pmol/ml,t=3.467,P=0.025];HbA₁c:[(1.01±0.36)% vs(0.24±0.07)%,t=3.724,P=0.031];平均血糖值:[(1.91±0.22) )mmol/L vs (0.33±0.03) mmol/L,t=4.823, P=0.026]; 血糖变异性:[(1.22±0.23)mmol/L vs(0.07±0.03) mmol/L, t=4.025,P=0.027];血糖标准差:[(0.88±0.12)vs(0.02±0.01),t=3.681,P=0.032]较治疗前明显下降。C组治疗前后HOMA-IR由2级均降至1级、ISI的改善C组优于D组(P<0.01)。结论 白藜芦醇软胶囊对血糖变异及胰岛素抵抗与剂量相关,一定剂量的白藜芦醇软胶囊可降低2型糖尿病患者的平均血糖波动度、血糖标准差,减少HOMA-IR,提高ISI;2型糖尿病患者在服用降糖药的同时,联合服用白藜芦醇软胶囊治疗是较好的选择。

Objective To explore the effect of resveratrol soft capsules on glucose variability in patients with type 2 diabetes and on insulin resistance.Methods Using the random number table method, 80 patients with type 2 diabetes were equally divided into four groups.Group A, B and C were given resveratrol soft capsules for twelve weeks plus conventional treatment. Group A orally took resveratrol soft capsules 250 mg twice a day, Group B 350 mg, Group C 500 mg,while Group D served as the control group (conventional treatment).Fasting blood glucose, blood lipids, insulin and serum glucose 2h after meals were detected. MBG, serum glucose fluctuation parameters, the index of insulin resistance (HOMA IR) and insulin sensitive index (ISI)were calculated.Results FPG in Group C and Group D before and after treatment was[(1.54±0.06)mmol/L vs (0.45±0.01)mmol/L,t=4.562,P=0.037) ]respectively, FISN was[(4.85±0.35) pmol/ml vs (0.76±0.13)pmol/ml,t=3.467,P=0.025] respectively,and HbA₁c was[(1.01±0.36)% vs(0.24±0.07)%,t=3.724,P=0.031]respectively. The average serum glucose value was[(1.91±0.22)mmol/L vs (0.33±0.03) mmol/L,t=4.823,P=0.026]respectively,serum glucose variability was[(1.22±0.23)mmol/L vs (0.07±0.03)mmol/L,t=4.025,P=0.027]respectively, and serum glucose standard deviation was[(0.88±0.12) vs (0.02±0.01),t=3.681,P=0.032]. After treatment,HOMA IR in Group C was reduced from Grade Two to Grade One, and the ISI of Group C improved more significantly than that of Group D (P<0.01).Conclusions A particular dose of resveratrol soft capsules can reduce the average serum glucose, daytime serum glucose fluctuations,standard deviations of serum glucose and HOMA IR while improving ISI in patients with type 2 diabetes.Patients with type 2 diabetes should take resveratrol soft capsules in combination with other antidiabetic drugs.