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1、提要目的：观察以益气健脾化痰活血法对糖耐异常患者(IGT)的临床干预疗效并探讨其作用机制。方法：采用双盲对照治疗组30例予益气健脾化痰活血汤（中药按1:5的容积比用水浸泡30min，煎煮40min，煎煮两次，滤取两次煎液约300m1，早中晚各一次温服，日一剂)。对照组30例，在同样条件下给予二甲双胍750mg/d，口服。两组均以40天为一个疗程，观察2个疗程。所有病例治疗前后观查空腹血糖,空腹胰岛素,血脂,糖化血红蛋白,OGTT试验,测定2h血糖,胰岛素，血尿便常规，肝肾功测定，心电图检查，症状体征变化。所有病例均2个疗程后做出疗效评估。结果：治疗组干预后空腹血糖,空腹胰岛素,血脂,
2、糖化血红蛋白,测定2h血糖,胰岛素，血尿便常规，肝肾功测定，心电图检查，症状体征变化等较前有明显改善，与对照组比较有显著性差异。试验期间未发现不良反应。一年后随访治疗组糖尿病转化率明显低于对照组。结论：益气健脾化痰活血法联合干预方式对IGT患者疗效显著，可以降糖、调脂；改善胰岛素抵抗；能明显改善IGT患者的临床症状；较好地逆转IGT及延缓IGT发展成DM的进程，并且用药安全，证明了中医药辨证论治的有效性和可行性，正确运用中医辩证论治对改善糖耐量具有很广阔的前景。关键词糖耐量减低；益气健脾化痰活血法；临床研究Invigoratethespleenyiqiphlegmmethodofre
3、sistanceinpatientswithabnormalsugar(IGT)clinicalinterventionSpecialty:InternalMedicineofTraditionalChineseMedicineAuthor:XuWenTutor:Prof.XuYunshengAbstractObjective:toobservethespleenyiqiphlegmmethodofresistancetoabnormalbloodsugar(IGT)patientswithclinicalcurativeeffectofinterventionanddiscusst
4、hemechanism.Methods:thedouble-blindcontrolledthetreatmentgroup20casestothespleenyiqiphlegmhuoxuesoup(accordingtothevolumeoftraditionalChinesemedicinewhichthanwaterfor30min,decoction40min,decoctiontwice,filtertaketwotimesFriedliquidabout300m1,earlyonetimeinthemiddleoftemperatureuniform,dayoneage
5、nt).20casesofcontrolgroup,underthesameconditionsgivemetformin25mg/d,oral.Bothgroupsto40daysforaperiodoftreatment,observetwotreatment.Allcasesbeforeandaftertreatmentobservationfastingplasmaglucoseandfastinginsulin,bloodfat,glycatedhemoglobin,OGTTtest,measure2hbloodglucose,insulin,hematuriaandcon
6、ventional,liverandkidneyfunctionmeasurement,ecg,symptomsandsignschange.Allcasesweretwomadeaftertreatmentefficacyevaluation.Results:aftertreatmentgroupinterventionfastingbloodglucoseandfastinginsulin,bloodfat,glycatedhemoglobin,2h,determinationofglucose,insulin,hematuriaandconventional,liverandk
7、idneyfunctionmeasurement,ecg,symptomsandsignschangebeforeahasobviouslyimproved,andthecontrolgroupwassignificantdifference.Duringthetestwasnotfoundtoadversereactions.Afterafollow-uptreatmentgroupdiabetesconversionratewassignificant
