Clinical Study On The Effect Of Shenqi Compound Dialectical On GLP-1 And Gg Expression In T2DM Patients With Large Vascular Lesions

Objective:To observe the improvement of symptoms and the vascular inflamatory factors adiponectin, clinic effect and an impact on the expression of serum GLP-1and Gg in type2diabetic patients with macrovascular disease, by way of ginseng-astragalus compound prescription.Methods:50patients with diabetic macrovascular complication were randomly divided into treatment group and control group. All patients were treated with basic treatment of diabets.Treatment group, while using the basic treatment plus TCM decoction ginseng-astragalus compound prescription in the principal of boosting qi and nourishing yin, transforming stasis and freeing the collaterals, every150ml,3times a day for12weeks; control group with the basic treatment of diabets. The patients’ symptoms, signs,blood glucose,HbAlc and dynamic changes of0h,0.5h,lh,2h,3h serum GLP-1,Gg,FINS in OGTT experiment before and after treatment were observed. And comprehensive efficacies were evaluated.Which Go, G30, G60, G120, G180will be respectively0,30,60,120,180min blood sugar levels in OGTT experiment;Which FINSo, FINS30, FINS6o, FINS120, FINS180will be respectively0,30,60,120,180min insulin levels in OGTT experiment;Which Glp-10, Glp-130, Glp-160, Glp-1120, Glp-1180will be respectively0,30,60,120,180min GLP-1levels in OGTT experiment;Which Gg0, Gg30, Gg60, Gg120, Gg180will be respectively0,30,60,120,180min Gg levels in OGTT experiment;Late insulin secretion index:(△FINS120/△G120)=(FINS120-FINS0)/(G120-G);Area under the curve (AUC) by using approximate trapezoid formula:180min AUC=(0min value+180min value)/2+30min value+60min value+120min value;Which Glp-1-AUC、Gg-AUC will be respectively area under the curve of Glp-1and Gg.Results:The clinical experiment results suggest that traditional Chinese medicine treatment group a total of25cases, including12cases had marked effect,12cases were effectively,1had no effect, the efficiency was48%, total effective rate was 96%;Control group a total of25cases, of which6cases were markedly effective, effective13cases,6cases ineffective, the efficiency of24%, the total effective rate was76%.and difference was statistically significant (P<0.05).Treatment group can significantly reduce the leveles of G0、G120and Gg0、Gg30、Gg-AUC, and increase the level of FINS0、FINS120、GLP-130、GLP-160and△FINS120/△G120、Glp-1-AUC. The difference of two groups was statistically significant (P<0.05).Treatment group significantly improved symptoms, signs, blood glucose and glycated hemoglobin of the patients.Conclusions:The method of boosting qi and nourishing yin, transforming stasis and freeing the collaterals can significantly improve the clinical symptoms, signs and can have better clinical therapeutic effect,and can also improve insulin-resistance and glucolipid metabolism,increase the level of GLP-1,promote the synthesis and secretion of insulin and reduce the level of Gg,thus can earlier prevent the occurrence and development of DA.