相关链接：研究表明金芪降糖片能有效治疗2型糖尿病，与西药联合应用能明显改善糖尿病患者的血糖和血脂及胰岛素抵抗，但它对血管内皮细胞的功能与作用报道甚少。

应用要点：本文结果证实金芪降糖片可通过降低糖尿病患者血浆中血管内皮细胞活性因子水平，起到保护血管内皮细胞作用，并有效延缓糖尿病合并症的发生和发展。

同行评价：文章观察中西医结合治疗前后糖尿病患者血中多种血管内皮细胞因子水平的变化，了解金芪降糖片对于血管内皮细胞的功能与作用，具有一定创新性。


摘要
目的:细胞因子可作用于血管内皮细胞，在糖尿病的血管病变中起重要作用。通过观察金芪降糖片治疗前后血管内皮细胞损伤相关因子的变化，探讨金芪降糖片对糖尿病患者血管内皮细胞活性因子的影响及临床应用价值。
方法：①对象：选择2005-03/2006-09在解放军济南军区总医院内分泌科就诊的2型糖尿病患者63例；金芪降糖片由天津中新药业隆顺榕制药厂生产。②分组：患者随机被分为两组：对照组30例，男19例，女11例，平均年龄（56.6±8.9）岁；金芪组33例，男20例，女13例，平均年龄（58.4±7.7）岁。③给药：对照组用常规西药双胍类等降糖药物治疗；金芪组在西药治疗基础上加服金芪降糖片8片，3次/d，连续治疗3个月。④评估：采用ELISA检测两组患者治疗前后血浆中内皮素1、可溶性细胞间黏附分子1、可溶性P-选择素和肿瘤坏死因子α内皮细胞活性因子水平，以及血糖、血脂、糖基化血红蛋白等各项指标的变化。
结果：63例患者全部进入结果分析。①与治疗前比较，治疗后金芪组血糖和血脂、糖基化血红蛋白均有显著变化（P < 0.05），对照组仅血糖有明显变化（P < 0.05）；与对照组治疗后比较，金芪组血糖、三酰甘油、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇都有明显改善（P < 0.05）。②与治疗前比较，金芪组治疗后患者血浆中细胞因子水平均显著降低（P < 0.05或P < 0.01），对照组4项指标水平皆无明显变化（P > 0.05）；与对照组治疗后比较，金芪组患者血浆中内皮素1、可溶性细胞间黏附分子1、可溶性P-选择素和肿瘤坏死因子α水平均显著降低（P < 0.01）。
结论：①金芪降糖片可通过降低糖尿病患者血浆中血管内皮细胞活性因子水平，起到保护血管内皮细胞的作用。②中西医结合治疗糖尿病，能有效地延缓糖尿病合并症的发生和发展。
关键词：中药疗法；糖尿病；胞间粘附分子1；P选择素；肿瘤坏死因子α

徐军，齐法莲，陈英剑，尹秋霞，克丙申，胡成进.糖尿病患者血管内皮细胞活性因子变化：接受金芪降糖片干预的效应[J].中国组织工程研究与临床康复，2008，12(11):2025-2028 [www.zglckf.com/zglckf/ejournal/upfiles/08-11/11k-2025(ps).pdf]

Changes in vascular endothelial cell active factors in patients with diabetes mellitus: Effects of Jinqi hypoglycemic tablets

Abstract

AIM：Cytokine plays an important role in vasculopathy of diabetes mellitus by affecting vascular endothelial cells. This article evaluates the influence and clinical application of Jinqi hypoglycemic table on vascular endothelial cells active factor of patients with diabetes mellitus by observing the change of correlation factor about vascular endothelial cells damage before and after therapy.
METHODS: ①Sixty-three cases of type 2 diabetes mellitus from Department of Endocrinology of General Hospital of Jinan Military Area Command of Chinese PLA were selected from March 2005 to September 2006. Jinqi hypoglycemic table was produced by Tianjin Long Shuen Rong Development Pharmaceutical Co. LTD China. ②The diabetes mellitus patients were randomly divided into two groups, a control group, with 30 cases, including 19 males and 11 females, mean age of (56.6±8.9) years, and a Jinqi group, with 33 cases, including 20 males and 13 females, mean age of (58.4±7.7) years. ③The patients in the control group were treated with routine biguanides hypoglycemic medicine. Jinqi hypoglycemic tablets were used besides western medicine in the Jinqi group, 8 tables, three times a day for successively 3 months. ④ELISA was used to detect plasma endothelin, soluble intercellular adhesion molecule-1 and soluble P-selectin and tumor necrosis factor alpha levels before and after treatment. Meanwhile the levels of blood glucose, blood lipid and HbAlc were detected.
RESULTS: Sixty-three patients were involved in the result analysis. ①Blood glucose, lipids and glycosylated hemoglobin were changed significantly (P < 0.05) after Jinqi treatment, while only blood glucose changed in control group (P < 0.05). Blood glucose, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were improved in the Jinqi group after treatment (P < 0.05). ②Plasma cytokine levels were decreased in the Jinqi group after treatment (P < 0.05 or P < 0.01). No significant differences were found in the four indexes in the control group (P > 0.05). Plasma endothelin 1, soluble intercellular adhesion molecule-1, soluble P-selectin and tumor necrosis factor alpha levels were significantly reduced in the Jinqi group after treatment as compared with the control group (P < 0.01).
CONCLUSION: ①Jinqi hypoglycemic tablet can protect vascular endothelin through regulating vascular endothelial cells active factor. ②Development of complications in diabetes mellitus patients can be effectively delayed using Chinese medicine on the basis of treatment with western medicine.

Xu J, Qi FL, Chen YJ, Yin QX, Ke BS, Hu CJ.Changes in vascular endothelial cell active factors in patients with diabetes mellitus: Effects of Jinqi hypoglycemic tablets.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(11):2025-2028(China) [www.zglckf.com/zglckf/ejournal/upfiles/08-11/11k-2025(ps).pdf]