Abstract: Objective　To explore clinical effects of acupuncture with liuwei dihuang pill on type 2 diabetes lipidmetabolic disorder and to investigate its influence on insulin resistance.Methods　225 patients with type 2 diabetes lipidmetabolic disorder who received treatment in Chun’an Chinese Traditional Medicine Hospital from June 2013 to March 2014 were selected,and were divided into 5 groups——groups of A,B,C,D and E by random number table method,45 cases per group.Patients in group A were given conventional treatment,based on which patients in group B took liuwei dihuang pill orally and patients in group C accepted acupuncture therapy,group D based on group A’s method took liuwei dihuang pill orally combined with acupuncture therapy,and group E used the same method as group D except for taking rosuvastatin capsule orally.Four weeks were taken as a course of treatment,and three courses of treatment was given to patients in the five groups.The related laboratory test index,blood rheology index,and traditional Chinese medicine syndrome score were compared among the five groups before and after the treatment.Results　A total of 215 patients finished the treatment as required.（1）Before treatment,there was no significant difference in fasting plasma glucose（FPG）,2 h postprandial glucose（2 hPG）,glycated hemoglobin（HbA1c）,insulin resistance index（Homa-IR） of patients in five groups（P>0.05）.There was significant difference in FPG,2 hPG,HbA1c,and Homa-IR of patients in five groups after treatment（P<0.05）;of which Homa-IR of patients in group B was significantly lower than that in group A（P<0.05）;Homa-IR of patients in group C was significantly lower than that in group A and B（P<0.05）;FPG,2 hPG,HbA1c,Homa-IR of patients in group D and E were significantly lower than those in group A,B,and C（P<0.05）.（2）Before treatment,there was no significant difference in total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,and high density lipoprotein cholesterol（HDL-C） of patients in five groups（P>0.05）.There was significant difference in TC,TG,LDL-C,and HDL-C of patients in five groups after treatment（P<0.05）;of which TC,TG and LDL-C of patients in group B and C were significantly lower than those in group A,while their HDL-C was significantly higher than that in group A（P<0.05）;TC,TG and LDL-C of patients in group D and E were significantly lower than those in group A,B and C,while their HDL-C was significantly higher than that in group A,B and C（P<0.05）.（3）Before treatment,there was no significant difference in whole blood viscosity,plasma viscosity,fibrinogen,and hematocrit of patients in five groups（P>0.05）.There was significant difference in whole blood viscosity,plasma viscosity,fibrinogen and hematocrit of patients in five groups after treatment（P<0.05）;of which whole blood viscosity,plasma viscosity,fibrinogen and hematocrit of patients in group C,D and E were lower than those in group A and B（P<0.05）.（4）Before treatment,there was no significant difference in traditional Chinese medicine syndrome score of patients in five groups（P>0.05）.there was significant difference in traditional Chinese medicine syndrome score of patients in five groups after treatment（P<0.05）;of which the traditional Chinese medicine syndrome score of patients in group B and C was significantly lower than that in group A（P<0.05）;the traditional Chinese medicine syndrome score of patients in group D and E was significantly lower than that in group A,B and C（P<0.05）.Conclusion　Acupuncture with liuwei dihuang pill can effectively lower the blood glucose level of patients with type 2 diabetes lipidmetabolic disorder,and can adjust dyslipidemia,reduce blood viscosity,improve status of insulin resistance.It also can be used alone without combining with conventional treatment of Western medicine.

Key words: Diabetes mellitus,type 2, Lipid metabolism disorders, Acupuncture, Liuwei dihuang decoction, Treatment outcome, Insulin resistance

摘要： 目的　了解针刺联合六味地黄丸治疗2型糖尿病脂代谢紊乱的临床疗效，并探讨其对胰岛素抵抗的影响。方法　于2013年6月—2014年3月选取在淳安县中医院就诊的2型糖尿病脂代谢紊乱患者225例，采用随机数字表法分为A、B、C、D、E 5组，每组45例。A组患者采用常规治疗，B组患者在常规治疗的基础上口服六味地黄丸，C组患者在常规治疗的基础上进行针刺治疗，D组患者在常规治疗基础上口服六味地黄丸联合针刺治疗，E组患者未口服瑞舒伐他汀胶囊，其他治疗同D组。4周为1个疗程，5组患者均治疗3个疗程。比较5组患者治疗前后的相关实验室检测指标、血液流变学指标及中医证候积分。结果　共215例患者按要求完成了治疗。（1）治疗前5组患者空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（Homa-IR）比较，差异无统计学意义（P>0.05）。治疗后5组患者FPG、2 hPG、HbA1c、Homa-IR比较，差异有统计学意义（P<0.05）；其中，B组患者Homa-IR低于A组，差异有统计学意义（P<0.05）；C组患者Homa-IR低于A、B组，差异有统计学意义（P<0.05）；D、E组患者FPG、2 hPG、HbA1c、Homa-IR低于A、B、C组，差异有统计学意义（P<0.05）。（2）治疗前5组患者总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）比较，差异无统计学意义（P>0.05）。治疗后5组患者TC、TG、LDL-C、HDL-C比较，差异有统计学意义（P<0.05）；其中，B、C组患者TC、TG、LDL-C低于A组，HDL-C高于A组，差异有统计学意义（P<0.05）；D、E组患者TC、TG、LDL-C低于A、B、C组，HDL-C高于A、B、C组，差异有统计学意义（P<0.05）。（3）治疗前5组患者全血黏度、血浆黏度、纤维蛋白原、红细胞比容比较，差异无统计学意义（P>0.05）。治疗后5组患者全血黏度、血浆黏度、纤维蛋白原、红细胞比容比较，差异有统计学意义（P<0.05）；其中，C、D、E组患者全血黏度、血浆黏度、纤维蛋白原、红细胞比容低于A、B组，差异有统计学意义（P<0.05）。（4）治疗前5组患者中医证候积分比较，差异无统计学意义（P>0.05）。治疗后5组患者中医证候积分比较，差异有统计学意义（P<0.05）；其中，B、C组患者中医证候积分低于A组，差异有统计学意义（P<0.05）；D、E组患者中医证候积分低于A、B、C组，差异有统计学意义（P<0.05）。结论　针刺联合六味地黄丸可以有效降低2型糖尿病脂代谢紊乱患者的血糖水平，调节血脂异常，降低血液黏稠度，改善胰岛素抵抗状态，亦可不联合西医常规治疗单独应用。

关键词: 糖尿病, 2型, 脂代谢障碍, 针刺, 六味地黄汤, 治疗结果, 胰岛素抵抗