靈芝對糖尿病患者降血糖之輔助治療

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(1)

2 0 1 0

2 . 5 2 4

( 95% ) 2

( UKPDS )

2

4 6 3000 mg

1 2 ( HbA1C )

4 ( p<0.01 )

-0.2 0.3 mg/dl.h 4 5 42.1 mg/dl.h ( p<0.05 )

( 180 mg/dl H b A1C 8% )

H b A1C ( p<0.01 )

2

H b A1C

2 ( Type 2 diabetes )

( )

( HbA

1

C )

( Fasting blood glucose )

( Postprandial blood glucose )

(2)

2

3(The Diabetes Control and Complications Tr i a l )

4( United Kingdom Prospective Diabetes Study )

U K P D S

6 4 4 %

4

5

6

7 - 9

2

5 0 2

( )

8 1 5 0 - 2 5 0

m g / d l

( )

3

2 ( 500 mg )

1 2

5 0 4

( 1 ) ( 1 )

( 2 ) 4 4 6

1 2

4 6 2 3 ( 12 11

p- v a l u e

2 3 2 3 -

( / ) 1 2 / 11 1 2 / 11 -

( years ) 6 . 5 0 . 8 8 . 5 1 . 2 0 . 2 2 1

( years ) 5 8 . 6 2 . 3 6 1 . 8 2 . 4 0 . 3 8 6

( kgs ) 6 5 . 5 2 . 7 6 5 . 9 2 . 6 0 . 7 8 3

( kg/m2 ) 2 6 . 5 1 . 0 2 5 . 3 0 . 7 0 . 9 11

FPG ( mg/dl) 1 8 0 . 1 6 . 5 1 8 4 . 7 3 . 2 0 . 4 1 5

2h PC ( mg/dl) 2 8 2 . 9 8 . 5 2 6 4 . 6 4 . 7 0 . 1 2 5

H b A1C ( %) 8 . 2 1 . 3 8 . 5 1 . 4 0 . 4 0 1

( mmHg ) 1 2 7 . 3 2 . 9 1 3 1 . 1 3 . 6 0 . 4 6 6

( mmHg ) 7 4 . 2 2 . 0 7 5 . 6 1 . 9 0 . 4 6 1

S u l f o n y l u r e a 1 3 1 4 0 . 9 8 8

M e t f o r m i n 2 3 0 . 8 3 6

S u l f o n y l u r e a M e t f o r m i n 8 6 0.838

Student's t-test F P G

2h PC 2

H b A1C

(3)

) 2 3 ( 12 11 )

( body mass index ) 2

( )

( Ganoderma tsugae ) t r i t e r-

penoids nucleosid p o l y s a c c h a r i d e f i n g e r p r i n t ( Ganoderma lucidum )

E D TA 1 0

2000 xg 1 5 - 7 0

H b A1C e n z y m a t i c

m e t h o d s 1 0

( Meal Tolerance Test ) 2 ( 30Kcal/kg/day )

(

1 / 5 5 5 %

3 0 % 15% )

1 2 3 4

SPSS 8.0

t - t e s t

paired Student t -t est

4 8 1 2

A

B (

180 mg/dl 180 mg/dl )

F P G H b A1C Glu cose Area 2h PC

B e f o r e A f t e r 1 B e f o r e A f t e r 2

FPG ( mg/dl ) 1 8 0 . 1 6 . 5 1 8 0 . 9 8 . 1 0 . 8 0 . 2 1 8 4 . 7 3 5 . 2 1 8 7 . 9 4 9 3 . 2 3 . 1

HbA1C ( % ) 8 . 2 1 . 3 7 . 9 0 . 6 - 0 . 3 0 . 1 8 . 5 1 . 4 8 . 5 1 . 7 0 . 1 0 . 2

Glucose Area ( mg/dl.h ) 8 9 7 . 3 3 7 . 7 8 9 7 . 1 3 8 . 2 - 0 . 2 0 . 3 9 0 1 . 1 3 4 . 4 9 4 6 . 5 5 6 . 3 4 5 . 0 4 2 . 1

2h PC ( mg/dl ) 2 8 2 . 9 8 . 5 2 9 2 . 7 1 4 . 0 9 . 8 8 . 1 2 6 4 . 8 4 . 7 2 8 0 . 5 11 . 0 1 6 . 1 7.8

p 0 . 0 5 p 0 . 0 5

F P G

B

A

(4)

4 8

1 2 ( A )

( 180 mg/dl 180 mg/dl )

1 8 0

m g / d l 4

( B )

( -0.2 0.3, 45 42.1 mg/dl.h p<0.05 )

( )

( 180 mg/dl

180 mg/dl 2 250 mg/dl 2 5 0

m g / d l 9 0 0

m g / d l . h 9 0 0

m g / d l . h H b A1C 8 % 8% ) ( ) F P G 180 mg/dl

F P G ( -3.3 8.4, 7.7

8.3 mg/dl p<0.05 ) F P G 1 8 0

m g / d l

2

P C 250 mg/dl 250 mg/dl

900 mg/ dl.h

1 4 6 . 2 42.1 mg/dl.h 7 0 . 0 16.4 mg/dl.h p 0 . 0 1

900 mg/ dl. h

H b A1C 8 %

H b A1C - 0 . 6 0 . 3 0 . 4

0 . 3 % p < 0 . 0 1 8 %

H b A1C

( )

2 ( HbA1C 8 % 8% )

1 2 6 5 . 4 5 1. 7 m g/ d l 2 7 1 . 9 42.4 mg/ dl 2 3 4

F P G 2h PC Glu cose Area H b A1C ( )

FPG ( mg/dl )

1 8 0 1 2 - 3 . 3 8 . 4 7 . 7 8 . 3

1 8 0 11 1 4 . 1 9 . 0 1 4 . 7 9 . 5

2h PC ( mg/dl )

2 5 0 1 2 9 . 8 8 . 1 1 6 . 1 7 . 8

2 5 0 11 3 1 . 4 8 . 6 3 0 . 0 8 . 1

Glucose Area ( mg/dl.h )

9 0 0 1 2 - 1 4 6 . 2 4 2 . 1 7 0 . 0 1 6 . 4

9 0 0 11 9 0 . 2 2 6 . 1 9 0 . 0 2 6 . 0

H b A1C ( % )

8 % 1 2 - 0 . 6 0 . 3 0 . 4 0 . 3

8 % 11 0 . 5 0 . 2 0 . 6 0.4

Student's t-test p 0 . 0 5 p 0 . 0 1

F P G

2h PC 2

H b A1C

(5)

( p 0.01 )

( 1 2 3 4 )

H b A1C

( )

1 2 4

4

1 2

4

1 0

1 5

Monnier

H b A1C

1 6 1 7

"DECODE"

2 1 8

1 9

2 0

1 8 0

m g / d l 4

8 1 2

1 2

8 % 900 mg/dl.h

1 8 0 m g / d l ( HbA1C 8% )

Type I error ( H b A1C

8 % 8% )

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2.Tseng CH, Tseng CP, Chong CK, et al. Increasing incidence of diagnosed type 2 diabetes in Taiwan: analysis of data from a na- tional cohort. Diabetologia 2006 49: 1755-60.

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Sulphonylurea failure in non-insulin-dependent diabetic pa- tients over six years .UK Prospective Diabetes Study (UKPDS) Group. Diabet Med 1998 ; 15: 297-303.

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J Altern Complement Med 2006; 12: 895-902.

6.Bell RA, Suerken CK, Grzywacz JG , Lang W, Quandt SA, Arcury TA. Complementary and alternative medicine use among adults with diabetes in the United States. Altern Ther Health Med 2006; 12: 16-22.

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8.Shiao MS. Natural products of the medical fungus Ganoderma lucidum: occurrence, biological activities, and pharmacological functions. Chemical Record 2003; 3: 172-80.

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10.Kadish AH, Litle RC, Sternberg JC. A new and rapid method for the determination of glucose by measurement of rate of oxy- gen consumption. Clin Chem 1968; 14: 116-31.

11.Hikino H, Ishiyama M, Suzuki Y, and Konno C. Mechanisms of hypoglycemic activity of ganoderan B: glycan of Ganoderma lucidum fruit bodies. Planta Med 1989; 55: 423-8.

12.Hikino H, Konno C, Mirin Y, Hayashi T. Isolation and hypo- glycem ic ac tivity of G anodera ns A a nd B , G lycans of Ganoderma lucidum fruit bodies1. Planta Med 1985; 51: 339- 40.

13.Kino K, Mizumoto K, Sone T, et al. An immunomodulating pro- tein, Ling Zhi-8 (LZ-8) prevents insulitis in non-obese diabetic mice. Diabetologia 1990; 33: 713-8.

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15. Kimura Y, Okuda H , A ric hi S. Effects of the extracts of Ganoderma lucidum on blood glucose level in rats. Planta Med 1988; 54: 290-4.

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The DECODE study group. European Diabetes Epidemiology Group. Diabetes epidemiology : collaborative analysis of diag- nostic criteria in Europe. Lancet 1999; 354: 617-21.

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on Metabolic Control in Type 2 Diabetes Subjects

- -- A Double Blinded Placebo Control Study

Chen-Wen Wang, Johannes Scheng-Ming Tschen , and Wayne Huey-Herng Sheu1

Diabetes mellitus has become one of leading causes of death worldwide. Owing to progressive deteriora- tion of current available hypoglycemic agents, Ganoderma lucidum , one of the most widely used herbs, was re- ported to lower blood glucose level in animal studies. We therefore undertook a clinical study to investigate the effect of Ganoderma lucidum on blood glucose control in subjects with type 2 diabetes mellitus. We conducted a double-blind, placebo-controlled trial in which 46 patients completed the trial. Subjects were randomized to take dry extract of Ganoderma lucidum 3000 mg or placebo in addition to regular oral hypoglycemic agents for a pe- riod of 12 weeks. As a group, no differences were found in values of fasting glucose, HbA1c before versus after treatment both in placebo and Ganoderma lucidum groups. However, plasma glucose under the curve during meal tolerance test reduced more significantly in those of taking Ganoderma lucidum than those taking placebo (p 0.01, 2-way ANOVA). In those subjects with poor glycemic control (fasting glucose 180 mg/dl, A1c 8.0%), treatment by Ganoderma lucidum revealed a greater reduction in values of fasting glucose (p 0.05) and glucose area under cruve (p 0.01). Results of this study suggest that Ganoderma lucidum might play some role in providing postprandial glucose lowering as supplementary therapy in treating subjects with type 2 diabetes mellitus. ( J Intern Med Taiwan 2008; 19: 54- 60 )

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