目的：观察针刺加温针治疗女性阴阳两虚型2型糖尿病（T2DM）的临床疗效。方法：将92例阴阳两虚型T2DM女性患者分为阴虚为主的阴阳两虚型（治疗1组）和阳虚为主的阴阳两虚型（治疗2组），两组各46例。进行针刺加温针治疗3个月。观察两组患者治疗前后空腹血糖（FPG）、空腹瘦素（FLP）、空腹胰岛素（FINS）、胰岛素敏感性指数（ISI）、胰岛素抵抗指数（Homa-IR）、胰岛素分泌指数（Homa-β）及总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDLC）水平、体质量、体质指数（BMI）、体脂百分率（F%）。结果：淤治疗1组总有效率为69.57%，治疗2组总有效率为84.78%，两组比较差异无统计学意义。于与治疗前相比，两组患者治疗后FLP、FPG、FINS、匀oma-IR、TC、TG、LDL-C、体质量、BMI、F%均显著下降（P<0.01），ISI、Homa-β、HDL-C显著升高（P<0.01）。盂治疗后治疗2组FPG、Homa-β和BMI改善优于治疗1组（P<0.05）。榆治疗后，两组患者的LDC-C、HDC-L达到正常水平，治疗2组的FPG也达到正常水平。结论：淤针刺加温针能显著调整阴阳两虚型T2DM患者的脂肪-胰岛轴水平，改善瘦素抵抗和胰岛素抵抗，增强胰岛素敏感性以及胰岛茁细胞的功能，纠正患者机体内分泌、糖以及脂质代谢的紊乱。于针刺加温针对阳虚为主阴阳两虚型T2DM患者降低血糖和改善胰岛茁细胞的功能优于阴虚为主的阴阳两虚型T2DM患者。

This study was aimed to observe the clinical effect of acupuncture together with warm acupuncture on female type 2 diabetes mellitus (T2DM) patients of dual deficiency of yin and yang syndrome. A total of 92 female T2DM patients of dual deficiency of yin and yang syndrome were divided into two groups, which were priority of yin deficiency in the type of dual deficiency of yin and yang (group 1) and priority of yang deficiency in the type of dual deficiency of yin and yang (group 2). There were 46 cases in each group. The treatment of acupuncture together with warm acupuncture was given for three month. The observation was made on the fasting plasma glucose (FPG), fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR), insulin secretion index (Homa-β), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), body mass, body mass index (BMI) and body fat percentage (F%) before and after treatment. The results showed that the total effective rate of group 1 was 69.57%, while the total effective rate of group 2 was 84.78%. There was no significant statistical difference between two groups. Compared with pretreatment, there were significant decrease on FLP, FPG, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, and F% of both groups after treatment (P < 0.01). There was obvious increase on ISI, Homa-β, and HDL-C (P < 0.01). After treatment, the FPG, Homa-β and BMI of group 2 were better than group 1 (P < 0.05). After treatment, the level of LDCC and HDC-L of both groups reached normal level. And the FPG of group 2 also reached normal level. It was concluded that acupuncture together with warm acupuncture can significantly adjust the level of fat-pancreatic islet shaft of T2DM patients of dual deficiency of yin and yang syndrome, reduce the leptin resistance and insulin resistance, enhance the sensibility of insulin and the function of pancreatic 茁cell, and correct the endocrine disorder, glycometabolism disorder and lipometabolism disorder. Acupuncture together with warm acupuncture did much better in lowering blood sugar and improving the function of pancreatic βcells of T2DM patients whose priority of yang deficiency in the type of dual deficiency of yin and yang than those whose priority of yin deficiency in the type of dual deficiency of yin and yang.

国家自然科学基金委面上项目（39770929）：针灸治疗非胰岛素依赖性糖尿病的机理研究，负责人：刘志诚；教育部高等学校博士学科点专项（20040315008）：针灸治疗2 型糖尿病胰岛素和瘦素抵抗的细胞分子机制，负责人：刘志诚；国家自然科学基金委面上项目（30873307）：针刺不同穴位影响肥胖大鼠下丘脑GS 活动及AMPK 表达的研究，负责人：徐斌。