七味白术散合生脉散在糖尿病合并冠心病治疗中临床意义
|
摘要
目的糖尿病合并冠心病在临床中较为常见,中西医结合治疗方案较多,未形成统一规范。本研究采用七味白术散合生脉散联合西药治疗糖尿病合并冠心病,观察中西医结合方法治疗糖尿病合并冠心病的临床疗效。方法选取辽宁省抚顺市中医院2015-10-01-2016-11-30收治的64名糖尿病合并冠心病患者,根据治疗方法不同分为对照组和中西医结合组,各32例。对照组给予常规西医治疗,结合组在常规西医治疗基础上给予七味白术散合生脉散治疗,治疗时间为30d。分别观察治疗前后患者空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2hour plasma glucose,2h PG)、中医症候评分、临床总有效率、血清亲环素A(cyclophilin A,CyPA)水平变化。结果治疗后中西医结合组FPG为(6.34±0.53)mmol/L,低于对照组的(6.84±0.58)mmol/L,t=-3.600,P=0.001。中西医结合组治疗后2hPG为(7.67±0.45)mmol/L,低于对照组的(8.53±0.64)mmol/L,t=-6.218,P<0.001。中西医结合组治疗后中医症候积分为(3.56±2.59)分,低于对照组的(9.43±3.36)分,t=-7.827,P<0.001。中西医结合组治疗后CyPA为(5.54±0.43)ng/mL,低于对照组的(7.89±0.64)ng/mL,t=-17.241,P<0.001。治疗后中西医结合组临床总有效率为93.75%,高于对照组的75.00%,χ~2=4.267,P=0.039。结论七味白术散合生脉散联合西药治疗糖尿病合并冠心病显著,能够有效控制患者血糖,改善患者临床症状,降低机体CyPA水平。
OBJECTIVE Diabetes combined with coronary heart disease is more common in the clinic.There are many treatments for integrated Chinese and Western medicine,but no unified norms have been formed.At present,Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are used to treat diabetes with coronary heart disease.The study aims to observe the clinical efficacy of integrated Chinese and Western medicine in the treatment of patients with diabetes mellitus complicated with coronary heart disease.METHODS Totally 64 patients with diabetes mellitus and coronary heart disease were from Fushun Hospital of Traditional Chinese Medicine from October 1,2015 to November 30,2016.These patients were randomly divided into control group and integrated Chinese and Western medicine group.There were 32 patients in each group.The control group was given conventional Western medicine treatment.The combination group was treated with traditional Chinese medicine on the basis of conventional western medicine treatment.The treatment cycle was 30 days.The changes of FPG,2 hPG,TCM symptom score,clinical total effective rate and CyPA were observed before and after treatment.RESULTS The FPG after treatment in the integrated Chinese and Western medicine group was(6.34±0.53)mmol/L,which was lower than that of the control group(6.84±0.58)mmol/L,t=-3.600,P=0.001.The 2 h-PG after treatment in the integrated Chinese and Western medicine group was(7.67±0.45)mmol/L,which was lower than that of the control group(8.53±0.64)mmol/L,t=-6.218,P<0.001.The score of TCM symptom after treatment in the integrated Chinese and Western medicine group was(3.56±2.59),which was lower than that of the control group(9.43±3.36),t=-7.827,P<0.001.CyPA was(5.54±0.43)ng/ml after treatment in the integrated Chinese and Western medicine group,which was lower than that of the control group(7.89±0.64)ng/ml,t=-17.241,P<0.001.After treatment,the total effective rate was 93.75%,which was higher than 75.00% of the control group,χ~2=4.267,P=0.039.CONCLUSIONS Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are effective in treating diabetes with coronary heart disease.It can effectively control the blood sugar of patients,improve the clinical symptoms of patients and reduce the level of CyPA in the body.
OBJECTIVE Diabetes combined with coronary heart disease is more common in the clinic.There are many treatments for integrated Chinese and Western medicine,but no unified norms have been formed.At present,Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are used to treat diabetes with coronary heart disease.The study aims to observe the clinical efficacy of integrated Chinese and Western medicine in the treatment of patients with diabetes mellitus complicated with coronary heart disease.METHODS Totally 64 patients with diabetes mellitus and coronary heart disease were from Fushun Hospital of Traditional Chinese Medicine from October 1,2015 to November 30,2016.These patients were randomly divided into control group and integrated Chinese and Western medicine group.There were 32 patients in each group.The control group was given conventional Western medicine treatment.The combination group was treated with traditional Chinese medicine on the basis of conventional western medicine treatment.The treatment cycle was 30 days.The changes of FPG,2 hPG,TCM symptom score,clinical total effective rate and CyPA were observed before and after treatment.RESULTS The FPG after treatment in the integrated Chinese and Western medicine group was(6.34±0.53)mmol/L,which was lower than that of the control group(6.84±0.58)mmol/L,t=-3.600,P=0.001.The 2 h-PG after treatment in the integrated Chinese and Western medicine group was(7.67±0.45)mmol/L,which was lower than that of the control group(8.53±0.64)mmol/L,t=-6.218,P<0.001.The score of TCM symptom after treatment in the integrated Chinese and Western medicine group was(3.56±2.59),which was lower than that of the control group(9.43±3.36),t=-7.827,P<0.001.CyPA was(5.54±0.43)ng/ml after treatment in the integrated Chinese and Western medicine group,which was lower than that of the control group(7.89±0.64)ng/ml,t=-17.241,P<0.001.After treatment,the total effective rate was 93.75%,which was higher than 75.00% of the control group,χ~2=4.267,P=0.039.CONCLUSIONS Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are effective in treating diabetes with coronary heart disease.It can effectively control the blood sugar of patients,improve the clinical symptoms of patients and reduce the level of CyPA in the body.
引文
[1]郭若一,郭艺芳.糖尿病患者心血管合并症的防治--解析2018年美国糖尿病协会糖尿病诊疗标准[J].心血管病学进展,2018,39(2):157-159.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[3]王丽.常见病康复诊疗规范-冠心病分级康复诊疗指南解读[J].安徽医学,2017,38(7):956-957.
[4]王忆勤,郭睿,许朝霞,等.中医四诊客观化研究在冠心病诊断中的应用[J].中医杂志,2016,57(3):199-203.
[5]吴朦,胡镜清,江丽杰,等.冠心病中医证分类及其关联理化指标的研究[J].世界科学技术-中医药现代化,2016,18(5):776-785.
[6]王阶,何庆勇.冠心病心绞痛中医疗效评价标准[J].中国实验方剂学杂志,2018,24(15):7-10.
[7]Tsujimoto T,Sugiyama T,Kajio H.Effects ofβ-blockers on all‐cause mortality in patients with type 2diabetes and coronary heart disease[J].Diabetes Obes Metab,2017,19(6):800-808.
[8]Farrokhian A,Bahmani F,Taghizadeh M,et al.Selenium supplementation affects insulin resistance and serum hs-CRP in patients with type 2diabetes and coronary heart disease[J].Horm Metab Res,2016,48(4):263-268.
[9]Sawas T,Lazo M,Carey W,et al.Mo1571insulin-like growth factor-1is associated with degree of hepatic steatosis but not coronary heart disease or diabetes in the third national health and nutrition examination survey(NHANES-Ⅲ)[J].Gastroenterol,2016,150(4):S1149.
[10]李永灵.中西医结合治疗冠心病合并糖尿病的可行性分析[J].中西医结合心血管病电子杂志,2016,4(8):126-127.
[11]Zhao W,Rasheed A,Tikkanen E,et al.Identification of new susceptibility loci for type 2diabetes and shared etiological pathways with coronary heart disease[J].Nature Genet,2017,49(10):1450.
[12]Emdin CA,Khera AV,Natarajan P,et al.Genetic association of waist-to-hip ratio with cardiometabolic traits,type 2diabetes,and coronary heart disease[J].JAMA,2017,317(6):626-634.
[13]Schrieks IC,Nozza A,Sthli BE,et al.Adiponectin,free fatty acids,and cardiovascular outcomes in patients with type 2diabetes and acute coronary syndrome[J].Diabetes Care,2018,41(8):1792-1800.
[14]白承父.生脉散合丹参饮加减对2型糖尿病伴冠心病患者血小板粘度、血管内皮功能及冠脉血流量的影响[J].四川中医,2017,35(6):108-110.
[15]张洁.七味白术散合补阳还五汤治疗肥胖2型糖尿病及改善胰岛素抵抗研究[J].陕西中医,2018,39(7):919-921.
[16]曹福建,张翠玲.中西医结合治疗肥胖型2型糖尿病临床研究[J].中医学报,2016,31(11):1688-1690.
[17]孙术宁,黄华鑫,黄超原,等.糖尿病合并冠心病用药规律文献研究[J].中医杂志,2018,59(14):1236-1240.
[18]刘志广,张菲斐,韩战营,等.合并2型糖尿病的冠心病患者血清CypA水平变化及其与冠脉病变的关系[J].河南医学研究,2014,23(2):22-25.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[3]王丽.常见病康复诊疗规范-冠心病分级康复诊疗指南解读[J].安徽医学,2017,38(7):956-957.
[4]王忆勤,郭睿,许朝霞,等.中医四诊客观化研究在冠心病诊断中的应用[J].中医杂志,2016,57(3):199-203.
[5]吴朦,胡镜清,江丽杰,等.冠心病中医证分类及其关联理化指标的研究[J].世界科学技术-中医药现代化,2016,18(5):776-785.
[6]王阶,何庆勇.冠心病心绞痛中医疗效评价标准[J].中国实验方剂学杂志,2018,24(15):7-10.
[7]Tsujimoto T,Sugiyama T,Kajio H.Effects ofβ-blockers on all‐cause mortality in patients with type 2diabetes and coronary heart disease[J].Diabetes Obes Metab,2017,19(6):800-808.
[8]Farrokhian A,Bahmani F,Taghizadeh M,et al.Selenium supplementation affects insulin resistance and serum hs-CRP in patients with type 2diabetes and coronary heart disease[J].Horm Metab Res,2016,48(4):263-268.
[9]Sawas T,Lazo M,Carey W,et al.Mo1571insulin-like growth factor-1is associated with degree of hepatic steatosis but not coronary heart disease or diabetes in the third national health and nutrition examination survey(NHANES-Ⅲ)[J].Gastroenterol,2016,150(4):S1149.
[10]李永灵.中西医结合治疗冠心病合并糖尿病的可行性分析[J].中西医结合心血管病电子杂志,2016,4(8):126-127.
[11]Zhao W,Rasheed A,Tikkanen E,et al.Identification of new susceptibility loci for type 2diabetes and shared etiological pathways with coronary heart disease[J].Nature Genet,2017,49(10):1450.
[12]Emdin CA,Khera AV,Natarajan P,et al.Genetic association of waist-to-hip ratio with cardiometabolic traits,type 2diabetes,and coronary heart disease[J].JAMA,2017,317(6):626-634.
[13]Schrieks IC,Nozza A,Sthli BE,et al.Adiponectin,free fatty acids,and cardiovascular outcomes in patients with type 2diabetes and acute coronary syndrome[J].Diabetes Care,2018,41(8):1792-1800.
[14]白承父.生脉散合丹参饮加减对2型糖尿病伴冠心病患者血小板粘度、血管内皮功能及冠脉血流量的影响[J].四川中医,2017,35(6):108-110.
[15]张洁.七味白术散合补阳还五汤治疗肥胖2型糖尿病及改善胰岛素抵抗研究[J].陕西中医,2018,39(7):919-921.
[16]曹福建,张翠玲.中西医结合治疗肥胖型2型糖尿病临床研究[J].中医学报,2016,31(11):1688-1690.
[17]孙术宁,黄华鑫,黄超原,等.糖尿病合并冠心病用药规律文献研究[J].中医杂志,2018,59(14):1236-1240.
[18]刘志广,张菲斐,韩战营,等.合并2型糖尿病的冠心病患者血清CypA水平变化及其与冠脉病变的关系[J].河南医学研究,2014,23(2):22-25.