解毒通脉方对2型糖尿病下肢血管病变患者踝肱指数及下肢动脉血流的影响
|
摘要
目的:观察解毒通脉方对2型糖尿病下肢血管病变患者踝肱指数(ankle branchial index,ABI)及下肢动脉血流的影响。方法:158例2型糖尿病下肢血管病变患者随机平均分为对照组及观察组各79例。所有患者均给予常规降低血糖治疗,对照组给予辛伐他汀片、羟苯磺酸钙分散片及阿司匹林肠溶片治疗,观察组在对照组治疗基础上给予解毒通脉方。比较两组患者治疗前后血液流变学指标、血脂水平、ABI、心脏-脚踝指数(cardio-ankle vascular index,CAVI)、中医证候积分及不良反应,并评价两组患者临床疗效。结果:与治疗前比较,两组患者全血黏度、血浆黏度、红细胞聚集指数、中医证候积分、总胆固醇、三酰甘油及低密度脂蛋白在治疗后均显著降低,而高密度脂蛋白胆固醇、ABI及CAVI均显著增高,且观察组上述观察指标均优于对照组,差异均有统计学意义(P<0.05)。观察组有效率显著高于对照组,差异具有统计学意义(P<0.05)。观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论:解毒通脉方治疗2型糖尿病下肢血管病变患者疗效显著,可显著提高踝肱指数,改善下肢动脉血流水平,缓解临床症状。
Objective:To observe the effect of Jiedu Tongmai prescription on ankle branchial index(ABI) and lower extremity limb artery blood flow in patients with type 2 diabetes mellitus with lower limb vascular disease.Methods:158 type 2 diabetic patients with lower extremity vascular disease were randomly divided into control group and observation group,with 79 cases each.All patients were given routine treatment of lowering blood sugar.The control group was given simvastatin tablets,calcium dobesilate dispersible tablets and aspirin enteric-coated tablets.The observation group was given Jiedu Tongmai prescription on the basis of the control group.The hemorheological indexes,blood lipid level,ABI,cardio-ankle vascular index(CAVI),TCM syndrome scores and adverse reactions were compared between the two groups before and after treatment,and the clinical efficacy of the two groups was evaluated.Results:Compared with before treatment,the whole blood viscosity,plasma viscosity,erythrocyte aggregation index,TCM syndrome score,total cholesterol,triglyceride and low density lipoprotein in the two groups were significantly decreased after treatment,while high density lipoprotein cholesterol,ABI and CAVI were significantly increased,and the above observation indexes in the observation group were better than those in the control group.The difference was statistically significant(P<0.05).The effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:Jiedu Tongmai prescription has remarkable curative effect on type 2 diabetic patients with lower extremity vascular disease.It can significantly improve ankle brachial index,lower extremity artery blood flow level and relieve clinical symptoms.
Objective:To observe the effect of Jiedu Tongmai prescription on ankle branchial index(ABI) and lower extremity limb artery blood flow in patients with type 2 diabetes mellitus with lower limb vascular disease.Methods:158 type 2 diabetic patients with lower extremity vascular disease were randomly divided into control group and observation group,with 79 cases each.All patients were given routine treatment of lowering blood sugar.The control group was given simvastatin tablets,calcium dobesilate dispersible tablets and aspirin enteric-coated tablets.The observation group was given Jiedu Tongmai prescription on the basis of the control group.The hemorheological indexes,blood lipid level,ABI,cardio-ankle vascular index(CAVI),TCM syndrome scores and adverse reactions were compared between the two groups before and after treatment,and the clinical efficacy of the two groups was evaluated.Results:Compared with before treatment,the whole blood viscosity,plasma viscosity,erythrocyte aggregation index,TCM syndrome score,total cholesterol,triglyceride and low density lipoprotein in the two groups were significantly decreased after treatment,while high density lipoprotein cholesterol,ABI and CAVI were significantly increased,and the above observation indexes in the observation group were better than those in the control group.The difference was statistically significant(P<0.05).The effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:Jiedu Tongmai prescription has remarkable curative effect on type 2 diabetic patients with lower extremity vascular disease.It can significantly improve ankle brachial index,lower extremity artery blood flow level and relieve clinical symptoms.
引文
[1]吕亚亚,师维雅,左玉琼,等.2型糖尿病Toll样受体4与颈动脉内膜中层厚度的相关性研究[J].中华内分泌代谢杂志,2015,31(12):1017-1021.
[2]刘薇,华琳,原晶,等.亚临床甲状腺功能减退对老年人2型糖尿病大血管并发症的影响[J].中华老年医学杂志,2015,34(12):1333-1337.
[3]刘娟,章丽.温通活血方联合拜阿司匹林对糖尿病下肢血管病变的临床观察[J].湖北中医药大学学报,2013,15(2):50-51.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南[M].北京:北京大学医学出版社,2011.
[5]赵昱,祝捷,仝小林.糖尿病并发症防治[M].北京:化学工业出版社,2010.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[7]徐秀.2型糖尿病患者踝肱指数与游离脂肪酸的相关性分析[J].浙江临床医学,2015,17(11):1932-1933.
[8]朱筱,陈敏,胡湘明.西洛他唑治疗2型糖尿病下肢血管病变的疗效[J].广东医学,2013,34(8):1281-1282.
[9]赵晶,邱春娟,张星光,等.胰岛素强化治疗对2型糖尿病下肢血管病变患者氧化应激水平的影响[J].解放军医药杂志,2013,25(11):46-48.
[10]吴媛,王慧敏,曾玉萍,等.长期低强度运动疗法改善老年2型糖尿病合并下肢血管病变的效果研究[J].护士进修杂志,2013,28(19):1734-1736.
[11]张丽峰,华孙英,孙叶萍,等.丹红注射液对2型糖尿病微血管病变患者血液流变学、血脂水平的影响[J].实用临床医药杂志,2013,17(23):90-91.
[12]吴晨燕.中西医结合治疗糖尿病高同型半胱氨酸血症30例[J].河南中医,2015,35(12):3154-3156.
[13]刘冬梅,尹学永,齐桂秋.中西医结合治疗2型糖尿病临床研究[J].河南中医,2015,35(10):2490-2492.
[14]李爽.通脉利湿汤治疗糖尿病下肢血管病变导致水肿1例[J].河南中医,2013,33(7):1168-1169.
[15]徐多多,庞欢欢,江美芳,等.玄参提取物化学成分及其大鼠血浆移行成分的LC-LTQ-Orbitrap分析[J].中国中药杂志,2016,41(3):521-527.
[16]张来宾,吕洁丽,陈红丽,等.当归中苯酞类成分及其药理作用研究进展[J].中国中药杂志,2016,41(2):167-176.
[2]刘薇,华琳,原晶,等.亚临床甲状腺功能减退对老年人2型糖尿病大血管并发症的影响[J].中华老年医学杂志,2015,34(12):1333-1337.
[3]刘娟,章丽.温通活血方联合拜阿司匹林对糖尿病下肢血管病变的临床观察[J].湖北中医药大学学报,2013,15(2):50-51.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南[M].北京:北京大学医学出版社,2011.
[5]赵昱,祝捷,仝小林.糖尿病并发症防治[M].北京:化学工业出版社,2010.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[7]徐秀.2型糖尿病患者踝肱指数与游离脂肪酸的相关性分析[J].浙江临床医学,2015,17(11):1932-1933.
[8]朱筱,陈敏,胡湘明.西洛他唑治疗2型糖尿病下肢血管病变的疗效[J].广东医学,2013,34(8):1281-1282.
[9]赵晶,邱春娟,张星光,等.胰岛素强化治疗对2型糖尿病下肢血管病变患者氧化应激水平的影响[J].解放军医药杂志,2013,25(11):46-48.
[10]吴媛,王慧敏,曾玉萍,等.长期低强度运动疗法改善老年2型糖尿病合并下肢血管病变的效果研究[J].护士进修杂志,2013,28(19):1734-1736.
[11]张丽峰,华孙英,孙叶萍,等.丹红注射液对2型糖尿病微血管病变患者血液流变学、血脂水平的影响[J].实用临床医药杂志,2013,17(23):90-91.
[12]吴晨燕.中西医结合治疗糖尿病高同型半胱氨酸血症30例[J].河南中医,2015,35(12):3154-3156.
[13]刘冬梅,尹学永,齐桂秋.中西医结合治疗2型糖尿病临床研究[J].河南中医,2015,35(10):2490-2492.
[14]李爽.通脉利湿汤治疗糖尿病下肢血管病变导致水肿1例[J].河南中医,2013,33(7):1168-1169.
[15]徐多多,庞欢欢,江美芳,等.玄参提取物化学成分及其大鼠血浆移行成分的LC-LTQ-Orbitrap分析[J].中国中药杂志,2016,41(3):521-527.
[16]张来宾,吕洁丽,陈红丽,等.当归中苯酞类成分及其药理作用研究进展[J].中国中药杂志,2016,41(2):167-176.