摘要
目的评价益气养阴消癥通络颗粒联合西医常规疗法治疗糖尿病下肢血管病变(DLEAD)气阴两虚兼血瘀证患者的临床疗效,以及对糖脂代谢、炎症因子和血管内皮功能的影响。方法采用随机数字表法将118例DLEAD患者分为对照组和观察组各59例。2组均口服厄贝沙坦片、辛伐他汀片、格列齐特片及拜阿司匹林肠溶片控制血压、血脂、血糖及血小板聚集;观察组在此基础上予益气养阴消癥通络颗粒,每次10 g,每日3次,口服。2组均连续治疗24周。观察2组临床疗效,比较2组治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)、踝肱指数(ABI)、趾肱指数(TBI)、足背动脉血管内径、血流量及峰值流速、中医症状评分、多伦多临床神经病变评分(TCSS)及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)、内皮素-1(ET-1)及凝血酶调节蛋白(TM)水平。对2组进行安全性监测。结果观察组总有效率为91.53%(54/59),对照组为78.43%(40/51),观察组临床疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后FPG、2 h PG、HbA1c、LDL-C、SBP、DBP水平下降,ABI和TBI指数升高,足背动脉血管内径、血流量及峰值流速改善,中医症状评分及TCSS各项评分降低,血清TNF-α、IL-6、Hcy、hs-CRP、VEGF、ET-1及TM水平下降(P<0.05);2组治疗后比较,观察组上述指标改善均优于对照组(P<0.05)。2组治疗期间,血、尿常规及肝、肾功能未见异常。结论在西医常规治疗基础上采用益气养阴消癥通络颗粒可明显减轻DLEAD气阴两虚兼血瘀证患者临床症状,改善下肢血管功能及血流动力学情况,减轻或延缓DLEAD进展,提高生活质量。其机制可能与调节血管内皮功能、抑制炎症反应有关。
Objective To study the clinical efficacy of Yiqi Yangyin Xiaozheng Tongluo Granules on qi-yin deficiency and blood-stasis syndrome caused by diabetic lower-extremity arterial disease(DLEAD),and the effects on glucose and lipid metabolism,inflammatory factors and vascular endothelial function.Methods Totally 118 DLEAD patients were divided into control group and observation group according to random number table method,59 cases in each group.Both groups were taken orally Irbesartan Tablets,Gliclazide Tablets,Simvastatin Tablets and Aspirin Enteric-coated Tablets for controlling blood pressure,blood fat,blood sugar and platelet aggregation.Patients in observation group were added with Yiqi Yangyin Xiaozheng Tongluo Granules,10 g per time,three times a day,orally.The course of treatment was 24 weeks.The clinical efficacy of both groups was observed.Before and after treatment,fasting plasma glucose(FPG),blood sugar 2 h after meal(2 h PG),glycosylated hemoglobin(HbA1c),low densitly lipoprotein-cholesterol(LDL-C),systolic pressure(SBP),diastolic pressure(DBP),ankle brachial index(ABI),toe branch index(TBI),internal diameter of dorsal artery of foot,blood flow,peak velocity,scores of TCM symptom,Toronto clinical scoring system(TCSS),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),homocysteine(Hcy),high sensitive C reactive protein(hs-CRP),vascular endothelial growth factor(VEGF),endothelin-1(ET-1)and thrombomodulin(TM)levers of serum were compared.The safety of the two groups was monitored.Results The total clinical effective rate of observation group was 91.53%(54/59),and the control group was 78.43%(40/51).The observation group was better than the control group(P<0.05).The levers of FPG,2 h PG,HbA1c,LDL-C,SBP and DBP were lower than those before treatment in two groups;the ABI and TBI increased;the vascular internal diameter,blood flow and peak velocity of the dorsal artery of the foot were improved;the scores of TCM symptoms and TCSS dimensions were reduced;serum levels of TNF-α,IL-6,Hcy,hs-CRP,VEGF,ET-1 and TM
作者
石静
李旺
张玉梅
俞晓英
SHI Jing;LI Wang;ZHANG Yumei;YU Xiaoying(Lanzhou Xigu District People’s Hospital,Lanzhou 730060,China;Pharmacy Department,Gem Flower Hospital of Gansu,Lanzhou 730060,China;Clinical College of Chinese Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2021年第8期103-109,共7页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金(81460611)
兰州市科技发展计划(2019-ZD-144)。
关键词
糖尿病下肢动脉病变
气阴两虚兼血瘀证
益气养阴消癥通络颗粒
肢体功能
糖脂代谢
炎症因子
血管内皮功能
diabetic lower-extremity arterial disease
qi-yin deficiency and blood-stasis syndrome
Yiqi Yangyin Xiaozheng Tongluo Granules
limb function
glucose and lipid metabolism
inflammatory factor
vascular endothelial function
