摘要
【目的】观察荷芪散治疗痰瘀互结证2型糖尿病(T2DM)合并冠心病(CHD)的临床疗效及其对血清氧化三甲胺(TMAO)水平的影响。【方法】将40例痰瘀互结证T2DM合并CHD患者随机分为观察组和对照组,每组各20例。2组患者均给予降压、调脂及抗血小板聚集等西医基础治疗,在此基础上,对照组给予利拉鲁肽治疗,观察组在对照组的基础上加用荷芪散治疗,疗程为1个月。观察2组患者治疗前后中医证候积分、糖代谢指标、脂代谢指标、左心室功能相关指标、炎症因子、内皮素1(ET-1)以及肠道菌群代谢产物TMAO水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面:治疗1个月后,观察组的总有效率为95.0%(19/20),对照组为70.0%(14/20),组间比较,观察组的临床疗效明显优于对照组(P<0.05)。(2)中医证候积分方面:治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.01),且观察组对中医证候积分的下降作用明显优于对照组(P<0.01)。(3)糖代谢相关指标方面:治疗后,2组患者的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均较治疗前明显下降(P<0.01),且观察组对FPG、2hPG、HbAlc、FINS、HOMA-IR的下降作用均明显优于对照组(P<0.05或P<0.01)。(4)脂代谢相关指标方面:治疗后,2组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均较治疗前明显下降(P<0.01),且观察组对TC、TG和LDL-C的下降作用均明显优于对照组(P<0.05)。(5)炎性因子、血管内皮因子以及肠道菌群代谢产物方面:治疗后,2组患者血清白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、ET-1和TMAO水平均较治疗前明显下降(P<0.01),且观察组对血清IL-6、hs-CRP、ET-1和TMAO水平的下降作用均明显优于对照组(P<0.05)。(6)超声心动图方面:治疗后,2组患者的左室射血分数(LVEF)、二尖瓣口血流频
Objective To investigate the clinical efficacy of Heqi Powder on type 2 diabetes mellitus(T2 DM)complicated with coronary heart disease(CHD)differentiated as phlegm blended with blood stasis syndrome,and to observe its effect on serum trimethylamine N-oxide(TMAO). Methods Forty T2 DM patients complicated with CHD and differentiated as phlegm blended with blood stasis syndrome were randomly divided into the observation group and the control group,with 20 patients in each group. The patients of both groups were given basic western medicine treatment for lowering blood pressure, regulating blood lipids and counteracting platelet aggregation,and additionally,the control group was given subcutaneous injection of Liraglutide Injection,and the observation group was given Heqi Powder orally together with subcutaneous injection of Liraglutide Injection. The course of treatment for the two groups lasted for one month. The changes of traditional Chinese medicine(TCM)syndrome scores, glucose metabolism indexes, lipid metabolism indexes, left ventricular function related indexes,inflammatory factors,endothelin 1(ET-1)and intestinal microflora metabolite TMAO level in the two groups were observed before and after treatment. After treatment, the clinical efficacy and safety of the two groups were evaluated. Results(1)Clinical efficacy:after one month of treatment,the total effective rate of the observation group was 95.0%(19/20),and that of the control group was 70.0%(14/20). The intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)TCM syndrome scores:after treatment,the TCM syndrome scores of both groups were significantly decreased compared with those before treatment(P<0.01),and the effect of the observation group on the decline of TCM syndrome scores was significantly superior to that of the control group(P<0.01).(3)Glucose metabolism related indicators: after treatment, the levels of fasting plasma glucose(FPG), 2-hour postprandi
作者
楚淑芳
董彦敏
赵恒侠
刘雪梅
渠昕
王高祥
李惠林
CHU Shu-Fang;DONG Yan-Min;ZHAO Heng-Xia;LIU Xue-Mei;QU Xin;WANG Gao-Xiang;LI Hui-Lin(Department of Endocrinology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China;Nanjing University of Chinese Medicine,Nanjing 210046 Jiangsu,China)
出处
《广州中医药大学学报》
CAS
2022年第2期241-248,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
深圳市科技计划项目(编号:JCYJ20180302173821841)
深圳市医疗卫生三名工程项目(编号:SZSM201512043)。
关键词
荷芪散
利拉鲁肽
2型糖尿病
冠心病
痰瘀互结证
血清氧化三甲胺(TMAO)
糖脂代谢
心功能
炎症因子
Heqi Powder
Liraglutide
type 2 diabetes mellitus(T2DM)
coronary heart disease(CHD)
phlegm blended with blood stasis syndrome
serum trimethylamine N-oxide(TMAO)
glucolipid metabolism
cardiac function
inflammatory factors
