摘要
目的评价益气活血通脉汤结合西医常规疗法治疗糖尿病下肢动脉硬化闭塞症的疗效。方法将符合入选标准的2017年3月-2019年3月泰州市中医院80例糖尿病下肢动脉硬化闭塞症患者按随机数字表法分为对照组39例和研究组41例。对照组采用静脉注射前列地尔注射液与口服西洛他唑片治疗,研究组在对照组基础上加服益气活血通脉汤。2组均治疗1个月。采用葡萄糖氧化酶法测定空腹血糖(fasting plasma glucose, FPG)、2 hPG,采用免疫散射比浊法测定TNF-α、IL-1及超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP),采用黏度计检测血浆黏度及全血黏度,采用微量热沉法测定纤维蛋白原(fibrinogen, Fib),采用Wintrobe法测定ESR。以彩色多普勒超声仪测定足背动脉和股浅动脉的血管内径、血流量和峰值流速,记录不良反应,评价临床疗效。结果研究组总有效率为90.2%(37/41)、对照组为71.8%(28/39),2组比较差异有统计学意义(χ^2=4.466,P=0.035)。治疗后,研究组FPG、2 hPG、TNF-α、IL-1、hs-CRP水平均低于对照组(t值分别为6.113、4.180、7.655、2.825、2.534,P<0.01或P<0.05);血浆黏度、全血黏度、Fib、ESR均低于对照组(t值分别为5.649、9.894、15.280、3.455,P值均<0.01)。治疗后,研究组股浅动脉、足背动脉的血管内径(t值分别为4.184、4.415)及血流量(t值分别为2.253、7.859)均高于对照组(P<0.01或P<0.05),峰值流速均低于对照组(t=6.346、6.427,P值均<0.01)。结论益气活血通脉汤结合西医常规疗法可有效改善糖尿病下肢动脉硬化闭塞症患者的血糖水平及血液高凝状态,升高股浅动脉、足背动脉的血管内径及血流量,降低峰值流速,提高临床疗效。
Objective To evaluate the efficacy of Yiqi-Huoxue-Tongmai Decoction combined with conventional western medicine therapy in the treatment of diabetic lower extremity arteriosclerosis obliterans.Methods A total of 80 patients with diabetic lower extremity arteriosclerosis obliterans in Taizhou Hospital of TCM from March 2017 to March 2019 who met the inclusion criteria were divided into the control group of 39 cases and study group of 41 cases,by random number table method.The control group was treated by intravenous injection of alprostadil injection and oral cilostazol tablets,and the study group was given Yiqi-Huoxue-Tongmai Decoction on the basis of the control group.Both groups were treated for 1 month.Fasting plasma glucose(FPG)and 2 hPG content were measured by glucose oxidase method,the TNF-α,IL-1 and hypersensitive C-reactive protein(hs-CRP)were measured by immunoturbidimetric method.Plasma viscosity and whole blood viscosity were measured by viscometer.Fibrinogen(Fib)level was measured by microcalorimetry.ESR was measured by Wintrobe method.The diameter of dorsalis pedis artery and superficial femoral artery,blood flow and peak velocity were measured by color doppler ultrasound,and adverse reactions were recorded,and the clinical efficacy was evaluated.Results The total effective rate of the study group was 90.2%(37/41)and that of the control group was 71.8%(28/39).The difference between the two groups was statistically significant(χ^2=4.466,P=0.035).After treatment,the levels of FPG,2 hPG,TNF-α,IL-1 and hs-CRP in the study group were significantly lower than those in the control group(t values were 6.113,4.180,7.655,2.825,2.534,respectively,P<0.01 or P<0.05);the plasma viscosity,whole blood viscosity,Fib and ESR were significantly lower than those in the control group(t values were 5.649,9.894,15.280,3.455,respectively,all Ps<0.01).After treatment,the vessel diameter of the superficial femoral artery and dorsalis pedis artery(t values were 4.184,4.415,respectively)and blood flow(t values were 2.253,7.859,respectively)in the study group were significantly higher than those in the control group(P<0.01 or P<0.05),and the peak flow velocity was significantly lower than that of the control group(t=6.346,6.427,P<0.01).Conclusions Yiqi-Huoxue-Tongmai Decoction combined with conventional western medicine therapy can improve the blood glucose level and hypercoagulable state of patients with diabetic lower extremity arteriosclerosis obliterans,as well as the blood flow velocity and blood flow of superficial femoral artery and dorsal foot artery.
作者
翟丽萍
王旭
Zhai Liping;Wang Xu(Department of Endocrine,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China;Department of Endocrine,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,China)
出处
《国际中医中药杂志》
2020年第11期1069-1073,共5页
International Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81973796)。
关键词
糖尿病并发症
闭塞性动脉硬化
益气活血通脉汤
前列地尔
西洛他唑
中西医结合疗法
Diabetes complications
Arteriosclerosis obliterans
Yiqi-Huoxue-Tongmai Decoction
Alprostadil
Cilostazol
Integrated Chinese traditional and western medicine therapy
作者简介
通信作者:王旭,Email:njzywangxu@126.com,电话:18051986182。
