摘要
目的探讨藤芪通络颗粒治疗2型糖尿病下肢血管病变气虚血瘀证患者的疗效及对血清丝氨酸蛋白酶抑制剂、视黄醇结合蛋白4水平的影响。方法选取2018年3月—2020年3月期间青岛市立医院本部内分泌科诊治的2型糖尿病下肢血管病变患者82例,采用随机数字表法分为治疗组和对照组,每组各41例。对照组患者给予基础干预措施,治疗组患者在对照组基础上给予藤芪通络颗粒治疗。两组患者均持续治疗12周后,观察比较两组患者临床疗效,治疗前后血糖、血清腹内脂肪型丝氨酸蛋白酶抑制剂(Visceral adipose-specific serine protease inhibitor,Vaspin)、血清视黄醇结合蛋白4(Retinol binding protein 4,RBP4)、中医证候积分、踝肱指数及足背动脉血流量。结果两组患者治疗后空腹血糖、餐后2 h血糖水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组空腹血糖、餐后2 h血糖水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后治疗组临床总有效率为87.80%(36/41)明显高于对照组68.29%(28/41),差异有统计学意义(P<0.05)。两组患者治疗后血清Vaspin水平均较治疗前升高,RBP4水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清Vaspin水平较对照组明显升高,RBP4水平较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后中医证候面色晦暗、肌肤甲错、自汗、气短懒言、倦怠乏力、肢体疼痛、肢体麻木积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后踝肱指数、足背动脉血流量均较治疗前升高,差异有统计学意义(P<0.05);且治疗组较对照组明显升高,差异有统计学意义(P<0.05)。结论2型糖尿病下肢血管病变气虚血瘀患者,采用藤芪通络颗粒进行治疗,可提升治疗效果,降低血糖以及血清RBP4水平,提高血清Vaspin水平,改善患者临床症状,提升踝肱指数以及足背动脉血流量。
Objective To explore the clinical efficacy of TengqiTongluo Granules(TQTL)in the treatment of lower extremity angiopathy with qi deficiency and blood stasis syndrome in patients with type 2 diabetes and the effects on serum levels of VAT-derived serine protease inhibitor(Vaspin)and retinol-binding protein 4(RBP4).Methods Eighty-two patients with lower extremity angiopathy induced by type 2 diabetes admitted to the department of endocrinology,Qingdao Municipal Hospital from March 2018 to March 2020 were randomly divided into a treatment group(n=41)and a control group(n=41)according to a random number table.All patients were treated by basic intervention,while those in thetreatment group received additional TQTL.After treatment for 12 weeks,the clinical efficacy,blood glucose,serum Vaspin,serum RBP4 before and after treatment,traditional Chinese medicine(TCM)syndrome scores,ankle-brachial index(ABI),and blood flow of dorsalis pedis artery of the two groups were compared.Results The fasting blood glucose and 2 h postprandial glucose levels of the two groups after treatment were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).The total effective rate of the treatment group was 87.80%(36/41),higher than 68.29%(28/41)of the control group(P<0.05).After treatment,serum Vaspin levels in the two groups increased and RBP4 levels decreased compared with those before treatment(P<0.05),and the above changes in the treatment were more significant than those in the control group(P<0.05).After treatment,TCM syndrome scores,including dark complexion,encrusted skin,spontaneous sweating,shortness of breath,laziness to speak,fatigue,and limb pain and numbness,in the two groups were all lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).The ABI and blood flow of dorsalis pedis artery of the two groups after treatment were higher than those before treatment(P<0.05),and the treatment group was higher than the control group(P<0.05).Conclusion TQTLcan enhance the therapeutic effect on type 2 diabetes-induced lower extremity angiopathy with qi deficiency and blood stasis syndrome by reducing blood glucose and serum RBP4 level,increasing serum Vaspin level,relieving clinical symptoms,and improving ABI and blood flow of dorsalis pedis artery.
作者
路巍
包蕾
张莹
王若平
LU Wei;BAO Lei;ZHANG Ying;WANG Ruo-ping(Department of Endocrinology,Qinglao Munieipal Hospital,Qinglao Shandong 266000;Department of Endocrinology,Qingdao Chengyang People's Hospital,Qingdao Shandong 266109;Department of Pharmacy,Yantai Yuhuangding Hospital,Yantai Shandong 264000;Department of Endocrinology,Qingdao Municipal Hospital(Easterm Hospital),Qingdao Shandong 266000)
出处
《世界中西医结合杂志》
2022年第4期778-782,共5页
World Journal of Integrated Traditional and Western Medicine
作者简介
通信作者:王若平,Email:13969748830@163.com。
