降浊通络益气养阴法联合西药治疗2型糖尿病脑梗死的临床研究

Clinical Research on Jiangzhuo Tongluo Therapy Combined with Supplementing Qi and Nourishing Yin Recipe in the Treatment of Type 2 Diabetic Cerebral Infarction

目的探讨降浊通络益气养阴法联合西药治疗2型糖尿病脑梗死(DCI)的临床疗效及作用机制。方法选取2017年4月—2019年1月我院收治的DCI病人130例,采用随机数字表法分为治疗组和对照组,各65例。两组均给予常规治疗,治疗组在常规治疗基础上联合降浊通络益气养阴法治疗,分别于治疗前后抽取晨起空腹静脉血,测定空腹血糖(FPG)、餐后2 h血糖(PBG)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂联素(APN)、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)水平,并计算胰岛素抵抗指数(HOMA-IR),采用美国国立卫生研究院卒中量表评分(NIHSS)评价神经功能缺损情况,采用彩色多普勒超声测定颈动脉内膜-中层厚度(IMT),并于治疗1个月后进行疗效评价。结果治疗后,治疗组临床疗效高于对照组,差异有统计学意义(P<0.05)。治疗后,两组FPG、PBG、FINS、HOMA-IR较治疗前降低(P<0.05),且治疗组FPG、PBG、FINS、HOMA-IR低于对照组(P<0.05)。治疗后,治疗组TG、TC、LDL-C降低,HDL-C升高,对照组TG降低,差异均有统计学意义(P<0.05),且治疗组TG、TC、LDL-C低于对照组,HDL-C高于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后两组APN升高,hs-CRP、Hcy降低,差异均有统计学意义(P<0.05),且治疗组APN高于对照组,hs-CRP、Hcy低于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后两组NIHSS评分、IMT降低(P<0.05),且治疗组NIHSS评分、IMT低于对照组,差异均有统计学意义(P<0.05)。结论降浊通络益气养阴法联合西药能有效调节DCI病人APN、hs-CRP、Hcy水平及血糖、血脂水平,并改善神经功能缺损。

Objective To explore the clinical research on Jiangzhuo Tongluo therapy combined with Supplementing Qi and Nourishing Yin recipe in the treatment of type 2 diabetic cerebral infarction(DCI).Methods One hundred and thirty patients with DCI were randomly divided into the treatment group and the control group,65 cases in each group.The control group were treated with traditional treatments,including blood sugar,blood lipid,and blood pressure controlling,antiplatelet aggregation,anti-coagulation,diet and exercise guidance.On the basis of the control group,the treatment group were treated with Jiangzhuo Tongluo Therapy combined with Supplementing Qi and Nourishing Yin recipe.After treatment for 1 month,the clinical efficacy,fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG),fasting insulin(FINS),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),adiponectin(APN),high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),and insulin resistance index(HOMA-IR)were compared between two groups.National Institute of Health Stroke Scale(NIHSS)was used to estimate the neurologic impairment.Intima-media thickness(IMT)was measured by the color Doppler ultrasonic diagnosis apparatus.Results After treatment,the clinical efficacy of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,FPG,PBG,FINS,and HOMA-IR in two groups were significantly lower than those before treatment,FPG,PBG,FINS,and HOMA-IR in the treatment group were lower than those in the control group(P<0.05).After treatment,TG,TC,and LDL-C in two groups were significantly lower than those before treatment,TG,TC,and LDL-C in the treatment group were lower than those in the control group,while HDL-C in the two groups was significantly higher than that before treatment,HDL-C in the treatment group was higher than that in the control group(P<0.05).After treatment,NIHSS scores and IMT in the two groups were significantly lower than those before treatment,NIHSS scores and IMT in the treatment group were lower than those in the control group(P<0.05).After treatment,APN in two groups was significantly higher than that before treatment,APN in the treatment group was higher than that in the control group(P<0.05),while hs-CRP and Hcy in two groups were significantly lower than those before treatment,hs-CRP and Hcy in the treatment group were lower than those in the control group(P<0.05).Conclusion Jiangzhuo Tongluo therapy combined with Supplementing Qi and Nourishing Yin recipe could effectively regulate APN,hs-CRP,Hcy,blood sugar,and blood lipid levels,and improve the neurologic impairment in the treatment of DCI.