玉液汤加减治疗糖尿病周围血管病变对促进足部血流循环、保护血管内皮的效果研究

Effect of Modified Yuye Decoction(玉液汤加减)on Promoting Blood Circulation and Protecting Vascular Endothelium in Feet in Treatment of Diabetic Peripheral Vascular Disease

目的观察玉液汤加减治疗糖尿病周围血管病变对促进足部血流循环、保护血管内皮的效果。方法选取医院于2019年1月—2021年6月收治的86例气阴两虚夹瘀型糖尿病周围血管病变分患者为两组,每组43例。对照组给予常规西药治疗,观察组在对照组基础上给予玉液汤加减治疗。记录两组足背动脉血流速度、血流量及足部温度、中医证候积分的变化,检测两组白细胞介素-12(IL-12)、血管细胞黏附因子-1(VCAM-1)、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)的变化,计算两组肱动脉内皮依赖性血管舒张功能(FMD)的变化,并统计两组总有效率。结果观察组的总有效率为90.70%(39/43),高于对照组的72.09%(31/43),组间比较发现,差异有统计学意义(P<0.05)。治疗后进行组内比较发现,两组足背动脉血流速度及血流量逐渐上升(P<0.05),进一步组间比较发现,观察组足背动脉血流速度及血流量高于对照组(P<0.05)。治疗后进行组内比较发现,两组IL-12、VCAM-1、TGF-β1、VEGF逐渐下降(P<0.05),进一步组间比较发现,观察组IL-12、VCAM-1、TGF-β1、VEGF低于对照组(P<0.05)。治疗后进行组内比较发现,两组FMD、足部温度逐渐上升(P<0.05),中医证候积分逐渐下降(P<0.05),进一步组间比较发现,观察组FMD、足部温度高于对照组(P<0.05),中医证候积分低于对照组(P<0.05)。结论玉液汤加减可改善糖尿病周围血管病变患者的足部血流循环,降低相关血清因子的表达,提高疗效。

Objective To observe the effect of Modified Yuye Decoction(玉液汤加减)treating diabetic peripheral vascular disease on blood circulation and protecting vascular endothelium in feet.Methods From January 2019 to June 2021,86 patients with peripheral vascular disease of Qi-Yin deficiency and blood stasis type of diabetes were divided into two groups,43 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Yuye Decoction on the basis of the control group.The changes of blood flow velocity,blood flow and foot temperature,TCM symptom score of dorsal foot artery were recorded.The changes of interleukin-12(IL-12),vascular cell adhesion factor-1(VCAM-1),transforming growth factorβ1(TGF-β1)and vascular endothelial growth factor(VEGF)were detected in both groups.The changes of brachial artery endothelial dependent vasodilation function(FMD)were calculated and the total effective rate was counted in both groups.Results Compared with that of the control group,the total effective rate of the observation group was 90.70%(39/43),which was higher than that(72.09%,31/43)of the control group(P<0.05).The blood flow velocity and blood flow of dorsal foot artery in the two groups were increased gradually(P<0.05).The blood flow velocity and blood flow of dorsal foot artery in the observation group were higher than those in the control group(P<0.05).The levels of IL-12,VCAM-1,TGF-β1 and VEGF of the two groups were decreased gradually(P<0.05),and those of the observation group were lower than those of the control group(P<0.05).The results showed that the foot temperature and FMD of the two groups were increased gradually(P<0.05)and the TCM symptom score decreased gradually(P<0.05).The foot temperature in the observation group was higher than that in the control group(P<0.05)and the TCM symptom score was lower than that in the control group(P<0.05).Conclusion Modified Yuye Decoction can improve the foot blood circulation in patients with diabetic peripheral vascular disease,reduce the expressions of related serum factors and improve the curative effect.