疏肝清脂汤对糖尿病下肢动脉粥样硬化病变患者血管内皮功能的影响

Effect of Shugan Qingzhi Decoction(疏肝清脂汤)on Vascular Endothelial Function in Diabetic Patients with Lower Extremity Atherosclerosis

目的探讨疏肝清脂汤对糖尿病下肢动脉粥样硬化病变患者血管内皮功能的影响。方法对2018年12月—2020年7月于该院就诊的患者进行筛选,参照纳、排标准,共纳入118例。依照随机数字表法,患者随机分两组,对照组59例采用常规西医治疗,治疗组在此基础上加用疏肝清脂汤,疗程均为3个月。观察两组患者中医证候积分改变情况,治疗前后患者血糖水平、踝肱指数(ABI)及血管内皮功能改善情况,并比较两组临床疗效。结果两组患者下肢麻木,下肢痛如针刺、痛有定处,胁肋胀痛等症状均有改善,中医证候积分均明显降低(P<0.05),且治疗组降低程度明显大于对照组(P<0.05);两组ABI、血糖指标糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)及血管内皮功能指标血管性假性血友病因子(vWF)、凝血酶调节蛋白(TM)、内皮素(ET)均明显下降(P<0.05),且组间比较,治疗组下降幅度更大(P<0.05);治疗组临床总有效率为91.53%(54/59),对照组临床总有效率为77.97%(46/59),治疗组疗效显著优于对照组(P<0.05)。结论疏肝清脂汤具有疏肝行气、活血化瘀、化浊清脂之效,可有效控制血糖水平,保护血管内皮功能,改善临床症状,治疗糖尿病下肢动脉粥样硬化病变的临床疗效较好,值得应用。

Objective To explore the effect of Shugan Qingzhi Decoction(疏肝清脂汤)on vascular endothelial function in diabetic patients with lower extremity atherosclerosis.Methods According to the inclusion criteria and exclusion criteria,the diabetic patients with lower extremity atherosclerosis diagnosed and treated in our hospital from December 2018 to July 2020 were screened,and 118 cases were finally included.All patients were randomly divided into two groups(group A and group B)according to the random number table method.The group A(control group)was given conventional western medicine treatment(Scheme A),and the group B(treatment group)was treated with Shugan Qingzhi Decoction on the basis of the Scheme A(Scheme B).The treatment course was 3 months.The change of TCM syndrome integral,the improvement of blood sugar level,ABI and vascular endothelial function before and after treatment,and the clinical efficacy of the two groups were observed and compared.Results After treatment,the symptoms such as numbness of lower limbs,pain of lower limbs(including acupuncture sensation and fixed pain)and swelling pain of hypochondriac were improved in both groups.The TCM syndrome scores of the two groups were significantly reduced(P<0.05),and the reduction degree of the treatment group was significantly greater than that of the control group(P<0.05).ABI,blood glucose indicators such as HbA1 c,FPG,2 h PG,and vascular endothelial function indicators such as vWF,TM,ET were significantly decreased in both groups(P<0.05),and the decrease in the treatment group was greater(P<0.05).According to the total clinical effective rate,the clinical efficacy of group B(91.53%,54/59)was significantly better than that of group A(77.97%,46/59)(P<0.05).Conclusion Shugan Qingzhi Decoction has the effects of soothing liver and promoting the circulation of Qi,improving blood circulation and dispersing blood stasis,removing turbidity and clearing fat.This treatment can effectively control blood sugar level,protect vascular endothelial function,improve clinical symptoms,and has good clinical efficacy in treating diabetic lower extremity atherosclerosis,which is worthy of application.