化痰通络法治疗糖尿病颈动脉粥样斑块30例疗效观察

Therapeutic Effect of Phlegm-Eliminating and Collateral-Dredging Therapy on Carotid Atherosclerotic Plaque of Patients with Diabetes Mellitus

目的:观察化痰通络法治疗糖尿病颈动脉粥样斑块的临床疗效。方法:将58例患者按照随机数字表法分为治疗组30例和对照组28例。所有病人予以口服降糖药或胰岛素控制血糖在理想范围,对照组给予口服舒降之片,治疗组在对照组基础上口服化痰通络法中药,治疗12周。治疗前后分别检测颈总动脉内-中膜厚度(IMT)、血管细胞黏附分子-1(sVCAM-1)和总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。结果:治疗组治疗后IMT、sVCAM-1及各项血脂指标较治疗前均明显改善,与治疗前比较,差异有显著性或非常显著性意义(P<0.05,P<0.01)。治疗后2组sVCAM-1、TG、HDL-C比较,差异均有显著性意义(P<0.05)。结论:化痰通络法能改善糖尿病患者颈动脉粥样硬化状况。

Objective： To observe the therapeutic efficacy of phlegm-eliminating and collateral-dredging therapy for carotid atheromatous plaque in patients with diabetes mellitus type 2 （T2DM）. Methods： Fifty-eight patients were randomized into the treatment group（n=30）and the control group（n=28）. On the basis of controlling blood glucose with hypoglycemic agents and insulin, the control group was given oral use of simvastatin, and the treatment group was given Chinese medicine with the action of eliminating phlegm and dredging collateral additionally. The treatment lasted 12 weeks, Before and after treatment, the intima- media thickness （IMT）, and serum levels of soluble vascular cell adhesion molecular I（sVCAM-1）, total cholesterol（TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） of the patients were examined. Results： After treatment IMT and the levels of serum sVCAM-1, TC, TG and LDL-C were decreased, and HDL was increased significantly in the treatment group （P 〈 0.05 or P 〈 0.01 compared with those before treatment）. And the improvement of sVCAM-1, TG and HDL-C was obvious in the treatment group after treatment （P〈 0.05 compared with that in the control group）. Conclusion： Phlegm-eliminating and collateral-dredging therapy is effective in ameliorating carotid atherosclerotic plaque.