维格列汀伍用丹参舒心胶囊对早期2型糖尿病患者肺功能的影响

Effects of vildagliptin combined with Danshenshuxin capsule on pulmonary function of patients with early type 2 diabetes mellitus

目的观察维格列汀联合丹参舒心胶囊对早期二甲双胍单药治疗不佳的2型糖尿病(T2DM)患者肺功能的影响,并对其有效性及安全性进行评价。方法选择早期(无微血管病变)经二甲双胍单药治疗且效果不佳的T2DM患者74例,随机分为观察组(n=38)和对照组(n=36),选择同期体检健康40例为健康组。对照组予二甲双胍(1 000 mg、2次/d)、银杏叶提取物片(40 mg、3次/d)、甲钴胺(0.5 mg、2次/d)等口服治疗,观察组予二甲双胍500 mg、3次/d)、维格列汀(50 mg、2次/d)、银杏叶提取物片(40 mg、3次/d)+丹参舒心胶囊(0.4 g、2次/d)、甲钴胺(0.5 mg、2次/d)口服治疗。治疗前记录3组血糖及肺功能等基本资料。T2DM患者连续治疗24周后观察2组治疗后空腹血糖(FBG)、餐后2 h血糖(2 h PG)、体重指数(BMI)与肺功能[肺活量(VC%)、用力肺活量(FVC%)、1 s用力呼气流量(FEV1%)、最大呼气峰流速(PEF%)、最大自主通气量(MVV%)、肺总量(TCL%)、一秒率(FEV1/FVC%)、肺一氧化碳弥散量(DLCO%)、肺单位体积一氧化碳弥散量(DLCO/VA%)]的变化情况,记录治疗过程中的不良反应。结果治疗前T2DM患者的FBG、2 h PG、BMI均高于健康组(P<0.05),肺功能各项指标均低于健康组(P<0.05)。治疗后T2DM两组FBG、2 h PG均低于治疗前(P<0.05),但2组FBG、2 h PG及BMI治疗前后比较差异均无统计学意义(P>0.05)。治疗后2组肺功能均优于治疗前(P<0.05),治疗后观察组肺功能优于对照组(P<0.05)。结论 T2DM患者早期即出现肺功能下降,维格列汀联合丹参舒心胶囊在控制血糖的同时能较好改善患者的肺功能,且安全可靠,不增加体重。

Objictive To investigate the effects of vildagliptin combined with Danshenshuxin capsule on pulmonary function of patients with early type 2 diabetes mellitus （T2DM）.Methods Seventy-four patients with early T2DM without microangiopathy who had been treated by metformin only were randomly divided into observation group （ n =38） and control group （ n =36）,moreover 40 healthy subjects were served as normal control group .The patients in control group were treated by metformin （1000mg,twice a day）, ginkgo biloba extract （40mg,twice a day） and mecobalamin （0.5mg,twice a day）, however, the patients in observation group were treated by metformin （1,000mg,three times a day）, vildagliptin （50mg,twice a day）,ginkgo biloba extract （40mg,three times a day）,Danshenshuxin capsule （0.4g,twice a day） and mecobalamin （0.5 mg,twice a day ） .Before treatment , the basic data including pulmonary function and blood glucose were recorded in both groups.After 24-week treatment, the changes of fasting plasma glucose （FBG）,2-hour postprandial blood glucose （2hPBG）, body mass index （BMI）,and pulmonary function parameters including VC%, FVC%, FEV1%, PEF%, MVV%,TLC%, FEV1/FVC%, DLCO% and DLCO/VA% were observed and compared among the three groups .Moreover the adverse reactions during treatment were observed .Results Before treatment,the levels of FBG,2 hPG,BMI in patients with T2DM were significantly higher than those of healthy subjects （ P 〈0.05）,however,the pulmonary function parameters were obviously lower than those of healthy subjects （ P 〈0.05）.After treatment, the levels of FBG and 2 hPG in observation group and control group were significantly higher than those before treatment （ P 〈0.05）.However there were no significant differences in the levels of FBG ,2 hPG,BMI in observation group and control group before treatment and after treatment （ P 〉0.05）.After treatment, the pulmonary function of patients in observation group and control group was superior to that before treatment （ P 〈0.05）, moreover, which in observation group was superior to that in control group （ P 〈0.05）.Conclusion The pulmonary function of patients with T 2Dm is decreased at early period ,and vildagliptin combined with Danshenshuxin capsule can effectively improve patient ＇ s pulmonary function and can control blodd glucose ,with safety and reliability ,without increasing body weight .