桃红四物汤对痰瘀互结型糖尿病合并动脉粥状硬化患者心率变异性、血脂及CRP的影响

Effect of Taohong Siwutang on Heart Rate Variability,Blood Lipids and CRP of Patients of Phlegm and Blood Stasis Type Diabetes Mellitus with Atherosclerosis

目的:探讨桃红四物汤对痰瘀互结型糖尿病合并动脉粥状硬化患者心率变异性、血脂及C反应蛋白(CRP)的影响。方法:收集广东省中医院内科收治的痰瘀互结型糖尿病合并动脉粥状硬化患者120例,随机分为治疗组和对照组,各60例。2组患者均给予常规治疗,二甲双胍0.25 g·d-1,阿卡波糖50 mg·d^(-1)或注射胰岛素。对照组予以消心痛及复方丹参滴丸,10粒/次,每日1次口服;治疗组常规治疗基础上予以桃红四物汤加减,200 m L·d^(-1),分早晚2次温热后口服,每4周为1个疗程。2组均连续治疗4周。治疗结束后,比较患者心率变异性,血脂,血糖,CRP水平及不良反应发生情况。结果:治疗后与对照组比较,治疗组临床总有效率较高(P<0.05)。与治疗前比较,两组患者24 h正常R-R间期的标准差(SDNN),相邻RR间期差值的均方根(RMSSD),相邻正常R-R间期差值>50 ms比率(PNN50)水平升高(P<0.05),与对照组比较,治疗组SDNN,RMSSD,PNN50水平较高(P<0.05)。与治疗前比较,空腹血糖(FPG),餐后2 h血糖(PBG)以及糖化血红蛋白(Hb A1c)水平降低(P<0.05);治疗后与对照组比较,治疗组FPG,PBG以及糖化血红蛋白水平较低(P<0.05)。治疗后2组总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),甘油三酯(TG),CRP水平降低,高密度脂蛋白-胆固醇(HDL-C)升高(P<0.05);与对照组比较,治疗组TC,LDL-C,TG水平较低,CRP,HDL-C水平较高(P<0.05)。结论:桃红四物汤对痰瘀互结型糖尿病合并动脉粥状硬化患者的临床疗效显著,能够调节心率变异性,下调CRP水平,安全性高,适宜临床应用推广。

Objective ： To investigate the effect of Taohong Siwutang on heart rate variability, blood lipids and C reactive protein （CRP） of patients of phlegm and blood stasis type diabetes mellitus with atherosclerosis. Method ： A total of 120 patients of phlegm and blood stasis type diabetes mellitus with atherosclerosis were selected and randomly divided into control group and experiment group, with 60 cases in each group. The two groups of patients were given conventional therapy, namely metformin 0.25 g-d-1, and acarbose 50 mg-d-1or injection with insulin. The control group was orally given isosorbide dinitrate and Danshen dripping pills, 10 pills each time, 1 times a day. In addition to the conventional therapy, experiment group was orally given with 200 mL warm Taohong Siwutang. One course of treatment was four weeks. The two groups were treated continuously for 4 weeks. Heart rate variability, blood lipids, blood glucose, CRP level and adverse reactions were compared between two groups after the treatment. Result： Compared with control group, the total clinical effective rate was higher in experimental group after treatment （P 〈 0.05）. Compared with before treatment, the normal 24 h normal R-R standard deviation of NN intervals （SDNN） , the adjacent R-R root mean square successive difference （RMSSD） , and the percentage of adjacent normal R-R difference 〉 50 ms （PNNS0） of two groups of patients were increased （P 〈 0.05）. Compared with control group, SDNN, RMSSD and PNN50 levels were higher in treatment group （P 〈 0.05）. Compared with before treatment, fasting blood glucose （FPG）, 2 h postprandial blood glucose （PBG） and glycosylated hemoglobin （HBAlc） were decreased （P 〈 0.05）. Compared with control group, fasting blood glucose, postprandial 2 h blood glucose and glycosylated hemoglobin levels were lower in experiment group （P 〈 0.05）. Total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, triglyceride （TG）, CRP, high- density lipoprotein cholesterol （HDL-C） were higher in two groups after treatment （P 〈 0.05 ）. Compared with control group, TC, LDL-C, TG and CRP levels were lower, while HDL-C level was higher in experiment group （P 〈 0.05）. Conclusion： Taohong Siwutang has a significant clinical efficacy on patients of phlegm and blood stasis type diabetes mellitus with atherosclerosis, and can regulate heart rate variability and down-regulate the level of CRP, with a high safety. Therefore, it is suitable for clinical application and promotion.