中西医结合治疗2型糖尿病合并脑梗死阴虚血瘀证效果观察

Clinical effect of integrated TCM and Western medical treatment on patients with diabetes 2 with cerebral infarction with yin deficiency and blood stagnation theory

目的评价自拟中药汤剂结合α硫辛酸治疗糖尿病合并脑梗死阴虚血瘀证患者的疗效。方法将202例2型糖尿病合并脑梗死患者随机分为两组，每组101例。所有患者均进行常规治疗，对照组采用α硫辛酸治疗，治疗组在对照组治疗基础上服用本院自拟中药汤剂。治疗前后，监测患者氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH—Px）、丙二醛（MDA）、血糖、血脂、B细胞功能等指标，对患者进行美国国立卫生研究院卒中量表（NIHSS）评分，采用中医证候积分计算患者的疗效指数，进行疗效判定。结果治疗组治疗后SOD与GSH—Px显著升高，MDA显著降低；与对照组比较，治疗组NIHSS、血糖、血脂、HOMA—IA显著下降；两组均未见显著不良反应。结论自拟中药汤剂联合α硫辛酸治疗糖尿病合并脑梗死阴虚血瘀证患者可显著减少患者氧化应激反应，降低血糖、血脂，疗效显著，且不良反应少，值得临床推广。

Objective To investigate the advantages of integrated treatment of both traditional Chinese medicine （TCM） and Western medicine for patients with type 2 diabetes with cerebral infarction with yin deficiency and blood stagnation. Methods A total of 202 patients with type 2 diabetes with cerebral infarction with yin deficiency and blood stagnation were randomly divided into two groups, with 101 cases in each group. All patients were treated with routine treatment. The control group were treated with α-alpha sulfur acid. The treatment group took the self-made TCM decoction. Before and after treatment, the levels of superoxide dismutase （SOD）, glutathione peroxidase （GSH-Px）, malondialdehyde （MDA）, blood glucose, blood lipid, beta cell function indexes were detected. The patients were measured by National Institutes of Health Stroke Scale （NIHSS）. Patient efficacy index was calculated according to TCM syndrome integral to evaluate clinical effect. Results SOD and GSH-Px were significantly increased in the treatment group after treatment, MDA decreased significantly. Compared with the control group, NIHSS, blood glucose, blood lipid, HOMA-IA were significantly decreased in the treatment group. Conclusions The yin deficiency and blood stagnation theory for curing patients with diabetes 2 with cerebral infarction can significantly reduce the oxidative stress, decrease blood glucose andblood lipid, has good curative effect and less adverse reactions. It is worthy of clinical promotion.