益气养阴活血汤联合西药对糖尿病合并冠心病患者临床症状及血清指标的改善作用

Improvement of Yiqi Yangyin Huoxue Tang Combined with Western Medicine on Clinical Symptoms and Serum Indexes in Patients with Diabetes and Coronary Heart Disease

目的:观察益气养阴活血汤联合西药治疗2型糖尿病合并冠心病患者的临床疗效。方法:纳入78例2型糖尿病合并冠心病气阴两虚证患者,随机分为2组各39例,2组均以门冬胰岛素30注射液、硝酸甘油片、阿托伐他汀钙片、盐酸曲美他嗪片治疗,观察组加用益气养阴活血汤。评价2组患者治疗前后的中医证候积分,检测2组患者治疗前后的血清脂肪因子(脂联素、内脂素、瘦素、抵抗素)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、炎症指标[急性时相血清淀粉样蛋白A(ASAA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左室射血分数(LVEF)],记录2组患者出现的不良反应情况。结果:治疗后,2组中医证候积分与FBG、HbA1c与ASAA、TNF-α、IL-6水平均较治疗前降低(P<0.01,P<0.05),观察组各项指标值均低于对照组(P<0.01,P<0.05)。2组脂联素均较治疗前升高,内脂素、瘦素及抵抗素均较治疗前下降,差异均有统计学意义(P<0.05);观察组4项指标与对照组比较,差异均有统计学意义(P<0.05)。观察组心功能指标LVEDD、LVESD、LVEF均优于对照组(P<0.01)。观察组不良反应发生率2.56%,对照组不良反应发生率15.38%,2组比较,差异有统计学意义(P<0.05)。结论:采用益气养阴活血汤联合西药治疗2型糖尿病合并冠心病可有效缓解症状、降低血糖、减轻炎症反应,改善患者的心功能及微循环,减少不良反应的发生,效果显著且安全。

Objective： To observe the clinical effect of YiqiYangyin Huoxue tang combined with western medicine on clinical symptoms and serumindexes in patients with type 2 diabetes and coronary heart disease. Methods：Divided 78 cases of patients with type 2 diabetes and coronary heart disease of both qiand yin deficiency syndrome into two groups randomly,39 cases in each group. Both groups were treated with insulin aspart 30 injection,nitroglycerin tablets,atorvastatin calciumtablets and trimetazidine dihydrochloride tablets, while the observation group was additionally treated with YiqiYangyin Huoxue tang. Assessed Chinese medicine（CM） syndrome score and determined levels of serumadipokine（adiponectin, visfatin, leptin, and resistin）, fasting blood glucose（FBG）, glycosylated hemoglobin（HbA1c）, inflammatory indexes [acute-serumamyloid A（ASAA）,tumor necrosis factor-α（TNF-α）,and interleukin-6（IL-6）],and cardiac function indexes [left ventricular end diastolic diameter（LVEDD）, left ventricular end systolic diameter（LVESD） and left ventricular ejection fraction（LVEF）] in both groups. Recorded adverse reaction in both groups. Results：After treatment,CMsyndrome scores,and levels of FBG,HbA1c,ASAA,TNF-α and IL-6 in both groups were decreased when compared with those before treatment（P0.01,P0.05）,and all the indexes in the observation group were lower than those in the control group（P0.01,P0.05）. Comparing with those before treatment,adiponectin in both groups were risen,while visfatin,leptin,and resistin were reduced,differences being significant（P0.05）;compared the four indexes in the observation group with those in the control group,differences were significant（P0.05）. LVEDD,LVESD and LVEF in the observation group were superior to those in the control group（P0.01）. The incidence of the adverse reaction was 2.56% in the observation group and15.38% in the control group,the difference being significant（P0.05）. Conclusion：The therapy of YiqiYangyin Huoxue tang combined with western medicine for type 2 diabetes and coronary heart disease can effectively relieve symptoms,reduce fasting blood glucose, relieve inflammatory reaction, improve cardiac function and micro-circulation of patients, and decrease adverse reaction with significant effect and safety.