桃蛭通瘀片对糖尿病气虚络阻证患者下肢循环的干预作用

Intervention Effect of Taozhi Tongyu Tablets(桃蛭通瘀片) on Lower Extremity Circulation in Diabetic Patients with Qi Deficiency and Collateral Obstruction Syndrome

目的观察桃蛭通瘀片对糖尿病气虚络阻证患者下肢循环的临床干预作用。方法将119例糖尿病气虚络阻证患者随机分为治疗组(59例)和对照组(60例)。对照组维持原糖尿病基础治疗,治疗组在基础治疗同时给予桃蛭通瘀片每次0.9 g,每日3次口服,两组疗程均为8周。比较治疗前后中医证候评分、踝肱指数(ABI)、足趾血流速度、趾肱指数(TBI)、白细胞介素6(IL-6)及血清肿瘤坏死因子α(TNF-α)水平。结果治疗后两组患者中医证候评分均较治疗前降低(P<0.01)、双侧ABI较治疗前提高(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。治疗后治疗组双侧TBI均较治疗前提高(P<0.01),与对照组比较差异均有统计学意义(P<0.01)。治疗后治疗组双侧足趾微血管流速均较治疗前提高(P<0.01),对照组右侧流速减低(P<0.05);两组治疗前后足趾微血管流速差值比较差异均有统计学意义(P<0.05)。治疗后两组IL-6均较治疗前降低(P<0.05),治疗组TNF-α较治疗前降低(P<0.01);两组IL-6、TNF-α治疗前后差值比较差异均有统计学意义(P<0.05)。结论桃蛭通瘀片可以有效改善糖尿病气虚络阻证患者的中医证候,改善下肢循环,同时可降低IL-6及TNF-α水平。

Objective To observe the clinical intervention effect of Taozhi Tongyu Tablets（桃蛭通瘀片） on the patients with diabetic Qi deficiency and collateral obstruction syndrome. Methods One hundred and nineteen patients with diabetes Qi deficiency and collateral obstruction syndrome were randomly divided into treatment group（59 cases） and control group（60 cases）. The control group maintained the basic treatment of diabetes. The treatment group was given Taozhi Tongyu Tablets 0. 9 g each time on the basis of basic treatment,3 times a day. The duration of treatment in both groups was 8 weeks. The scores of Chinese medicine syndrome,ankle-brachial index（ABI）,toe blood flow,toe-brachial index（TBI）,interleukin-6（IL-6） and serum tumor necrosis factor-α（TNF-α） levels before and after treatment were compared. Results After treatment,the scores of Chinese medicine syndromes of both groups were lower than those before treatment（P〈0. 01）,and the bilateral ABI was higher than before treatment（P〈0. 05）,but there was no significant difference between groups（P〈0. 05）. After treatment,bilateral TBI in the treatment group was significantly higher than before treatment（P〈0. 01）,and there was a significant difference compared with the control group（P〈0. 01）. After treatment,the microvessel flow velocity of toe in both sides of the treatment group was higher than before treatment（P〈0. 01）,and the flow rate in the right side of the control group was decreased（P〈0. 05）. There was a statistically significant difference in the difference of flow velocity of the toe microvessel between the two groups before and after treatment（P〈0. 05）. After treatment,IL-6 levels in the two groups were lower than before treatment（P〈0. 05）,and TNF-α in the treatment group was lower than before treatment（P〈0. 01）. There was a statistically significant difference in the differentials between before and after treatment of IL-6 and TNF-α in both groups（P〈0. 05）. Conclusion Taozhi Tongyu Tablets can effectively improve the TCM syndromes of patients with diabetes Qi deficiency and collateral obstruction syndrome,improve the lower extremity circulation,and reduce the levels of IL-6 and TNF-α.