桃红四物汤治疗痰瘀互结型糖尿病合并颈动脉粥样硬化临床研究

Clinical Study of Taohong Siwu Tang for Diabetes of Phlegm and Blood Stasis Type with Carotid Atherosclerosis

目的:观察桃红四物汤加减治疗痰瘀互结型糖尿病合并颈动脉粥样硬化的临床疗效。方法:选取60例痰瘀互结型糖尿病合并颈动脉粥样硬化患者,随机分成对照组和治疗组各30例。2组均给予二甲双胍片、阿卡波糖片或注射胰岛素治疗,治疗组加服桃红四物汤加减,2组均治疗4周。治疗结束后观察血糖相关指标及颈动脉收缩期峰值流速(PSV)、阻力指数(R)I、内-中膜厚度(IMT)、最大切向应变(Smax)、最大切向应变率(SRmax)的变化。结果:与治疗前比较,2组空腹血糖(FBG)、餐后2 h血糖(P2hBG)以及糖化血红蛋白(HbA1c)水平均降低(P<0.05)。治疗组FBG、P2hBG及HbA1c水平均较对照组下降更明显(P<0.05)。与治疗前比较,2组IMT及RI均较治疗前减小(P<0.05),PSV均较治疗前增加(P<0.05)。治疗组IMT及RI较对照组减小更明显(P<0.05),PSV较对照组增加更明显(P<0.05)。与治疗前比较,2组Smax、SRmax均增加(P<0.05)。与对照组治疗后比较,治疗组Smax、SRmax增加更明显(P<0.05)。治疗组患者的动脉弹性比对照组好。结论:桃红四物汤加减对痰瘀互结型糖尿病合并颈动脉粥样硬化患者的治疗效果能起到加强作用,速度向量成像技术(VV)I能有效显示动脉内壁的弹性情况,对临床疗效进行评估。

Objective： To observe the clinical effect of Taohong Siwu tang for diabetes of phlegm and blood stasis type with carotid atherosclerosis. Methods： Selected 60 cases of patients with diabetes of phlegm and blood stasis type with carotid atherosclerosis,and divided them into the control group and the treatment group randomly,30 cases in each group. The control group was given metformin tablets, acarbose tablets and insulin injection for treatment, while the treatment group was additionally given Taohong Siwu tang for treatment. The treatment in the two groups lasted for four weeks. After treatment, observed the changes of indexes related to blood glucose and peak systolic velocity（PSV） of carotid, resistance index（RI）, intima-media thickness（IMT）,maximum tangential strain（Smax） and maximum rate of tangential strain（SRmax）. Results：Compared with those before treatment,the levels of fasting blood glucose（FBG）,postprandial 2 h blood glucose（P2hBG） and glycosylated hemoglobin（HbA1c） in the two groups were all decreased（P〈0.05）. The decrease of levels of FBG,P2hBG and HbA1c in the treatment group were all more obvious than those in the control group（P〈0.05）. Compared with those before treatment,the IMT and RI in the two groups were both reduced（P〈0.05）,while PSV in the two groups were both increased（P〈0.05）. The decrease of IMT and RI in the control group was more obvious than that in the treatment group（P〈0.05）, while the increase of PSV was more obvious than that in the control group（P〈0.05）.Compared with those before treatment,Smax and SRmax in the two groups were both decreased（P〈0.05）. Compared with the control group after treatment,Smax and SRmax in the treatment group were both decreased（P〈0.05）. Arterial elasticity in the treatment group was better than that in the control group. Conclusion：Taohong Siwu tang has a strengthening effect in treating patients with diabetes of phlegm and blood stasis type with carotid atherosclerosis,and velocity vector imaging（VVI） can effectively display the elasticity of the arterial wall.