丹蛭降糖胶囊对2型糖尿病亚临床血管病变患者血管重构的影响

Effect of Danzhi Jiangtang Capsule on Vascular Remodeling of Type 2 Diabetic Patients with Subclinical Vascular Disease

目的:探讨丹蛭降糖胶囊对2型糖尿病亚临床血管病变气阴两虚夹瘀证患者血管重构的作用及对血清中转化生长因子(transforming growth factor,TGF)-β1和核因子(nuclear factor,NF)-κB水平的影响。方法:98例2型糖尿病亚临床血管病变患者随机分为观察组49例和对照组49例。对照组依据《中国2型糖尿病防治指南》行常规治疗;观察组在对照组基础上口服丹蛭降糖胶囊,每次5粒,3次·d-1。治疗后,比较两组患者气阴两虚夹瘀证主症评分、颈部动脉指标及血管重构发生情况。检测两组患者血清中TGF-β1和NF-κB水平。结果:治疗后,观察组气阴两虚夹瘀证主症评分、颈动脉内膜中层厚度(intima-media thickness,IMT)和斑块积分明显低于对照组(P<0.01)。治疗后,观察组重构发生率及负性重构明显少于对照组(P<0.05)。治疗后,观察组血清中TGF-β1和NF-κB水平明显低于对照组(P<0.01)。结论:丹蛭降糖胶囊治疗2型糖尿病亚临床血管病变气阴两虚夹瘀证临床疗效显著,可显著减轻颈动脉IMT,缩小斑块,降低血管重构发生,其作用机制可能与降低血清中TGF-β1和NF-κB水平有关。

Objective：To investigate role of Danzhi Jiangtang capsule on vascular remodeling of Type 2 diabetic patients with sub- clinical vascular disease with deficiency of both Qi and Yin with Blood-stasis syndrome and the effect on serum levels of transfor- ming growth factor （TGF） 131 and Nuclear factor （NF）-KB. Methods ：98 sudden deafness cases with Type 2 diabetic patients with subclinical vascular disease were randomly divided into control group （49 cases） and treatment group （49 cases）. The control group was given routine therapy according to Guidelines for Prevention and Control of type 2 Diabetes in China＂. On basis of the treatment of the control group, the treatment group was treated with Danzhi Jiangtang Capsule, with 5 particles/time and tid. The treatment course in both groups was 6 months. Scores of primary symptoms of deficiency of both Qi and Yin with Blood-stasis syn- drome, carotid artery index and occurrence of vascular remodeling between two groups were compared. Serum levels of TGF-β1 and NF-KB in both groups were measured. Results：After treatment, the scores of primary symptoms of deficiency of both Qi and Yin with Blood-stasis syndrome, carotid IMT and plaque score were significantly lower than that of the control group respectively （ P 〈 0.01 ）. Occurrence rate of vascular remodeling and negative remodeling of the treatment group were remarkably less than that of the control group after treatment （P 〈 0.05 ）. Serum levels of TGF-β1 and NF-KB of treatment group was significantly lower than those of control group after treatment （ P 〈 0.01 ）. Conclusion ： Based on routine therapy, Danzhi Jiangtang Capsule in treating Type 2 diabetic patients with subclinical vascular disease with deficiency of both Qi and Yin with Blood-stasis syndrome can alleviate ca- rotid IMT, reduce plaque, decrease occurrence of vascular remodeling and regulate serum levels of TGF-β1 and NF-KB, which may be one of working mechanism of the clinical efficacy of the medication.