蛭龙活血通瘀胶囊治疗糖尿病心肌病心功能不全的临床观察

Clinical efficacy of Zhilong Huoxue Tongyu capsules in the treatment of cardiac insufficiency of diabetic cardiomyopathy

目的:观察蛭龙活血通瘀胶囊对糖尿病心肌病心功能不全患者的临床疗效。方法:将60例糖尿病心肌病心功能不全患者分为对照组和治疗组,各30例,两组均采取西医常规降糖、心衰规范化等治疗,治疗组在此基础上加用蛭龙活血通瘀胶囊治疗。治疗周期为3个月。观察两组患者治疗后空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖、糖化血红蛋白 A1c( Glycosylated hemoglobin A1c,HbA1c)、TC、TG、LDL-C、HDL-C、 NT-proBNP、左室射血分数(left ventricular ejection fraction,LVEF)、E峰/A 峰比值( E/A)、NYHA心功能分级、中医证候疗效及卫生经济学指标。结果:与对照组比较,治疗组治疗后FBG、2 hPG、HbA1c、TC、TG、LDL-C、NT-proBNP均降低,HDL-C升高,LVEF、E/A值升高,心功能明显改善(P < 0.05 ),治疗组中医证候疗效明显改善,缩短住院时间,节约医疗成本(P < 0.05)。治疗组不良反应发生率明显低于对照组,差异有统计学意义(χ2= 6.6667,P < 0.05)。结论:蛭龙活血通瘀胶囊在糖尿病心肌病心功能不全患者具有协同控制血糖、血脂等作用,能有效改善心脏功能,改善中医证候疗效,降低不良事件的发生及经济费用等,值得临床推广与应用。

Objective: To observe the clinical efficacy of Zhilong Huoxue Tongyu capsules in the treatment of cardiac insufficiency of diabetic cardiomyopathy. Methods: A total of sixty diabetic cardiomyopathy patients with cardiac insufficiency were randomly divided into control group and treatment group, with 30 cases in each group. Both groups were treated with routine Western medicine, i.e., glucose-lowering treatment and standard heart failure therapy. The treatment group was treated with Zhilong Huoxue Tongyu capsules in addtion to those routine therapies. The course of treatment was 3 months. The changes in fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin A1c ( HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), mitral ratio of peak early to late diastolic filling velocity (E/A ratio), NYHA classification, outcome of TCM syndromes, and health economic indicators were all observed in these two groups. Results: Compared with the control group, the treatment group showed significant decreases in FBG, 2hPG, HbA1c, TC, TG, LDL-C, and NT-proBNP. In contrast, HDL-C, LVEF, and E/A ratio in the treatment group significantly increased compared with the control group, the latter two indicating a significant improvement in cardiac function (P < 0.05). Meanwhile, the treatment group showed significantly improved outcome of TCM syndromes, shortened length of hospital stay, and reduced medical costs (P < 0.05). Furthermore, the incidence of adverse events in the treatment group was significantly lower than that in the control group (χ2 = 6.6667, P < 0.05). Conclusion: Zhilong Huoxue Tongyu capsules can control blood glucose and blood lipids synergistically in patients with cardiac insufficiency of diabetic cardiomyopathy. It can effectively improve cardiac function, improve the outcome of TCM syndromes, and reduce the occurrence of adverse events and medical costs. In summary, Zhilong Huoxue Tongyu capsules hold promise for clinical application.