补阳还五汤联合硫辛酸注射液对气虚络阻型2型糖尿病合并下肢动脉病变患者下肢循环指标及炎症因子的影响

Effects of Buyang Huanwu decoction and thioctic acid injection on lower limb circulation index and inflammatory factor in type 2 diabetes mellitus with Qi deficiency obstructing collaterals syndrome and arteriopathy of lower limbs

目的观察补阳还五汤联合硫辛酸注射液治疗气虚络阻型2型糖尿病合并下肢动脉病变的临床疗效,以及对下肢循环指标及炎症因子的影响。方法将96例气虚络阻型2型糖尿病合并下肢动脉病变患者按照抽签法随机分为2组,均予糖尿病常规基础治疗。对照组48例予硫辛酸注射液治疗;治疗组48例在对照组治疗基础上加补阳还五汤治疗。2组均治疗4周。比较2组治疗前后血糖指标变化,双侧下肢循环指标踝肱指数、足趾微血管流速及趾肱指数变化,以及血清炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-8及超敏C反应蛋白(hs-CRP)变化。结果2组治疗后血糖指标空腹血糖(FPG)、餐后2h血糖(2hPG)及糖化血红蛋白(HbA1c)均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗前后胰岛素抵抗指数(HOMA-IR)比较差异无统计学意义(P>0.05)。治疗组治疗后双侧踝肱指数、足趾微血管流速、趾肱指数均较本组治疗前升高(P<0.05);治疗后治疗组双侧足趾微血管流速、趾肱指数均高于对照组(P<0.05);对照组治疗后双侧踝肱指数较本组治疗前升高(P<0.05)。治疗组治疗后TNF-α、IL-6、IL-8及hs-CRP均较本组治疗前降低(P<0.05),且低于对照组治疗后(P<0.05);对照组治疗后IL-6、IL-8及hs-CRP均较本组治疗前降低(P<0.05)。结论补阳还五汤联合硫辛酸注射液治疗气虚络阻型2型糖尿病合并下肢动脉病变,能改善患者下肢循环,减轻炎症反应。

Objective To observe the clinical efficacy of Buyang Huanwu decoction combined with thioctic acid injection in treating type 2 diabetes mellitus with Qi deficiency obstructing collaterals syndrome and arteriopathy of lower limbs, and the effects on circulatory indexes and inflammatory factors of lower limbs. Methods 96 patients with type 2 diabetes mellitus with Qi deficiency obstructing collaterals syndrome combined with lower extremity artery disease were randomly divided into two groups by drawing lots. All patients were given routine basic treatment of diabetes mellitus. 48 cases in control group were treated by thioctic acid injection. 48 cases in treatment group were treated by Buyang Huanwu decoction on the basis of the control group. Both groups were treated for 4 weeks. The changes of blood sugar index, bilateral lower extremity circulation indicators ankle brachial index, toe microvascular flow velocity and toe brachial index were compared between the two groups before and after treatment. The changes of serum inflammatory factor, such as tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6),IL-8, and high-sensitivity C-reactive protein (hs-CRP) were compared between the two groups before and after treatment. Results After treatment, fasting blood glucose (FPG), postprandial 2-hour blood glucose (2-hPG) and glycosylated hemoglobin (HbA 1c) in the two groups were lower than those in the group before treatment ( P <0.05), and the decrease in the treatment group was more obvious ( P <0.05). There was no significant difference in insulin resistance index (HOMA-IR) between the two groups before and after treatment ( P >0.05). After treatment, bilateral ankle brachial index, toe microvascular flow velocity and toe brachial index in the treatment group were higher than those before treatment ( P <0.05). After treatment, the microvascular flow velocity and toe brachial index of bilateral toes in the treatment group were higher than those in the control group ( P <0.05). After treatment, the bilateral ankle brachial index of the control group was higher than that before treatment ( P <0.05). After treatment, the levels of TNF-α, IL-6, IL-8 and hs-CRP in the treatment group were lower than those before treatment( P <0.05), and the treatment group were lower than the control group ( P <0.05). After treatment, the levels of IL-6, IL-8 and hs-CRP in the control group were lower than those before treatment ( P <0.05). Conclusion Buyang Huanwu decoction combined with thioctic acid injection can improve lower limb circulation and alleviate inflammation in type 2 diabetes mellitus patients with Qi deficiency obstructing collaterals syndrome.