四妙勇安汤加减治疗2型糖尿病合并冠心病的疗效观察及对血清ApoB、ApoA-Ⅰ的影响

Effect of Simiao Yong′an Decoction on Efficacy and Serum ApoB and ApoA-Ⅰof T2DM Complicated with CHD

目的研究四妙勇安汤加减联合常规治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)合并冠心病(coronary heart disease,CHD)患者的疗效及对血清载脂蛋白A-Ⅰ(apolipoprotein A-Ⅰ,ApoA-Ⅰ)和载脂蛋白B(apolipoprotein B,ApoB)的影响。方法选取2017年4月—2019年10月期间该院收治的84例T2DM合并CHD患者,采用随机数字表法分为对照组和观察组,每组42例。对照组给予常规西药治疗,观察组在对照组的基础上给予四妙勇安汤加减,治疗28 d后评价两组患者的疗效及安全性,分别于治疗前后检测两组患者的血糖相关指标(FBG、HbA1c、FINS)、血脂相关指标(TC、TG、LDL-C、HDL-C)及血清中ApoA-Ⅰ和ApoB的浓度。结果两组患者经治疗均取得了良好的疗效,观察组总有效率高于对照组(P<0.05);治疗后两组患者血糖及血脂相关指标均得到改善(P<0.05),且观察组均优于对照组(P<0.05);治疗后两组患者血清ApoA-Ⅰ浓度均升高、ApoB浓度均降低(P<0.05),且与对照组相比,观察组ApoA-Ⅰ浓度较高、ApoB浓度较低(P<0.05);两组患者均未见明显不良反应。结论四妙勇安汤加减可有效提高常规西药对T2DM合并CHD患者的疗效,升高血清ApoA-Ⅰ和降低ApoB的浓度,降低ApoB/ApoA-Ⅰ的比例,且无明显不良反应。

Objective To investigate theefficacy of Simiao Yong′an Decoction combined with conventional therapy in the treatment of type 2 diabetes mellitus(T2 DM)complicated with coronary heart disease(CHD)and the effect on serum apolipoprotein A-Ⅰ(ApoA-Ⅰ)and apolipoprotein B(ApoB).Methods Eighty-four patients with T2 DM complicated with CHD admitted to the hospital from April 2017 to October 2019 were randomly divided into the control group and the observation group,42 patients of each group.The control group was treated with conventional therapy of western medicines.The observation group was treated with Simiao Yong′an Decoction combined with conventional therapy of western medicines.After 28 days′treatments,the efficacy and safety were evaluated.The indexes related to plasma glucose and lipid,serum ApoA-Ⅰand ApoB were detected before and after treatment of the two groups.Results The two groups were significantly effective.The total effective rate of the observation group was higher than that of the control group(P<0.05).The indexes related to plasma glucose and lipid of the two groups were all improved after treatment(P<0.05),and the observation group′s was more superior(P<0.05).After treatment,the serum ApoA-Ⅰof the two groups were both increased and ApoB were decreased(P<0.05).As compared with those of the control group,the serum ApoA-Ⅰwas lower and ApoB was higher of the observation group(P<0.05).There was no obvious adverse reactions of the two groups.Conclusion Simiao Yong′an Decoction could further improve the efficacy of conventional therapy of western medicines in the treatment of T2 DM complicated with CHD,increase the concentration of serum ApoA-Ⅰand decrease the serum ApoB and the ratio of ApoB/ApoA-Ⅰwithout obvious adverse reactions.