真武汤加减治疗痰瘀互结型2型糖尿病肾病患者的疗效及对血管内皮生长因子的影响

Effect of Modified Zhenwu Decoction(真武汤)in Treatment of Type 2 Diabetic Nephropathy with Phlegm and Blood Stasis and Influence on VEGF

目的探析真武汤联合盐酸二甲双胍治疗痰瘀互结型2型糖尿病肾病患者的临床疗效及对血管内皮生长因子的影响。方法将该院2019年2月—2020年2月收治的90例痰瘀互结型2型糖尿病肾病患者按照不同疗法纳入对照组(45例)与试验组(45例),对照组予以盐酸二甲双胍缓释片治疗,试验组予以真武汤联合盐酸二甲双胍缓释片治疗,对比两组患者的临床疗效、中医证候评分、血脂水平(总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白数)以及血管内皮生长因子水平。结果试验组的总有效率(91.11%,41/45)高于对照组(75.56%,34/35)(P<0.05);试验组治疗后的中医证候评分(12.7±2.4)分低于对照组(15.9±2.7)分(P<0.05);试验组治疗后的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平[(4.22±0.60)mmol/L、(1.15±0.24)mmol/L、(1.68±0.32)mmol/L、(2.25±0.43)mmol/L]均优于对照组[(5.75±0.83)mmol/L、(2.68±0.32)mmol/L、(1.25±0.35)mmol/L、(3.88±0.96)mmol/L](P<0.05);试验组治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白水平[(7.11±1.85)mmol/L、(8.14±1.77)mmol/L、(6.40±1.15)%]均低于对照组[(8.24±2.02)mmol/L、(10.69±2.11)mmol/L、(7.51±1.20)%](P<0.05);试验组治疗后的血管内皮生长因子水平[(172.7±32.4)pg/mL]低于对照组[(265.9±72.7)pg/mL](P<0.05)。结论真武汤联合盐酸二甲双胍治疗痰瘀互结型2型糖尿病肾病患者的临床疗效满意,总有效率高,能够明显改善患者的临床症状,且有助于调节血脂、血糖以及血管内皮生长因子水平,适合在临床中推广并应用。

Objective To explore the clinical effect of Zhenwu Decoction(真武汤) combined with metformin hydrochloride in the treatment of type 2 diabetic nephropathy of phlegm and blood stasis type and the effect on vascular endothelial growth factor.Methods Ninety cases of type 2 diabetic nephropathy with phlegm and blood stasis were included into the control group(45 cases) and the treatment group(45 cases).The control group was treated with metformin hydrochloride sustained-release tablets.The treatment group was treated with Zhenwu Decoction and metformin salt sustained-release tablets.The clinical efficacy,TCM syndrome score and blood pressure of the two groups were compared.Lipid levels(total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol),blood glucose levels(fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin) and vascular endothelial growth factor level were compared.Results The total effective rate(91.11%,41/45) in the treatment group was higher than that in the control group(75.56%,34/45)(P<0.05).The TCM syndrome score[(12.7±2.4)points] in the treatment group was lower than that in the control group[(15.9±2.7)points](P<0.05).The levels of total cholesterol,triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the treatment group[(4.22±0.60)mmol/L,(1.15±0.24)mmol/L,(1.68±0.32)mmol/L,(2.25±0.43)mmol/L] were better than those of the control group[(5.75±0.83)mmol/L,(2.68±0.32)mmol/L,(1.25±0.35)mmol/L,(3.88±0.96)mmol/L](P<0.05).The levels of fasting blood glucose,2 hours postprandial blood glucose and glycosylated hemoglobin in the treatment group[(7.11±1.85)mmol/L,(8.14±1.77)mmol/L,(6.40±1.15)%] were lower than those of the control group[(8.24±2.02)mmol/L,(10.69±2.11)mmol/L,(7.51±1.20)%](P<0.05).The level of vascular endothelial growth factor[(172.7±32.4)pg/mL] in the treatment group was lower than that in the control group[(265.9±72.7)pg/mL](P<0.05).Conclusion The clinical effect of Zhenwu Decoction combined with metformin hydrochloride in the treatment of type 2 diabetic nephropathy with phlegm and blood stasis type is satisfactory,and the total effective rate is high.It can significantly improve the clinical symptoms of patients,and it is helpful to regulate the levels of blood lipid,blood glucose and vascular endothelial growth factor,which is suitable for clinical application.