清热降浊方联合阿托伐他汀治疗T2DM合并MS的疗效及对CK-MB、SHBG的影响

Clinical Effects ofHeat-clearing Turbidity-lowering Prescription Combined with Atorvastatin in Treating T2DM Complicated with MS and Its Influence on CK-MB and SHBG

目的:探讨清热降浊方联合阿托伐他汀治疗2型糖尿病(type 2 diabetes mellitus,T2DM)合并代谢综合征(metabolic syndrome,MS)的疗效及对肌酸激酶同工酶(creatine kinase-MB,CK-MB)、血清性激素结合球蛋白(sex hormone-binding globulin,SHBG)的影响。方法:将T2DM合并MS患者100例采用随机数字表法分为观察组和对照组各50例。对照组予阿托伐他汀治疗,观察组在此基础上联用清热降浊方。观察两组患者干预前及干预15周后体质量和体质量指数(body mass index,BMI)、血糖血脂、胰岛β细胞功能、血管内皮细胞功能、CK-MB、SHBG水平。结果:干预后两组患者体质量和BMI较干预前降低,观察组低于对照组(P<0.05);干预后两组患者甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)均较干预前改善,且观察组TG、TC、FPG、2 h PG低于对照组,HDL-C高于对照组,差异具有统计学意义(P<0.05);干预后两组患者胰岛素分泌指数(insulin secretion index,HOMA-β)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)、内皮素1(endothelin-1,ET-1)、一氧化氮(nitric oxide,NO)较干预均改善,且观察组改善优于对照组(P<0.05);干预后两组患者CK-MB、SHBG水平较干预前改善,且观察组改善优于对照组(P<0.05)。结论:清热降浊方联合阿托伐他汀对T2DM合并MS患者病情有改善作用,有助于减轻患者体质量,改善BMI、血糖、血脂及胰岛β细胞功能、血管内皮细胞功能,降低CK-MB水平,提高SHBG水平。

Objective:To explore clinical effects of heat-clearing turbidity-lowering prescription and atorvastatin in treating T2DM complicated with MS and its impacts on CK-MB and SHBG.Methods:All 100 patients with T2DM complicated with MS were divided into the observation group and the control group using random number table method,50 cases in each group.The control group were treated by atorvastatin,the observation group took heat-clearing turbidity-lowering prescription.To observe body mass,BMI,blood glucose,blood lipid,isletsβcell function,function of vascular endothelial cells,the levels of CK-MB and SHBG between both groups before the intervention and 15 weeks after the intervention.Results:After the intervention,body mass and BMI of both groups lowered than these before the intervention,the observation group was lower than the control group(P<0.05);after the intervention,the levels of TG,TC,HDL-C,FBG and 2 h PG of both groups were improved than before the intervention,the observation group was lower than the control group in the levels of TG,TC,FPG and 2hPG,higher than the control group in HDL-C,and the difference has statistical meaning(P<0.05);after the intervention,HOMAβ,HOMA-IR,ET-1 and NO of both groups were improved after the intervention than these before the intervention,and the improvements of the observation group were superior to these of the control group(P<0.05);after the intervention,the levels of CK-MB and SHBG in both groups were improved than these after the intervention,and the improvements of the observation group were better than these of the control group(P<0.05).Conclusion:Heat-clearing turbidity-lowering prescription and atorvastatin could improve the conditions of the patients suffering T2DM complicated with MS,it could help reduce body mass of the patients,improve BMI,blood glucose,blood lipid,isletsβcell function,the function of vascular endothelial cells,reduce the levels of CK-MB and raise the levels of SHBG.