益气养阴、活血祛浊法对2型糖尿病血管保护作用的临床观察

Clinical Observation on Protective Effect of Yiqi Yangyin and Huoxue Quzhuo Therapy on Blood Vessels of Type 2 Diabetes Mellitus

目的:探讨益气养阴、活血祛浊法对2型糖尿病患者血管的保护作用及机制。方法:选取2017年5月-2020年5月北京中医药大学房山医院内分泌科病房和门诊的2型糖尿病患者60例。按随机数字表法将患者分为治疗组和对照组,每组30例。在常规糖尿病饮食及运动基础上,对照组给予常规西药降糖治疗,治疗组在对照组基础上加用益气降浊汤。比较两组临床疗效,并观察两组治疗前后中医症候积分、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)等指标的变化。结果:治疗组总有效率虽高于对照组,但差异无统计学意义(P>0.05)。治疗前,两组中医症候评分比较,差异无统计学意义(P>0.05);治疗后,两组中医症候评分均较治疗前改善,且治疗组优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组FBG、2 h PBG、HbA1c、Hcy、hs-CRP、ET-1、VEGF比较,差异均无统计学意义(P>0.05);治疗后,两组FBG、2 h PBG、HbA1c、Hcy、hs-CRP、ET-1、VEGF均较治疗前下降,且治疗组均低于对照组,差异均有统计学意义(P<0.05)。结论:益气养阴、活血祛浊中药方剂益气降浊汤,能显著改善2型糖尿病患者临床症状,降低血糖,保护血管内皮功能,且未发现不良反应。

Objective:To investigate the protective effect and mechanism of Yiqi Yangyin and Huoxue Quzhuo therapy on blood vessels in patients with type 2 diabetes mellitus.Method:A total of 60 patients with type 2 diabetes mellitus in the endocrinology ward and outpatient department of Fangshan Hospital Beijing University of Chinese Medicine from May 2017 to May 2020 were selected.The patients were divided into treatment group and control group by random number table,30 cases in each group.On the basis of routine diabetic diet and exercise,the control group was given conventional western medicine for hypoglycemic treatment,and the treatment group was given Yiqi Jiangzhuo Decoction on the basis of the control group.The clinical effect of two groups was compared,and the changes of TCM syndrome score,fasting blood glucose (FBG),2-hour postprandial blood glucose(2 h PBG),glycosylated hemoglobin (HbA1c),homocysteine (Hcy),high-sensitivity C-reactive protein (hs-CRP),endothelin-1 (ET-1) and intravascular endothelial growth factor (VEGF) were observed before and after treatment.Result:The total effective rate in the treatment group was higher than that in the control group,but the difference was not statistically significant (P>0.05).Before treatment,comparison of TCM syndrome scores between two groups,there was no significant difference (P>0.05).After treatment,TCM syndrome scores of two groups were improved compared with those before treatment,and the treatment group was better than that of the control group,the differences were statistically significant (P<0.05).Before treatment,comparison of FBG,2 h PBG,HbA1c,Hcy,hs-CRP,ET-1 and VEGF between two groups,there were no statistical significance (P>0.05).After treatment,FBG,2 h PBG,HbA1c,Hcy,hs-CRP,ET-1 and VEGF in both groups decreased compared with those before treatment,and the treatment group were lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:Yiqi Jiangzhuo Decoction can significantly improve the clinical symptoms of T2DM patients,reduce blood sugar,and protect the vascular endothelial function of the patients.No obvious adverse reactions were observed.