木丹颗粒联合白虎汤加味对Ⅱ型糖尿病心自主神经病变泌汗功能的影响

Effect of Mudan Granules Combined with Supplemented Baihu Decoction on Sweat Secretion in Type 2 Diabetic Cardiac Autonomic Neuropathy

目的 探究木丹颗粒联合白虎汤加味对2型糖尿病心自主神经病变(Diabetic cardiac autonomic neuropathy, DCAN)泌汗功能的影响。方法 选取2019年10月—2020年11月期间辽宁省盘锦市中心医院收治的DCAN患者64例。根据随机数字表法分为对照组和研究组,每组各32例。对照组给予西医治疗,研究组给予木丹颗粒与白虎汤加味联合西医治疗。治疗8周后,观察比较两组患者临床疗效,治疗前后血糖、血脂[空腹血糖(Fasting blood glucose, FBG)、餐后2 h血糖(2-hour postprandial blood glucose, 2 h PBG)、甘油三酯(Triglyce ride, TG)、总胆固醇(Total cholesterol, TC)],炎性因子水平[血清C反应蛋白(C-reactive protein, CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-6(Interleukin-6,IL-6)],中医症状积分,泌汗功能[双手电化学皮肤电导率(Hands electrochemistry skin conductivity, HESC)、双足电化学皮肤电导率(Feets electrochemistry skin conductivity, FESC)]的变化,不良反应情况。结果 治疗后研究组总有效率为93.10%(27/29)明显高于对照组70.37%(19/27),差异有统计学意义(P<0.05)。治疗后两组患者FBG、2 h PBG、TG、TC水平均较治疗前下降,差异有统计学意义(P<0.05);且研究组均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎性因子CRP、IL-6、TNF-α水平均较治疗前下降,差异有统计学意义(P<0.05);且研究组均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者中医症状心慌、胸闷、气短、多汗积分均较治疗前降低,差异有统计学意义(P<0.05);且研究组均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者泌汗功能HESC、FESC指标均较治疗前升高,差异有统计学意义(P<0.05);且研究组均明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良反应总发生率为34.48%(10/29),与对照组33.33%(9/27)比较,差异无统计学意义(P>0.05)。结论 DCAN患者予以木丹颗粒联合白虎汤加味治疗,在降低血脂、血糖,改善机体炎症反应,泌汗功能等方面具有显著疗效,且安全性高。

Objective To explore the effect of MudanGranules combined with supplemented Baihu Decoction on sweat secretion in type 2 diabetic cardiac autonomic neuropathy(DCAN).Methods A total of 64 DCAN patients admitted in Panjin Central Hospital from October 2019 to November 2020 were selected as the research objects.They were divided into a control group(n=32)and anobservation group(n=32)according to the random number table.The control group was treated with western medicine, while the observation group receivedMudan Granules combined with supplemented Baihu Decoction on the basis of western medicine.The treatment lasted for eight weeks.Then the clinical efficacy, incidence of adverse reactions, blood glucose, blood lipids, inflammatory factor levels, TCM symptom scores, and changes in sweat secretion of the two groups were comparedbefore and after treatment.Results The total effective rate(93.10%,27/29)of the observation group was higher than that(70.37%,19/27)of the control group(P<0.05).Compared with the conditions before treatment, fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),triglyceride(TG),and total cholesterol(TC)decreased after treatment, and the decrease was more significant in the observation groupthan the control group(P<0.05).After treatment, the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)reduced(P<0.05),with the reduction in the observation more obvious(P<0.05).Additionally, thescores of TCM symptoms such as palpitation, chest tightness, shortness of breath, and spontaneous sweating lowered in the two groups after treatment(P<0.05),with the scores of the observation group loweringmore remarkably(P<0.05).Compared with those before treatment, the sweat secretion function indexes hands electrochemical skin conductance(HESC)and feet electrochemical skin conductance(FESC)of the two groups increased after treatment(P<0.05),and the increase in the observation group wasmore significant(P<0.05).There was no difference in the total incidence of adverse reactions between the observation group(34.48%,10/29)and the control group(33.33%,9/27)(P>0.05).Conclusion MudanGranules combined with supplemented Baihu Decoction has marked curative effect in reducing blood lipids, blood glucose and improving body inflammation and sweat secretion function among the DCAN patients, with high safety.