神香苏合丸联合阿司匹林治疗2型糖尿病合并冠状动脉粥样硬化性心脏病临床观察

Clinical Observation of Shenxiang Suhe Pills Combined with Aspirin in the Treatment of Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease

目的探讨神香苏合丸联合阿司匹林治疗2型糖尿病合并冠状动脉粥样硬化性心脏病(简称冠心病)的临床疗效,以及对患者心脏功能和血流动力学指标的影响。方法选取海南省东方市人民医院2018年6月至2020年6月收治的2型糖尿病合并冠心病患者80例,按随机信封法分为观察组和对照组,各40例。两组患者均给予对症治疗,对照组加用阿司匹林,观察组在对照组基础上加用神香苏合丸,均连续治疗4周。结果观察组总有效率为97.50%,显著高于对照组的85.00%(P<0.05)。治疗后,与对照组比较,观察组患者的三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平均显著降低(P<0.05),高密度脂蛋白胆固醇水平显著升高(P<0.05);舒张早期最大充盈速度和舒张早期最大充盈速度/舒张晚期最大充盈速度均显著升高(P<0.05),舒张晚期最大充盈速度显著降低(P<0.05),左室舒张早期充盈加速时间和左室舒张晚期充盈加速时间均显著缩短(P<0.05);全血黏度(切变率分别为1/s和5/s)、血浆黏度(切变率为10/s)、红细胞聚集指数、纤维蛋白原水平均显著降低(P<0.05)。治疗期间,观察组患者恶心呕吐、体温异常、皮疹不良反应总发生率为2.50%,显著低于对照组的10.00%(P<0.05)。结论神香苏合丸联合阿司匹林治疗2型糖尿病合并冠心病临床疗效较好,可有效改善患者的心脏功能和血流动力学指标,且安全性较好。

Objective To investigate the clinical efficacy of Shenxiang Suhe Pills combined with aspirin in the treatment of type 2 diabetes mellitus(T2DM)complicated with coronary heart disease(CHD),and its effect on the cardiac function and hemodynamic indexes.Methods A total of 80 patients with T2DM complicated with CHD admitted to the Dongfang People′s Hospital from June 2018 to June 2020 were selected and divided into the observation group and the control group according to the random envelope method,with 40 cases in each group.Both groups were given symptomatic treatment,on this basis,patients in the control group were treated with aspirin,and patients in the observation group were treated with Shenxiang Suhe Pills on the basis of the control group.Both groups were treated for continuous four weeks.Results The total effective rate in the observation group was 97.50%,which was significantly higher than 85.00%in the control group(P<0.05).After treatment,compared with those in the control group,the levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the observation group were significantly lower(P<0.05),while the level of high-density lipoprotein cholesterol(HDL-C)in the observation group was significantly higher(P<0.05).Compared with those in the control group,the peak early diastolic filling velocity(VE)and the ratio of VE to peak late diastolic filling velocity(VA)in the observation group were significantly higher(P<0.05),while the VA in the observation group was significantly lower(P<0.05),and the left ventricular early diastolic filling acceleration time(EAT)and the left ventricular late diastolic filling acceleration time(EDT)in the observation group were significantly shorter(P<0.05).Compared with those in the control group,the whole blood viscosity(shear rates of 1/s and 5/s),plasma viscosity(shear rate of 10/s),erythrocyte aggregation index and the level of fibrinogen in the observation group were significantly lower(P<0.05).During the treatment,the total incidence of nausea,vomiting,abnormal body temperature and rash in the observation group was 2.50%,which was significantly lower than 10.00%in the control group(P<0.05).Conclusion Shenxiang Suhe Pills combined with aspirin is effective and safe in the treatment of T2DM complicated with CHD,which can effectively improve the cardiac function and hemodynamic indexes of patients.