参芪活血汤对2型糖尿病下肢血管病变患者症状及血清Vaspin、ANGPTL4水平的影响

Effects of Shenqi Huoxue Decoction on symptoms and serum Vaspin and ANGPTL4 levels in T2DM patients with lower extremity vascular disease

目的探讨2型糖尿病下肢血管病变患者采用参芪活血汤治疗的作用及对患者血清脂肪特异性丝氨酸蛋白酶抑制因子(Vaspin)、血管生成素样蛋白4(ANGPTL4)水平的影响。方法选取2019年5月至2021年5月黑龙江中医药大学附属第一医院收治的2型糖尿病下肢血管病变患者120例,按照随机数字表法分为观察组(n=60)和对照组(n=60)两组,对照组给予常规西药加盐酸丁咯地尔治疗,观察组在此基础上加用参芪活血汤治疗。治疗3个月,观察治疗后两组患者中医证候积分、血流动力学、Vaspin和ANGPTL4水平、炎性因子水平及不良反应发生情况。结果两组治疗后1月、3月中医证候积分均逐步降低,差异有统计学意义(P<0.01);治疗后1月、3月与对照组比较,观察组中医证候积分更低(P<0.05)。观察组下肢病变动脉峰值血流速度(PFV)和搏动指数(PI)及血清Vaspin、ANGPTL4水平明显高于对照组(P<0.01,P<0.05),肿瘤坏死因子(TNF)-α、白介素(IL)-6水平明显低于对照组(P<0.01)。两组患者药物不良反应发生率差异无统计学意义(P>0.05)。结论在盐酸丁咯地尔基础上联用参芪活血汤治疗TASC分级B级及以下的糖尿病下肢血管病变,可能提高患者血清Vaspin、ANGPTL4水平,抑制机体炎症反应,促进下肢血液循环,从而有效改善患者临床症状。

Objective To investigate the effect of Shenqi Huoxue Decoction in the treatment of type 2 diabetes mellitus(T2DM)patients with lower extremity vascular disease and the effect on serum visceral adipose-specific serine protease inhibitor(Vaspin)and angiopoietin like protein 4(ANGPTL4)levels.Methods A total of 120 patients with diabetic lower extremity vascular diseases admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from May 2019 to May 2021 were selected and randomly divided into observation group(n=60)and control group(n=60).The conventional Western medicine and buflomedil hydrochloride were used in control group,and Shenqi Huoxue decoction was used in observation group on the basis of the control group.After 3 months of treatment,TCM syndrome score,hemodynamics,levels of Vaspin,ANGPTL4 and inflammatory factors and incidence of adverse reactions were compared between two groups.Results At 1-and 3-month after treatment,TCM syndrome scores were gradually decreased in two groups(P<0.01)and were statistically lower in observation group than those in control group(P<0.05).Compared with control group,the levels of peak arterial flow velocity(PFV),pulsatility index(PI),and serum levels of Vaspin and ANGPTL4 significantly increased(P<0.01,P<0.05),and the levels of TNF-αand IL-6 deceased in observation group(P<0.05).There was no statistical difference in the incidence of adverse drug reactions between two groups(P>0.05).Conclusion Buflomedil hydrochloride combined with Shenqi Huoxue Decoction in the treatment of diabetic lower extremity vascular lesions with TASC grade B and below may increase the serum Vaspin and ANGPTL4 levels,inhibit the body s inflammatory response,and promote lower extremity blood circulation,thereby effectively improving the clinical symptoms of patients.