黄连温胆汤联合前列地尔对脑梗死合并糖尿病患者的疗效及sICAM⁃1的影响

Effect of Huanglian Wendan decoction combined with alprostadil on cerebral infarction with diabetes and the influence of sICAM⁃1

目的探讨黄连温胆汤联合前列地尔对脑梗死合并糖尿病患者的疗效及可溶性细胞间粘附分子(sICAM⁃a)的影响。方法将皖西卫生职业学院附属医院中医科收治的脑梗死合并糖尿病患者90例,随机分为两组,各45例。对照组采用前列地尔治疗;观察组采用黄连温胆汤联合前列地尔治疗,持续治疗2周为一疗程。干预前后采血测定空腹血糖(FBG)、餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA⁃IR)及可溶性细胞间黏附分子⁃1(sICAM⁃a)、可溶性血管粘附分子(sVCAM⁃a)的水平,比较两组间的临床疗效。结果与干预前比,两组干预后FBG、2hPG及HOMA⁃IR降低;观察组干预后FBG、2hPG及HOMA⁃IR低于对照组,差异有统计学意义(t=7.467、13.129、12.536,P<0.05)。与干预前比,两组干预后血sICAM⁃1、sVCAM⁃1水平降低;观察组患者干预后血sICAM⁃1、sVCAM⁃1水平低于对照组,差异有统计学意义(t=20.230、23.314,P<0.05)。两组治疗后干预1周、干预2周NIHSS评分均较治疗前降低;与对照组比较观察组干预1周、干预2周NIHSS评分较低,差异有统计学意义(t值=4.149,P<0.05)。相比对照组有效率77.78%,观察组的总有效率93.33%较高,差异有统计学意义(χ^(2)=4.406,P<0.05)。与干预前比,两组干预后脑梗死面积缩小;观察组患者干预后脑梗死面积低于对照组,差异有统计学意义(t值=17.810,P<0.05)。结论黄连温胆汤联合前列地尔对脑梗死合并糖尿病患者的疗效确切,有助于改善血糖和神经功能,降低血sICAM⁃1、sVCAM⁃1水平。

Objective To investigate the effect of Huanglian Wendan decoction combined with al⁃prostadil on patients with cerebral infarction and diabetes mellitus and the influence of soluble intercellular ad⁃hesion molecule(sICAM⁃a).Methods 90 patients with cerebral infarction complicated with diabetes admit⁃ted to the TCM Department of the Affiliated Hospital of West Anhui Health Vocational College were randomly divided into 2 groups with 45 cases each.The control group was treated with alprostadil.The observation group was treated with Huanglian Wendan Tang combined with alprostadil,with a continuous treatment period of 2 weeks.Blood samples were collected before and after the intervention to measure the levels of Glucose test Fasting blood sugar(FBG),2 hours postprandial blood glucose(2hPG),fasting insulin(FINS),insulin re⁃sistance index(HOMA⁃IR),soluble intercellular adhesion molecule⁃1(sICAM⁃1),and soluble vascular adhe⁃sion molecule(sVCAM⁃1),the clinical efficacy between the two groups were compared.Results Compared with before intervention,FBG,2hPG and HOMA⁃IR in the two groups decreased after intervention;FBG,2hPG and HOMA⁃IR in the observation group were lower than those in the control group after intervention,and the differences were statistically significant(t=7.467,13.129,12.536,P<0.05).Compared with before inter⁃vention,blood sICAM⁃1 and sVCAM⁃1 levels were decreased in two groups after intervention.The serum sICAM⁃1 and sVCAM⁃1 levels in the observation group were lower than those in the control group after inter⁃vention,and the difference was statistically significant(t=20.230,23.314,P<0.05).The NIHSS score of the two groups after 1 week and 2 weeks of intervention was lower than before treatment.Compared with the control group,the NIHSS score of the observation group was lower after 1 week and 2 weeks of intervention,and the difference was statistically significant(t=4.149,P<0.05).Compared with 77.78%of the control group,the total effective rate of the observation group was 93.33%,the difference was statistically significant(χ^(2)=4.406,P<0.05).Compared with before intervention,cerebral infarction size decreased in both groups after intervention.The cerebral infarction area in the observation group was lower than that in the control group after intervention,and the difference was statistically significant(t=17.810,P<0.05).Conclusion Huanglian Wendan decoction com⁃bined with alprostadil has a definite therapeutic effect on patients with cerebral infarction complicated with diabe⁃tes,which can help improve blood sugar and nerve function,and reduce blood levels of sICAM⁃1 and sVCAM⁃1.