生脉活血汤联合达格列净治疗冠心病合并2型糖尿病疗效观察

Effects Observation of Shengmai Huoxue Decoction(生脉活血汤)and Dapagliflozin in Treatment of Coronary Heart Disease with Type 2 Diabetes Mellitus

目的研究生脉活血汤联合达格列净运用于冠心病合并2型糖尿病中的价值。方法选择2021年2月—2022年5月医院收住的冠心病合并2型糖尿病患者80例,以随机列表法进行分组,汤剂组40例采取生脉活血汤联合达格列净,单药组40例使用达格列净,比较两组血糖、血脂、凝血功能指标、心绞痛发作频率及发作时长、不良反应。结果两组用药前血糖指标差异无统计学意义(P>0.05),用药后汤剂组糖化血红蛋白、餐后2h及空腹血糖均低于单药组(P<0.05)。两组用药前血脂指标差异无统计学意义(P>0.05),用药后汤剂组低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)小于单药组,但高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)大于单药组(P<0.05)。两组用药前心绞痛发作情况差异无统计学意义(P>0.05),用药后汤剂组发作频率、发作时长均少于单药组(P<0.05)。两组用药前凝血功能差异无统计学意义(P>0.05),用药后汤剂组D-二聚体(D-dimer,D-D)、纤维蛋白原(Fibrinogen,FIB)小于单药组,但部分活化凝血酶原时间(Partial activated prothrombin time,APTT)、凝血酶原时间(Prothrombin time,PT)大于单药组(P<0.05)。汤剂组不良反应5.00%(2/40)与单药组10.00%(4/40)差异无统计学意义(P>0.05)。结论生脉活血汤联合达格列净治疗冠心病合并2型糖尿病的疗效更为理想,可促进血糖血脂水平改善,同时减少心绞痛发作次数,稳定患者病情,增强凝血功能,不良反应少,安全性高。

Objective To study the clinical value of Shengmai Huoxue Decoction(生脉活血汤)and dapagliflozin in treating the coronary heart disease with type 2 diabetes mellitus.Methods Eighty coronary heart disease patients with type 2 diabetes mellitus treated from February 2021 to May 2022 in the hospital were selected.According to random number table,the patients were divided into decoction group(40 cases,Shengmai Huoxue Decoction and dapagliflozin)and single group(40 cases,dapagliflozin).The blood glucose,blood lipid,coagulation function indicators,angina attack frequency and duration and adverse reactions were compared.Results Before medication,the blood glucose levels between groups were not significantly different(P>0.05).After medication,the glycosylated hemoglobin,2-hour postprandial plasma glucose and fasting blood glucose in the decoction group were lower than those of the single group(P<0.05).Before medication,the blood lipid levels between groups were not significantly different(P>0.05).After medication,the levels of low-density lipoprotein cholesterol(LDL-C),triglycerides(TG)and total cholesterol(TC)in the decoction group were lower than those of the single group,but the high-density lipoprotein cholesterol(HDL-C)levels were higher than those of the single group(P<0.05).Before medication,the angina attack conditions between two groups were not significantly different(P>0.05).After medication,the angina attack frequency and duration in the decoction group were lower than those in the single group(P<0.05).Before medication,the blood coagulation function indicators between two groups were not significantly different(P>0.05).After medication,the contents of D-dimer(D-D)and fibrinogen(FIB)in the decoction group were lower than those in the single group but the activated partial thromboplastin time(APTT)and prothrombin time(PT)were longer than those of the single group(P<0.05).The adverse drug rate in the decoction group(5.00%,2/40)and the single group(10.00%,4/40)was not significantly different(P>0.05).Conclusion Shengmai Huoxue Decoction and dapagliflozin can reduce the angina attack frequency and adverse drug reactions,stabilize the illness states,improve the blood glucose and blood lipid levels,the coagulation function and the treatment safety for coronary heart disease patients with type 2 diabetes mellitus.