中西医结合治疗糖尿病心血管自主神经病变的临床疗效

Clinical effect of integrated Chinese and Western medicine on diabetic cardiovascular autonomic neuropathy

目的探讨中西医结合治疗糖尿病心血管自主神经病变(DCAN)的临床疗效。方法选取2021年1月至2023年5月于石家庄市第二医院就诊的80例DCAN患者作为研究对象,采用随机数字表法分为对照组(40例)和观察组(40例),对照组采取常规西医治疗,观察组在对照组基础上采用中医综合治疗(益气养阴活血汤+针灸),1个疗程为14 d,2个疗程宜间隔7 d,两组共治疗3个疗程。比较两组临床疗效;比较两组空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR);比较两组窦性RR间期标准差(SDNN)、全程NN节段的窦性RR间期标准差(SDANN)、全程相邻RR之差的均方根(RMSSD)、相邻RR间期差值>50 ms的个数占总窦性心搏个数的百分比(PNN50);比较两组不良反应发生率。结果观察组临床总有效率(90.00%)明显高于对照组(70.00%),差异有统计学意义(P<0.05)。两组治疗后FBG、2 h PBG、HbA1c、HOMA-IR均明显低于治疗前,且观察组均明显低于对照组,差异均有统计学意义(P<0.05)。两组治疗后SDNN、SDANN、RMSSD、PNN50均明显高于治疗前,且观察组均明显高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论中西医结合治疗DCAN临床疗效明显,能够有效改善血糖水平、心率变异性,且不增加不良反应,具有较高的临床参考价值。

Objective To investigate the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of diabetic cardiovascular autonomic neuropathy(DCAN).Methods A total of 80 patients with DCAN who were treated in the Second Hospital of Shijiazhuang from January 2021 to May 2023 were selected as the research objects,and they were divided into control group(40 cases)and observation group(40 cases)by random number table method.The control group was treated with conventional Western medicine,and the observation group was treated with traditional Chinese medicine(Yiqi Yangyin Huoxue decoction+acupuncture)on the basis of the control group.One course of treatment was 14 d,and the two courses should be separated by 7 d.The clinical efficacy was compared between the two groups.Fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c)and insulin resistance index(HOMA-IR)were compared between the two groups.The standard deviation of the sinus RR interval(SDNN),the standard deviation of the sinus RR interval of the whole NN segment(SDANN),the root mean square of the successive RR differences(RMSSD)and the percentage of successive RR interval differences>50 ms in the total number of sinus beats(PNN50)were compared between the two groups.The incidence of adverse reactions was compared between the two groups.Results The total effective rate of the observation group(90.00%)was significantly higher than that of the control group(70.00%),and the difference was statistically significant(P<0.05).After treatment,FBG,2 h PBG,HbA1c and HOMA-IR in the two groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The SDNN,SDANN,RMSSD and PNN50 after treatment in the two groups were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The clinical effect of integrated traditional Chinese and Western medicine in the treatment of DCAN is obvious,which can effectively improve blood glucose level and heart rate variability without increasing adverse reactions,and has high clinical reference value.