黄芪桂枝五物汤加减对2型糖尿病下肢血管病变患者踝肱指数血流动力学的影响

Effects of modified Huangqi Guizhi Wuwu Decoction on ankle brachial index and hemodynamics in type 2 diabetes patients with lower limb vascular disease

目的探讨黄芪桂枝五物汤加减对2型糖尿病下肢血管病变患者踝肱指数、血流动力学的影响。方法选取2022年6月至2023年6月河南省郑州市第九人民医院80例2型糖尿病下肢血管病变住院患者,进行前瞻性研究,将所有患者根据治疗方法分为对照组(40例,常规治疗联合阿托伐他汀钙片、阿司匹林肠溶片治疗)和研究组(40例,在对照组治疗基础上采用黄芪桂枝五物汤加减治疗),2组患者均行2个月的治疗。对比2组患者治疗前后中医证候积分、踝肱指数(ABI)、心脏-脚踝指数(CAVI)、血流动力学指标,以及2组患者治疗期间不良反应发生情况。结果治疗后2组患者倦怠乏力、咽干口燥等中医证候积分均相较于治疗前下降,且研究组患者上述积分均相较于对照组下降;治疗后2组患者ABI、CAVI均相较于治疗前上升,且研究组患者上述指标相较于对照组上升;治疗后2组患者全血黏度、血浆黏度指标均相较于治疗前下降,且研究组患者上述指标均相较于对照组下降(均P<0.05);将2组患者治疗期间头晕、恶心等的发生情况进行对比,差异无统计学意义(P>0.05)。结论2型糖尿病下肢血管病变应用黄芪桂枝五物汤加减治疗,可有效缓解患者临床症状,提高踝肱指数,改善下肢动脉血流水平,且安全性良好。

Objective To investigate the effects of modified Huangqi Guizhi Wuwu Decoction on ankle brachial index and hemodynamics in type 2 diabetes patients with lower limb vascular disease.Methods A prospective study was conducted on 80 inpatients with type 2 diabetes with lower limb vascular disease who visit-ed Zhengzhou Ninth People′s Hospital from June 2022 to June 2023.All patients were divided into a control group(40 cases,treated with conventional therapy combined with atorvastatin calcium tablets and aspirin enteric coated tablets)and a study group(40 cases,treated with modified Huangqi Guizhi Wuwu Decoction in addition to the control group)according to different treatment methods.Both groups of patients received treatment for a period of 2 months.The TCM syndrome scores,ankle brachial index(ABI),cardiac ankle index(CAVI),hemorheological indicators,and incidence of adverse reactions during treatment were compared between the two groups of patients before and after treatment.Results Compared with before treatment,the traditional Chinese medicine(TCM)syn-drome scores of fatigue and lassitude,dry throat and mouth in both groups decreased after treatment;moreover,the above scores in the study group decreased compared with the control group.After treatment,ABI and CAVI in both groups increased compared with before treatment,and the above indicators in the study group increased compared with the control group.After treatment,the levels of whole blood viscosity and plasma viscosity in both groups decreased compared with before treatment,and the above indicators in the study group decreased compared with the control group(all P<0.05).The occurrence of dizziness,nausea,and other adverse events during treatment was compared between the two groups,and the difference was not statistically significant(P>0.05).Conclusion The application of modified Huangqi Guizhi Wuwu Decoction in the treatment of lower limb vascular diseases of type 2 diabetes can effectively alleviate the clinical symptoms of patients,improve ankle brachial index,improve the blood flow level of lower limb arteries,and has good safety。