四妙勇安汤加减方治疗2型糖尿病大血管病变30例临床观察

Clinical effect of modified Simiao Yongan decoction in treatment of macroangiopathy in type 2 diabetes: An analysis of 30 cases

目的:观察四妙勇安汤加减方治疗2型糖尿病大血管病变患者的临床疗效。方法:选择糖尿病合并下肢大血管病变患者60例,随机分为2组,每组各30例。治疗组采用四妙勇安汤加减方联合基础治疗,对照组采用西洛他唑片联合基础治疗。治疗3个月为1个疗程,观察2组患者治疗前后的中医证候积分、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血清蛋白(GSP)变化及血管病变积分变化。结果:愈显率治疗组为50. 00%,对照组为23. 33%,组间比较,差异有统计学意义(P <0. 05)。2组患者治疗后怕冷、皮温低、间歇跛行及疼痛积分较治疗前均明显降低,差异有统计学意义(P <0. 05或P <0. 01);且2组间歇性跛行及疼痛积分治疗后组间比较,差异亦有统计学意义(P <0. 05)。2组治疗后2hPG、GSP值均较治疗前明显降低,差异有统计学意义(P <0. 01);且2组GSP治疗后组间比较,差异亦有统计学意义(P <0. 01)。结论:四妙勇安汤加减方治疗2型糖尿病大血管病变疗效较西洛他唑片治疗为优,值得进一步探究其疗效机制。

Objective:To investigate the clinical effect of modified Simiao Yongan decoction in the treatment of macroangiopathy in patients with type 2 diabetes.Methods:A total of 60 patients with type 2 diabetes and macroangiopathy in the lower extremities were enrolled and randomly divided into treatment group and control group,with 30 patients in each group.The patients in the treatment group were given modified Simiao Yongan decoction combined with basic treatment,and those in the control group were given cilostazol tablets combined with basic treatment.Each course of treatment was 3 months.The two groups were compared in terms of the changes in traditional Chinese medicine(TCM)syndrome score,fasting blood glucose(FBG),2-hour postprandial glucose(2 hPG),glycosylated serum protein(GSP),and macroangiopathy score.Results:There was a significant difference in cure and marked response rate between the treatment group and the control group(50.00%vs 23.33%,P<0.05).Both groups had significant reductions in the scores of fear of cold,low skin temperature,intermittent claudication,and pain after treatment(P<0.05 or P<0.01),and there were significant differences in the scores of intermittent claudication and pain between the two groups after treatment(P<0.05).Both groups had significant reductions in 2 hPG and GSP after treatment(P<0.01),and there was a significant difference in GSP between the two groups after treatment(P<0.01).Conclusion:Modified Simiao Yongan decoction has a better clinical effect than cilostazol tablets in the treatment of macroangiopathy in patients with type 2 diabetes,and further studies are needed to clarify related mechanisms.