益气养阴活血方联合常规疗法治疗2型糖尿病并发急性脑梗死临床研究

Clinical Study on Yiqi Yangyin Huoxue Prescription Combined with Routine Therapy for Type 2 Diabetes Mellitus Complicated with Acute Cerebral Infarction

目的:观察益气养阴活血方联合常规疗法治疗2型糖尿病(T2DM)并发急性脑梗死(ACI)患者的临床疗效。方法:将100例T2DM并发ACI气阴两虚兼血瘀证患者按照随机数字表法分为对照组和观察组各50例。2组均予常规疗法治疗,观察组给予益气养阴活血方内服,2组均连续治疗4周。治疗前后采用神经功能缺损评分(NIHSS)评价神经功能缺损程度,以Barthel指数(BI)评定量表评价日常生活能力,检测全血黏度、血浆黏度、D-二聚体(D-D)、纤维蛋白原(FIB)等血液流变学指标和血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)、超敏C-反应蛋白(hs-CRP)和空腹血糖(FBG)、糖化血红蛋白(HbA1c)水平。比较2组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P <0.05)。2组NIHSS均较治疗前下降,BI评分均较治疗前升高,差异均有统计学意义(P <0.01);观察组NIHSS低于对照组,BI评分高于对照组,差异均有统计学意义(P <0.01)。2组血清IL-6、TNF-α、hs-CRP、全血黏度、血浆黏度、D-D、FIB和FBG、HbA1c水平均较治疗前下降(P <0.01),观察组9项指标值均低于对照组(P <0.01)。结论:在常规疗法基础上给予益气养阴活血方治疗T2DM并发ACI患者可有效减轻神经功能缺损程度,提高患者的日常生活能力,调节血糖,减轻致炎因子导致的脑损害,改善血液循环,起到促进脑神经恢复的作用。

Objective:To observe the clinical effect of Yiqi Yangyin Huoxue prescription combined with routine therapy for patients with type 2 diabetes mellitus(T2 DM)complicated with acute cerebral infarction(ACI).Methods:A total of 100 cases of patients with T2 DM complicated with ACI with dual deficiency of qi and yin as well as blood stasis syndrome were divided into the control group and the observation group according to the random number table method,50 cases in each group.Both groups were treated with routine therapy,and the observation group was additionally treated with Yiqi Yangyin Huoxue prescription orally.Both groups were treated for four weeks.Before and after treatment,the neurologic impairment was evaluated by the National Institutes of Health Stroke Scale(NIHSS),and the activities of daily living was evaluated by Barthel Index(BI)scoring form;the hemorheological indexes including whole blood viscosity,plasma viscosity,D-dimer(D-D)and fibrinogen(FIB)as well as the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),fasting plasma glucose(FBG)and hemoglobin A1 c(HbA1 c)in serum were detected.Compared the clinical effect of the two groups.Results:After treatment,the clinical effect in the observation group was superior to that in the control group(P<0.05).The NIHSS in the two groups were decreased when compared with those before treatment,while the scores of BI in the two groups were increased when compared with those before treatment,differences being significant(P<0.01).The NIHSS in the observation group was lower than that in the control group,while the score of BI in the observation group was higher than that in the control group,differences being significant(P<0.01).The levels of IL-6,TNF-α,hs-CRP,whole blood viscosity,plasma viscosity,D-D,FIB,FBG and HbA 1 c in serum in the two groups were decreased when compared with those before treatment(P<0.01),and the above nine indexes in the observation group were lower than those in the control group(P<0.01).Conclusion:Yiqi Yangyin Huoxue prescription based on the routine therapy for patients with T2 DM complicated with ACI can reduce the degree of neurologic impairment,improve the activities of daily living,regulate the blood glucose,alleviate the brain damage caused by inflammatory factors,improve blood circulation and promote the recovery of cranial nerve.