七味白术散合生脉散在糖尿病合并冠心病治疗中临床意义

Clinical significance of Qiwei Baizhu Powder and Shengmai Powder in treating diabetes complicated with coronary heart disease

目的糖尿病合并冠心病在临床中较为常见,中西医结合治疗方案较多,未形成统一规范。本研究采用七味白术散合生脉散联合西药治疗糖尿病合并冠心病,观察中西医结合方法治疗糖尿病合并冠心病的临床疗效。方法选取辽宁省抚顺市中医院2015-10-01-2016-11-30收治的64名糖尿病合并冠心病患者,根据治疗方法不同分为对照组和中西医结合组,各32例。对照组给予常规西医治疗,结合组在常规西医治疗基础上给予七味白术散合生脉散治疗,治疗时间为30d。分别观察治疗前后患者空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2hour plasma glucose,2h PG)、中医症候评分、临床总有效率、血清亲环素A(cyclophilin A,CyPA)水平变化。结果治疗后中西医结合组FPG为(6.34±0.53)mmol/L,低于对照组的(6.84±0.58)mmol/L,t=-3.600,P=0.001。中西医结合组治疗后2hPG为(7.67±0.45)mmol/L,低于对照组的(8.53±0.64)mmol/L,t=-6.218,P<0.001。中西医结合组治疗后中医症候积分为(3.56±2.59)分,低于对照组的(9.43±3.36)分,t=-7.827,P<0.001。中西医结合组治疗后CyPA为(5.54±0.43)ng/mL,低于对照组的(7.89±0.64)ng/mL,t=-17.241,P<0.001。治疗后中西医结合组临床总有效率为93.75%,高于对照组的75.00%,χ~2=4.267,P=0.039。结论七味白术散合生脉散联合西药治疗糖尿病合并冠心病显著,能够有效控制患者血糖,改善患者临床症状,降低机体CyPA水平。

OBJECTIVE Diabetes combined with coronary heart disease is more common in the clinic.There are many treatments for integrated Chinese and Western medicine,but no unified norms have been formed.At present,Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are used to treat diabetes with coronary heart disease.The study aims to observe the clinical efficacy of integrated Chinese and Western medicine in the treatment of patients with diabetes mellitus complicated with coronary heart disease.METHODS Totally 64 patients with diabetes mellitus and coronary heart disease were from Fushun Hospital of Traditional Chinese Medicine from October 1,2015 to November 30,2016.These patients were randomly divided into control group and integrated Chinese and Western medicine group.There were 32 patients in each group.The control group was given conventional Western medicine treatment.The combination group was treated with traditional Chinese medicine on the basis of conventional western medicine treatment.The treatment cycle was 30 days.The changes of FPG,2 hPG,TCM symptom score,clinical total effective rate and CyPA were observed before and after treatment.RESULTS The FPG after treatment in the integrated Chinese and Western medicine group was(6.34±0.53)mmol/L,which was lower than that of the control group(6.84±0.58)mmol/L,t=-3.600,P=0.001.The 2 h-PG after treatment in the integrated Chinese and Western medicine group was(7.67±0.45)mmol/L,which was lower than that of the control group(8.53±0.64)mmol/L,t=-6.218,P<0.001.The score of TCM symptom after treatment in the integrated Chinese and Western medicine group was(3.56±2.59),which was lower than that of the control group(9.43±3.36),t=-7.827,P<0.001.CyPA was(5.54±0.43)ng/ml after treatment in the integrated Chinese and Western medicine group,which was lower than that of the control group(7.89±0.64)ng/ml,t=-17.241,P<0.001.After treatment,the total effective rate was 93.75%,which was higher than 75.00%of the control group,χ~2=4.267,P=0.039.CONCLUSIONS Qiwei Baizhu Powder and Shengmai Powder combined with western medicine are effective in treating diabetes with coronary heart disease.It can effectively control the blood sugar of patients,improve the clinical symptoms of patients and reduce the level of CyPA in the body.