益肾活血汤联合西药治疗老年2型糖尿病疗效观察

Therapeutic Effect of Yishen Huoxue decoction combined with Western Medicine on Elderly Patients with Type 2 Diabetes Mellitus

[目的]观察益肾活血汤联合西药治疗老年2型糖尿病效。[方法]将50患者按随机数字表法分为观察组和对照组各25例。对照组格列齐特,30 mg/次,1次/d;二甲双胍,250 mg/次,2次/d;30 d后,格列齐特,60 mg/次,1次/d;二甲双胍,750 mg/次,2次/d。治疗组益肾活血汤[熟地黄20 g,山茱萸10 g,肉桂(后下) 3 g,炒当归10 g,丹参15g,川穹10 g,炒白芍10 g,山药15 g,山茱萸10 g,制附子(先煎) 6 g,鹿角胶(烊化) 15 g,炙黄芪20 g],水煎400 m L,2次/d,早晚温服,肾阳虚加巴戟天15 g,淫羊藿15 g;血瘀或肢体麻木、疼痛加红花8 g,赤芍10 g;腰酸痛加川牛膝10 g,怀牛膝10 g,炒杜仲10 g;尿糖高倍用黄芪、山药;西药治疗同对照组。连续治疗10周为1疗程。观测临床表现、空腹血糖、餐后2 h血糖、糖化血红蛋白、收缩压、舒张压、低密度脂蛋白、高密度脂蛋白、不良反应。治疗1疗程(10周),判定疗效。[结果]空腹血糖、餐后2 h血糖、糖化血红蛋白两组均有改善(P <0. 05),治疗组改善优于对照组(P <0. 05)。收缩压、舒张压、低密度脂蛋白、高密度脂蛋白两组均有改善(P <0. 05),治疗组改善优于对照组(P <0. 05)。[结论]益肾活血汤联合西药治疗老年2型糖尿病,可改善血糖、血压、血脂,无严重不良反应,值得推广。

[Objective]To observe the effect of Yishen Huoxue decoction combined with western medicine in the treatment of senile type 2 diabetes mellitus.[Method]50 patients were divided into observation group and control group according to random number table method,25 cases in each group.The control group was treated with gliclazide,30 mg/time,once a day;metformin,250 mg/time,twice a day;after 30 days,gliclazide,60 mg/time,once a day;metformin,750 mg/time,twice a day.In the treatment group,Yishen Huoxue decoction(Shudihuang 20 g,Shanzhuyu 10 g,Rougui 3 g,Chaodanggui 10 g,Danshen15 g,Chuanxiong,Chaobaishao eeach 10 g,Shanyao 15 g,Zhifuzi 6 g,Lujiaojiao 15 g,Zhihuangqi 20 g),decocted 400 m L twice a day,warm clothes in the morning and evening,kidney yang deficiency plusBajitian,Yinyanghuo each 15 g;blood stasis or limb numbness,pain plus Honghua 8 g,Chishao 10 g;lumbar pain plus Chuanniuxi,Huaiqniuxi,Chaoduzhong each 10 g;high urine sugar with Huangqi,Shanyao;western medicine treatment with the same control group.Continuous treatment for 10 weeks is a course of treatment.The clinical manifestations,fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,systolic blood pressure,diastolic blood pressure,low density lipoprotein,high density lipoprotein and adverse reactions were observed.One course of treatment(10 weeks)was used to determine the curative effect.[Result]Fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin were improved in both groups(P<0.05),and the improvement in treatment group was better than that in control group(P<0.05).Systolic blood pressure,diastolic blood pressure,low density lipoprotein and high density lipoprotein were improved in both groups(P<0.05),and the improvement in treatment group was better than that in control group(P<0.05).[Conclusion]Yishen Huoxue decoction combined with western medicine can improve blood sugar,blood pressure and blood lipid in elderly patients with type 2 diabetes mellitus,without serious adverse reactions,which is worthy of promotion.