稳糖消渴汤联合短期胰岛素强化疗法对初发2型糖尿病大血管病变的影响

Effect of Stabilized Xiaoke Decoction Combined with Short-term Intensive Insulin Therapy on Macroangiopathy in Type 2 Diabetic Patients

目的:探讨稳糖消渴汤联合短期胰岛素强化疗法对初发2型糖尿病患者大血管病变的影响。方法:选取2015年6月—2017年12月在医院收治的初发2型糖尿病患者116例,根据数字表法随机将患者分为西医治疗组和中西医治疗组,每组58例。西医治疗组患者接受胰岛素强化治疗,中西医治疗组在对照组的基础上给予稳糖消渴汤,治疗1个月后,比较两组患者的中医证候的改变,大血管病变状况,血糖控制水平,总体治疗效果。结果:治疗前,两组患者的胸脘满闷、头痛昏蒙、口干咽燥、呕恶痰涎、舌胖大苔白腻以及脉弦滑证候的差异无统计学意义;治疗后,与治疗前相比,胸脘满闷、头痛昏蒙、口干咽燥、呕恶痰涎、舌胖大苔白腻以及脉弦滑证候评分均显著降低,中西医治疗组患者的评分低于西医治疗组,差异均具有统计学意义。治疗前,两组患者的内膜中层厚度和斑块面积的差异无统计学意义,治疗后,与治疗前相比,内膜中层厚度和斑块面积均显著降低,中西医治疗组患者的内膜中层厚度和斑块面积低于西医治疗组,差异均具有统计学意义。治疗前,两组患者的空腹血糖和餐后2 h血糖含量差异无统计学意义,治疗后,与治疗前相比,空腹血糖和餐后2 h血糖含量均显著降低,中西医治疗组患者的空腹血糖和餐后2 h血糖含量低于西医治疗组,差异均具有统计学意义。中西医治疗组患者的显效比例以及总有效率的均高于西医治疗组,差异具有统计学意义。结论:将稳糖消渴汤联合短期胰岛素强化疗法应用于治疗初发2型糖尿病患者可以有效的提升总体临床治疗效果和中医证候,控制血糖,改善患者的大血管病变,值得临床推广。

Objective:To investigate the effect of a combination of Stabilized Xiaoke Decoction and short-term insulin intensive treatment on the macroangiopathy in newly diagnosed type 2 diabetic patients.Methods:This study selected 116 patients with type 2 diabetes initially treated in our hospital from June 2015 to December 2017.According to the digital table method,the patients were randomly divided into Western medicine treatment group and Chinese and Western medicine treatment group,58 cases in each group.Western medicine treatment group received insulin intensive treatment and the Chinese and Western medicine treatment group was given Stabilized Xiaoke Decoction on the basis of the control group.After 1 month of treatment,the changes in TCM syndromes,macrovascular disease status,blood glucose control leveland overall treatment effect were compared between the two groups of patients.Results:Before treatment,there was no statistically significant difference between the two groups’chest tightness,headache,fainting,dry mouth and throat,vomiting,sputum,tongue enlarged,greasy tongueand string-like pulse.After treatment,compared with those before treatment,the chest fullness,headache,fainting,dry mouth and thorat,vomiting,sputum,tongue enlarged,greasy tongueand string-like pulse scores were significantly reduced.The scores of Chinese and Western medicine treatment groups were lower than those of western medicine treatment group and the differences were statistically significant.Before treatment,the difference in intima-media thickness and plaque area between the two groups was not statistically significant.After treatment,the intima media thickness and plaque area were significantly lower than before treatment.The intima-media thickness and plaque area of the Chinese and Western medicine treatment group were lower than those of the western medicine treatment group and the differences were statistically significant.Before treatment,there was no statistically significant difference in fasting glucose or postprandial blood glucose levels between the two groups.After treatment,fasting blood glucose and postprandial blood glucose levels were significantly reduced compared to those before treatment.Fasting blood glucose and 2 h postprandial blood glucose levels were lower in the Chinese and Western medicine treatment group than in the western medicine treatment group and the differences were statistically significant.The effective ratio and total effective rate of Chinese and Western medicine treatment group were higher than those of western medicine treatment group,the difference was statistically significant.Conclusion:The application of Stabilized Xiaoke Decoction combined with short-term insulin intensive therapy in the treatment of newly diagnosed type 2 diabetic patients can effectively improve the overall clinical efficacy and TCM syndromes,control blood glucoseand improve the patients with macroangiopathy.It is worthy of clinical promotion.