抵当汤加减对痰瘀互结证糖尿病下肢动脉血管病变患者中CD40/CD40L和IL-10的影响  

Effect of Modified Didang Decoction on CD40/CD40L and IL-10 in Diabetic Patient with Lower Extremity Arterial Vascular Lesions of Phlegm and Blood Stasis Binding Syndrome

作　　者：刘伟[1] 刘莹莹[1] 高学清[1] 汪雪晴 柯娟[1] Liu Wei;Liu Yingying;Gao Xueqing;Wang Xueqing;Ke Juan(Department of Chinese Medicine,Taihe Hospital East Branch,Shiyan 442000,China)

机构地区：[1]湖北省十堰市太和医院东院区中医部,十堰442000

出　　处：《世界中医药》2018年第8期1875-1878,1882,共5页World Chinese Medicine

基　　金：湖北省卫计委和计划生育委员会科研项目(WJ2015MB232)

摘　　要：目的:观察抵当汤加减对痰瘀互结证糖尿病下肢动脉血管病变的临床疗效,同时分析其对血糖及部分血液指标的影响。方法:选取2016年4月至2017年4月十堰市太和医院收治的痰瘀互结证2型糖尿病伴下肢动脉血管病变患者70例,随机分为对照组和观察组,每组35例。对照组接受调节膳食结构、加强锻炼,每日注射人胰岛素,观察组在对照组治疗基础上加用抵当汤加减。比较2组患者中医证候积分,胰岛素水平空腹血糖(FPG)以及CD4、CD40L和IL-10表达的变化。结果:2组中医证候积分均较治疗前降低(P<0.05),其中观察组患者降低大于对照组,差异有统计学意义(P<0.05)。观察组每日的胰岛素用量及FPG均比本组治疗前降低,差异有统计学意义(P<0.05);治疗后每日胰岛素的用量观察组均低于对照组,差异有统计学意义(P<0.05)。治疗后的CD40及CD40L均较治疗前减少,差异有统计学意义(P<0.05),与治疗前比较,2组CD40及CD40L均减少,差异有统计学意义(P<0.05)。2照组治疗后IL-10均较治疗前明显升高,差异有统计学意义(P<0.05),观察组IL-10升高大于对照组,差异有统计学意义(P<0.05)。结论:抵当汤加减可有效治疗痰瘀互结证糖尿病下肢动脉血管病变,其作用机制可能与降低CD40/CD40L,以及升高IL-10表达有关。Objective： To observe the clinical curative effect of Didang decoction on diabetic patient with lower extremity arterial vascular lesions of phlegm and blood stasis binding syndrome,and at the same time analyze the influence on the hematology indexes like CD40/CD40 L and IL-10. Methods： A total of 70 cases of diabetic patient with lower extremity arterial vascular lesions of phlegm and blood stasis binding syndrome who treated in the endocrine department in Taihe Hospital from April 2016 to April 2017 were included in the study and randomly divided into the control group and the observation group,with 35 cases in each group.The control group adjusted dietary pattern,strengthened exercise and daily injections of human insulin. Besides,the treatment group was added Didang decoction on the basis of the control group. TCM syndrome integrals,insulin as well as FPG levels,CD40,CD40-L and IL-10 changes in serum concentration levels of two groups before and after treatment were compared. Results：1） TCM syndrome integrals of the two groups reduced than before the treatment（ P 〈0. 05）,the reduction of the treatment group was more significantly than the control group（ P 〈0. 05）. 2） the levels of insulin as well as FPG declined after treatment（ P 〈0. 05）,and the downward trend of the test group was more obvious. Compared with the control group,there were with statistically significant differences（ P 〈0. 05）. 3） Detected by ELISA,CD40 and CD40 L levels of the two groups of the patient decreased after treatment,while IL-10 levels of both group were higher after treatment with significant differences（ P 〈0. 05）. Apart from this,the upward trend of the treatment group was higher than the control group. Conclusion： The modified Didang decoction can effectively treat diabetic patient with lower extremity arterial vascular lesions of phlegm and blood stasis binding syndrome,and the mechanism may related to the reduction of CD40/CD40 L expression and increase of IL-10 level.

关 键 词：抵当汤 痰瘀互结证 糖尿病 下肢动脉血管 CD40 CD40L IL-10 疗效 

分 类 号：R289.5[医药卫生—方剂学] R587.2[医药卫生—中药学]