益肾化瘀汤治疗围绝经期糖尿病心脏自主神经病变疗效及对患者心率变异性、炎症因子的影响  

Effects of Yishen Huayu decoction on the treatment of perimenopausal diabetic cardiac autonomic neuropathy and the heart rate variability and inflammatory factors

作　　者：魏巍[1] 陈颖超 何璐羽 张桂玲[1] WEI Wei;CHEN Yingchao;HE Luyu(Department of Endocrine,Baoding First Hospital in Hebei Province,Baoding 071000)

机构地区：[1]河北省保定市第一医院内分泌科,保定071000 [2]华北理工大学临床医学系,唐山063000

出　　处：《陕西中医》2020年第12期1747-1750,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省医学科学研究重点计划项目(20181476)。

摘　　要：目的:探讨益肾化瘀汤治疗围绝经期糖尿病心脏自主神经病变(DCAN)的临床疗效。方法:选择围绝经期DCAN患者110例,按照随机数字表法分为两组,各55例。对照组予以糖尿病常规治疗,口服甲钴胺片;治疗组在对照组治疗基础上口服益肾化瘀汤,两组均连续治疗8周。比较两组治疗前后心率变异性指标,R-R间期的标准差(SDNN)、相邻R-R间期之差的均方根(rMSSD)、相邻R-R间期差值>50 ms个数百分比(PNN50)、心率变异的低频(LF)、心率变异的高频(HF)和LF/HF值。比较血糖相关指标,空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)。比较性激素相关指标,雌二醇(E2)、促卵泡激素(FSH)和黄体生成素(LH)。比较炎症指标,肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)。比较两组治疗总有效率。结果:治疗后治疗组SDNN、rMSSD、PNN、LF、HF均高于对照组,HF低于对照组,差异具有统计学意义(P<0.01)。血清FPG、2hPG、HbA1c、LH、FSH、TNF-α、IL-1β、IL-6水平低于对照组,E2水平高于对照组,治疗总有效率高于对照组,差异均有统计学意义(P<0.05)。结论:益肾化瘀汤能调节性激素和葡萄糖代谢,降低炎症因子水平,纠正心脏自主神经失衡,治疗围绝经期DCAN效果较好。Objective:To investigate the clinical effect of Yishen Huayu decoction in the treatment of perimenopausal diabetic cardiac autonomic neuropathy(DCAN).Methods:110 cases of perimenopausal DCAN patients were selected and divided into two groups according to the random number table method,each group was 55 cases.The control group received routine treatment for diabetes and oral metocobalamin tablets.In the treatment group,on the basis of the treatment in the control group,Yishen Huayu decoction was taken orally,and both groups were treated continuously for 8 weeks.The two groups were compared before and after treatment on heart rate variability indicators standard deviation of R-R interval(SDNN),root mean square of difference between adjacent R-R intervals(rMSSD),percentage of difference between adjacent R-R intervals>50ms(PNN 50),low frequency(LF)of heart rate variation,high frequency(HF)of heart rate variation and LF/HF value,plasma glucose related indexes,fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),sex hormones related indexes estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)and inflammation indexes(TNF-α,IL-1β)and IL-6),and compare the total therapeutic effectiveness of the two groups.Results:The level of SDNN,rMSSD,PNN,LF and HF in the treatment group were higher than that in the control group,and HF was lower than that in the control group,difference statistically significant(P<0.01).Serum levels of FPG,2hPG,HbA1c,LH,FSH,TNF-α,IL-1,and IL-6 were lower than those in the control group;E2 levels were higher than those in the control group,and the total therapeutic effective rate was higher than that in the control group,difference statistically significant(P<0.05).Conclusion:Yishen Huayu decoction is beneficial to regulate sex hormone and glucose metabolism,reduce the level of inflammatory factors,correct the imbalance of cardiac autonomic nerves,and has significant effect on treating perimenopausal DCAN.

关 键 词：围绝经期 糖尿病心脏自主神经病变 益肾化瘀汤 心率变异性 炎症因子 

分 类 号：R587.1[医药卫生—内分泌]