玉液汤对2型糖尿病合并颈动脉粥样硬化的影响  

Effect of Yuye Decoction on Type 2 Diabetes Mellitus Complicated with Carotid Atherosclerosis

作　　者：焦素杰 冯晓 张娜 JIAO Sujie;FENG Xiao;ZHANG Na(Endocrinology Department,Dezhou Hospital of Traditional Chinese Medicine,Dezhou 253000,China)

机构地区：[1]德州市中医院内分泌科,德州253000

出　　处：《世界中医药》2021年第4期638-642,共5页World Chinese Medicine

基　　金：山东省医药卫生科技发展计划立项项目(2015QZ008)。

摘　　要：目的:观察玉液汤对2型糖尿病合并颈动脉粥样硬化疗效及其对外周血T淋巴细胞和相关细胞因子影响性。方法:选取2017年4月至2019年4月德州市中医院收治的2型糖尿病合并颈动脉粥样硬化患者98例作为研究对象,按照随机数字表法分为对照组和观察组,每组49例。对照组常规西医降糖、降脂等治疗,观察组在对照组基础上加用汤剂玉液汤口服,均治疗8周。观察各组血糖、氧化应激、T淋巴细胞及其细胞因子、炎症介质等指标变化。结果:1)2组疗程完成时辅助性T细胞(Th1)、Th17、白细胞介素-2(IL-2)、IL-17、γIFN和氧化指标丙二醛(MDA)、8-异前列腺素F2a(8-ios-PGF2a)较治疗前均显著下降(P<0.05),而Th2、调节性T细胞(Treg)、IL-4、IL-6、1L-10及和氧化指标超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)较治疗前均显著升高(P<0.05),且观察组以上指标均显著优于对照组(P<0.05)。2)2组疗程完成时同型半胱氨酸(Hcy)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)较治疗前均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。3)2组疗程完成时空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、颈动脉中膜厚度(IMT)较治疗前均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。4)观察组显效率、总有效率分别为53.06%、89.79%,显著高于对照组的34.69%、75.51%,差异有统计学意义(P<0.05)。结论:玉液汤可有效减轻2型糖尿病合并颈动脉粥样硬化颈动脉狭窄程度,其作用机制可能与抗炎和抗氧化应激有关。Objective:To observe the therapeutic effect of Yuye Decoction on type 2 diabetes mellitus complicated with carotid atherosclerosis and its effect on peripheral blood T lymphocytes and related cytokines.Methods:A total of 98 patients with type 2 diabetes mellitus complicated with carotid atherosclerosis admitted to Dezhou Hospital of Traditional Chinese Medicine from April 2017 to April 2019 were selected as the research objects and were randomly divided into a control group(n=49)and an observation group(n=49).The control group was treated with routine Western medicine for lowering blood sugar and lipid,while the observation group was treated with Yuye Decoction on the basis of the control group for 8 weeks.The changes of blood glucose,oxidative stress,T lymphocytes and their cytokines and inflammatory factors were observed in each group.Results:1)At the end of the course of treatment,the levels of helper T cells(Th1),Th17,interleukin-2(IL-2),IL-17,γIFN,malondialdehyde(MDA)and 8-isoprostaglandin F2a(8-ios-PGF2a)in the 2 groups were significantly lower than those before treatment.However,Th2,(Treg),IL-4,IL-6,1L-10 of regulatory T cells and superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)of regulatory T cells were significantly higher than those before treatment,and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).2)At the end of treatment,homocysteine(Hcy),procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in both groups were significantly lowered(P<0.05),and those in the study group were significantly lower than those in the control group(P<0.05).3)At the end of the course of treatment,fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1c)and carotid intima-media thickness(IMT)in the 2 groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).4)The marked

关 键 词：玉液汤 2型糖尿病 颈动脉粥样硬化 T淋巴细胞 细胞因子 氧化应激 炎症介质 颈动脉中膜厚度 

分 类 号：R255.4[医药卫生—中医内科学] R259[医药卫生—中医学]