自拟参荷方辅助西药治疗既往他汀类单药治疗效果不佳T2DM合并高胆固醇血症的疗效及作用机制  

Curative Effect and Mechanism of Self-made Shenhe Prescription Adjuvant Western Medicine in the Treatment of T2DM Patients Complicated with Hypercholesterolemia with Ineffective Stain Monotherapy

作　　者：朱锦锦[1] 李路霞 李俊玲[1] 刘向朴 ZHU Jin-jin;LI Lu-xia;LI Jun-ling;LIU Xiang-pu(Jiyuan Second People's Hospital,Henan Jiyuan 459000)

机构地区：[1]济源市第二人民医院,河南济源459000

出　　处：《深圳中西医结合杂志》2022年第6期36-39,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨自拟参荷方辅助西药治疗既往他汀类单药治疗效果不佳2型糖尿病(T2DM)合并高胆固醇血症的疗效及作用机制。方法:选取济源市第二人民医院2019年1月至2020年12月期间收治的134例既往他汀类单药治疗效果不佳T2DM合并高胆固醇血症,随机分为对照组与观察组,各67例。其中对照组采用单纯西医治疗,观察组则在对照组的基础上加用自拟参荷方治疗,比较两组治疗前后中医证候评分、颈动脉内中膜厚度(CIMT)、动脉粥样硬化斑块Crouse积分、糖代谢指标、脂代谢指标及炎症细胞因子水平。结果:治疗后两组患者的中医证候评分均有不同程度下降,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的CIMT水平及Crouse积分均有不同程度下降,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA1c)均有不同程度下降,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均有不同程度下降,且观察组低于对照组,差异具有统计学意义(P<0.05);治疗后两组患者的高密度脂蛋白胆固醇(HDL-C)均有不同程度上升,且观察组高于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、IL-8及肿瘤坏死因子-α(TNF-α)水平均有不同程度下降,且观察组患者低于对照组,差异具有统计学意义(P<0.05)。结论:自拟参荷方辅助西药治疗既往他汀类单药治疗效果不佳T2DM合并高胆固醇血症可有效缓解临床症状,改善粥样斑块,并有助于调节糖脂代谢;而这一疗效优势可能与该方案对于炎症细胞因子表达高效抑制作用有关。Objective To investigate the clinical effects and mechanism of self-made Shenhe prescription adjuvant western medicine in the treatment of T2DM patients complicated with hypercholesterolemia with ineffective statin monotherapy.Methods A total of 134 patients with T2DM complicated with hypercholesterolemia with ineffective statin monotherapy who were admitted to Jiyuan Second People's Hospital from January 2019 to December 2020 with poor response to statin monotherapy were randomly divided into control group and observation group,with 67 cases in each group.The control group was treated with pure western medicine,and the observation group was treated with self-made Shenhe prescription on the basis of the control group.traditional Chinese medicine(TCM)syndrome scores,carotid intima-media thickness(CIMT),atherosclerotic plaque score Crouse integral,glucose metabolism indexes,lipid metabolism indexes and levels of inflammatory cytokines were compared between the two groups before and after treatment.Results After treatment,TCM syndrome scores of the two groups decreased to varying degrees,and the TCM syndrome scores the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,CIMT level and Crouse scores in the two groups were decreased to varying degrees,and the indicators of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,fasting blood glucose(FPG),2h postprandial blood glucose(2h PG)and glycosylated hemoglobin(HbA1c)in the two groups were decreased to varying degrees,and the indicators of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the levels total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the two groups were decreased to varying degrees,and the indicators in the observation group were lower than those in the control group,the di

关 键 词：2型糖尿病 高胆固醇血症 自拟参荷方 

分 类 号：R587.1[医药卫生—内分泌]