活血降糖饮治疗2型糖尿病下肢动脉病变的临床观察  

Clinical Observation on Treatment of Lower Extremity Arterial Disease in Type 2 Diabetes with Huoxue Jiangtang Yin(活血降糖饮)

作　　者：张鹏翔 孟璐 赵恒侠[2] 李惠林[2] 刘德亮[2] 秦应娟 邓玉秀 ZHANG Pengxiang;MENG Lu;ZHAO Hengxia;LI Huilin;LIU Deliang;QIN Yingjuan;DENG Yuxiu(The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen Guangdong 518033,China;Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen Guangdong 518033,China;Bijie Hospital of Traditional Chinese Medicine,Bijie Guizhou 551700,China;Puning Hospital of Traditional Chinese Medicine,Puning Guangdong 515300,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033 [3]毕节市中医院,贵州毕节551700 [4]普宁市中医医院,广东普宁515300

出　　处：《中医药导报》2022年第12期100-104,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：贵州省卫生计生委科学技术基金项目(gzwjkj2018-1-091);深圳市科技计划项目(JCYJ20210324111212033)。

摘　　要：目的:研究活血降糖饮治疗2型糖尿病合并下肢动脉病变的临床疗效。方法:将109例2型糖尿病伴有下肢动脉病变的患者随机分为治疗组54例和对照组55例。在控制各组患者血糖水平的情况下予以口服阿司匹林肠溶片及阿托伐他汀钙片治疗,治疗组加用活血降糖饮治疗,持续12周。分别检测治疗前后受试者的中医证候积分、体质量指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、Apelin血浆浓度水平,并检测踝肱指数(ABI)、腘动脉及足背动脉内膜中层厚度(IMT)与足背动脉/腘动脉血流比值。结果:两组患者治疗后中医证候积分、BMI、FPG、2 h PG、HbA1c、TG、TC、LDL-c、IL-6、TNF-α、腘动脉及足背动脉IMT水平均较治疗前显著下降,HDL-c、Apelin、ABI与足背动脉/腘动脉血流量比值则显著升高,差异均有统计学意义(P<0.05)。治疗组患者治疗后中医证候积分、BMI、FPG、2 h PG、LDL-c、IL-6、TNF-α、足背动脉IMT水平均低于对照组,中医证候积分、BMI、TC、LDL-c、IL-6、TNF-α、腘动脉及足背动脉IMT的治疗前后差值均高于对照组,差异均有统计学意义(P<0.05或P<0.01);Apelin、ABI水平,以及Apelin、ABI、足背动脉/腘动脉血流量比值的治疗前后差值均高于对照组,差异均有统计学意义(P<0.05或P<0.01)。相关性分析提示血清Apelin水平与ABI、足背动脉/腘动脉血流比值呈正相关(P<0.01),而与中医证候积分、腘动脉和足背动脉IMT水平呈负相关(P<0.01)。结论:活血降糖饮联合阿司匹林及阿托伐他汀钙片治疗2型疗尿病下肢动脉病变疗效显著,同时可以调节Apelin血浆浓度水平,并可以显著改善患者下肢动脉病变的症状与进程。Objective:To study the clinical effect of Huoxue Jiangtang Yin in the treatment of type 2 diabetes with lower extremity arterial disease.Methods:A total of 109 cases of type 2 diabetes with lower extremity arterial disease were randomly divided into treatment group(54 cases)and control group(55 cases).The patients in each group were treated with aspirin enteric coated tablets and atorvastatin calcium tablets while the blood glucose level was controlled.The treatment group was treated with Huoxue Jiangtang Yin for 12 weeks.The TCM syndrome score,body mass index(BMI),glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-c),high density lipoprotein cholesterol(HDL-c),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α)and Apelin plasma concentration levels were detected before and after treatment.The ankle-brachial index(ABI),intima-media thickness(IMT)of popliteal artery and dorsalis pedis artery and dorsalis pedis artery/popliteal artery blood flow ratio were measured.Results:After treatment,TCM syndrome score,BMI,FPG,2 h PG,Hb A1c,TG,TC,LDL-c,IL-6,TNF-α,popliteal artery and dorsalis pedis artery IMT levels were significantly lower than those before treatment,HDL-c,Apelin,ABI and dorsalis pedis artery/popliteal artery blood flow ratio was significantly increased,the difference was statistically significant(P<0.05).After treatment,the TCM syndrome score,BMI,FPG,2 h PG,LDL-c,IL-6,TNF-αand IMT of dorsalis pedis artery in the treatment group were significantly lower than those in the control group(P<0.05 or P<0.01).The difference of TCM syndrome score,BMI,TC,LDL-c,IL-6,TNF-α,IMT of popliteal artery and dorsalis pedis artery before and after treatment in the treatment group was significantly higher than that in the control group(P<0.05 or P<0.01).The levels of Apelin,ABI and the difference of Apelin,ABI and dorsalis pedis artery/popliteal artery blood flow ratio before and after treatment was

关 键 词：2型糖尿病 下肢动脉病变 活血降糖饮 APELIN 临床研究 

分 类 号：R255.4[医药卫生—中医内科学]