五味消渴方加味治疗糖尿病下肢血管病变气虚血瘀型临床研究  

Clinical effect of modified Wuwei Xiaoke Formula for diabetic lower extremity arterial disease of qi deficiency and blood stasis

作　　者：黄蓉[1] 邓小敏[1] 周卫惠[1] HUANG Rong;DENG Xiaomin;ZHOU Weihui(Department of Endocrinology,The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi 530023)

机构地区：[1]广西中医药大学第一附属医院内分泌科,广西南宁530023

出　　处：《河北中医》2022年第12期1969-1972,1978,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z20180527)。

摘　　要：目的观察五味消渴方加味治疗糖尿病下肢血管病变(DLEAD)气虚血瘀型的临床疗效。方法将40例DLEAD气虚血瘀型患者按照随机数字表法分为2组,对照组20例予常规西药治疗,治疗组20例在对照组治疗基础上应用五味消渴方加味治疗。2组均4周为1个疗程,治疗2个疗程。比较2组疗效;比较2组治疗前后血糖、血脂指标变化;比较2组治疗前后踝肱指数(ABI)变化;比较2组治疗前后下肢动脉血管血流量变化;比较2组治疗前后中医证候评分变化;观察2组不良反应发生情况。结果治疗组总有效率95.00%(19/20),对照组总有效率80.00%(16/20),治疗组疗效优于对照组(P<0.05)。2组治疗后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1)c)均较本组治疗前降低(P<0.05),治疗后治疗组FPG、2 hPG、HbA_(1)c均低于对照组(P<0.05)。2组治疗后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均较本组治疗前降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)较本组治疗前升高(P<0.05);治疗后治疗组TC、TG、LDL-C均低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。2组治疗后ABI均较本组治疗前升高(P<0.05),治疗后治疗组ABI高于对照组(P<0.05)。2组治疗后股动脉、腘动脉及足背动脉血管血流量均较本组治疗前增加(P<0.05),治疗后治疗组股动脉、腘动脉及足背动脉血管血流量均高于对照组(P<0.05)。2组治疗后中医证候主症、次症评分均较本组治疗前降低(P<0.05),治疗后治疗组中医证候主症、次症评分均低于对照组(P<0.05)。2组均无不良反应出现。结论五味消渴方加味治疗DLEAD气虚血瘀型,能改善患者血糖、血脂水平,增加下肢动脉血管血流量,疗效显著,安全性高。Objective To observe the clinical effect of modified Wuwei Xiaoke Formula for diabetic lower extremity arterial disease(DLEAD)of qi deficiency and blood stasis.Methods Totally 40 DLEAD patients(qi deficiency and blood stasis)were randomly assigned into the treatment group(n=20)and the control group(n=20).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with modified Wuwei Xiaoke Formula.The treatment continued for 2 courses(1 course for 4 weeks),the aim was to compare blood glucose(BG)and blood lipid indexes,ankle brachial index(ABI),lower extremity arterial blood flow,traditional Chinese medicine(TCM)syndrome score;the curative effect and adverse reactions were assessed.Results The overall effective rate in treatment group was better than that in control group(95.00%[19/20]vs 80.00%[16/20],[P<0.05],respectively).After treatment,fasting plasma glucose(FPG),two hour plasma glucose(2 hPG),glycosylated hemoglobin(HbA_(1)c)in groups were decreased(P<0.05),the treatment group was more common(P<0.05);total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C)in groups were decreased(P<0.05),while high density lipoprotein-cholesterol(HDL-C)in groups was increased(P<0.05);lower TC,TG and LDL-C levels,and higher HDL-C levels were detected in the treatment group than those in the control group(all P<0.05);ABI of post-treated in the treatment group was increased than that of pre-treated in same group,ABI of post-treated in the control group was increased than that of pre-treated in same group,the improvement were more in the treatment group as compared to the control group(P<0.05).Blood flow(BF)of femoral artery(FA),arteria poplitea(AP),dorsal aorta(DA)in groups was increased(P<0.05),the treatment group was more prevalent(P<0.05);the scores of nervous symptoms,nerve reflection,sensory function in groups were decreased(P<0.05),which were decreased in the treatment group as compared to the control group(P<0.05);main symptoms and seconda

关 键 词：糖尿病 血管疾病 糖尿病血管病变 中药疗法 

分 类 号：R587.1[医药卫生—内分泌] R587.29[医药卫生—内科学] R247[医药卫生—临床医学]