丹蛭降糖胶囊对2型糖尿病合并下肢大血管病变患者临床疗效及血清Hcy、Cys C水平的影响  

Clinical Efficacy of Danzhi Jiangtang Capsules on Patients with Type 2 Diabetes Mellitus Complicated with Lower-extremity Macroangiopathy and Serum Levels of Hcy and Cys C

作　　者：吴吉萍[1] 方朝晖[1] 陆瑞敏[1] 赵进东[1] 汪四海[1] WU Jiping;FANG Zhaohui;LU Ruimin;ZHAO Jindong;WANG Sihai(First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,合肥230031

出　　处：《中国实验方剂学杂志》2023年第18期102-108,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81774286);国家中医临床研究基地业务建设第二批科研专项(JDZX2015123);安徽省高校协同创新项目(GXXT-2020-025);安徽省名中医方朝晖工作室项目(2019-8-515)。

摘　　要：目的:观察具有益气养阴通络功效的丹蛭降糖胶囊对2型糖尿病(T2DM)合并下肢大血管病变患者临床疗效及血清同型半胱氨酸(Hcy)、胱抑素C(Cys C)水平的影响。方法:选择2017年5月至2019年12月安徽中医药大学第一附属医院内分泌科住院的T2DM合并下肢大血管病变患者80例,随机分为治疗组和对照组,两组各40例,两组患者均给予糖尿病相关的基础治疗,治疗组在基础治疗的基础上加用丹蛭降糖胶囊口服,治疗前后分别测定两组的糖基化血红蛋白A1c(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、空腹C肽(C-P)、餐后2 h C肽(2 hC-P)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),血清Hcy及Cys C水平,计算两组患者治疗前后中医证候积分。结果:治疗12周后门诊随访,治疗后两组患者HbA1c、FPG、2 hPG水平均较本组治疗前明显下降(P<0.05),C-P水平均较本组治疗前明显升高(P<0.05),2 hC-P水平有升高,但差异无统计学意义;与对照组治疗后比较,治疗组患者HbA1c、FPG、2 hPG水平下降程度更为明显(P<0.05),C-P、2 hC-P水平差异无统计学意义;治疗后两组患者TG、TC、LDL-C水平均较本组治疗前明显下降(P<0.05),HDL-C明显升高(P<0.05),且治疗组患者TG、LDL-C水平降低程度明显大于对照组(P<0.05),而TC、HDL-C水平比较差异无统计学意义;治疗后两组患者中医证候积分均较本组治疗前改善(P<0.05),且治疗组中医证候积分改善优于对照组(P<0.05);治疗后治疗组总有效率明显优于对照组(χ^(2)=7.585,P<0.05)。治疗后两组患者CysC及Hcy水平均较本组治疗前明显下降(P<0.05),且治疗组患者CysC、Hcy水平降低程度明显大于对照组(P<0.05);对照组患者治疗后下肢多普勒超声图无明显改善,而治疗组患者治疗后下肢多普勒超声图显示下肢动脉内-中膜厚度稍下降,斑块面积稍有缩小,但差异无统计学意义。结论:丹蛭�Objective:To observe the clinical efficacy of Danzhi Jiangtang capsules with the functions of replenishing Qi,nourishing Yin,and dredging collaterals on patients with type 2 diabetes mellitus(T2DM)combined with lower-extremity macroangiopathy and serum levels of homocysteine(Hcy)and cystatin C(Cys C).Method:A total of 80 eligible patients who were treated in the department of endocrinology of the First Affiliated Hospital of Anhui University of Chinese Medicine from May 2017 to December 2019 were randomized into the treatment group(40 cases)and control group(40 cases).Both groups received the basic therapies for diabetes and Danzhi Jiangtang capsules(oral)was added to the treatment group.The levels of glycosylated hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2-hour postprandial glucose(2 hPG),fasting C-peptide(C-P),and 2-hour postprandial C-peptide(2 hC-P),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C)and serum levels of Hcy and Cys C were measured and the traditional Chinese medicine(TCM)syndrome scores were calculated before and after treatment in the two groups.Result:After 12 weeks of treatment,levels of HbA1c,FPG,and 2 hPG were lower than those before treatment in the two groups(P<0.05).Levels of C-P(P<0.05)and 2 hC-P were higher than those before treatment in the two groups.After treatment,levels of HbA1c,FPG,and 2 hPG in the treatment group were lower than those in the control group(P<0.05),while levels of C-P and 2 hC-P showed no significant difference between two groups.After treatment,the levels of TG,TC,and LDL-C were lower than those before treatment(P<0.05)and HDL-C level was higher than that before treatment(P<0.05)in both groups.After treatment,levels of TG and LDL-C in the treatment group were lower than those in the control group(P<0.05),and levels of TC and HDL-C demonstrated no significant difference between two groups.After the treatment,the TCM syndrome score was lower than that before the treatment in bo

关 键 词：益气养阴通络 2型糖尿病 同型半胱氨酸 胱抑素C 糖脂代谢 中医证候 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R287