加味黄连温胆汤治疗糖尿病无症状心肌缺血的临床观察

作者	单位
呼永河	天津中医学院第一附属医院内分泌科天津300193
李静	天津中医学院第一附属医院内分泌科天津300193
武娜杰	天津中医学院第一附属医院内分泌科天津300193
吴深涛	天津中医学院第一附属医院内分泌科天津300193

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中文摘要:

目的观察加味黄连温胆汤治疗糖尿病无症状心肌缺血的临床疗效。方法将65例患者随机分为两组,对照组(30例)服用单硝酸异山梨酯(欣康片)20mg,每日2次;治疗组(35例)加服加味黄连温胆汤。疗程均为1个月。观察两组治疗前后血糖、糖化血红蛋白、血脂、心肌酶谱、血液流变学、尿白蛋白、血常规、尿常规和肝肾功能,及24h动态心电图监测和心电图平板运动试验等指标。结果临床总有效率治疗组(88.6%,31/35)和对照组(56.7%,17/30)比较差异有显著性(P<0.05)。治疗组治疗后心肌缺血发作频率、发作累计时间、与活动有关发生率均明显低于对照组;血脂、血液流变学方面均较治疗前有明显改善(P<0.05或P<0.01),红细胞聚集指数(RBCAI)、红细胞变形指数(RBCTI)与对照组比较差异有显著性(P<0.05)。对照组仅全血黏度治疗后有改善(P<0.05),其余指标治疗前后比较差异无显著性。结论加味黄连温胆汤具有改善心肌缺血和血液流变学、降低血脂作用。

英文摘要:

Objective To investigate the clinical efficacy of modified Huanglian Wendan Decoction (MHWD) on diabetic asymptomatic myocardial ischemia. MethodsNinety patients were randomly divided into two groups. The control group (n=30) was given Xinkang tablet (XKT) at a dose of 20mg, twice a day. The treated group (n=35) was given MHWD besides XKT as that given to the control group. The treatment course for both groups was 1 month. Indexes, including blood glucose, glycosylated hemoglobin, blood lipids, myocardial zymogram, hemorheologic parameters, urinary albumin, routine examination of blood and urine, function of liver and kidney, as well as 24h dynamic electrocardiogram and electrocardiogram exercise test were measured in the two groups before and after treatment. ResultsThe total clinical effective rate in the treated group and the control group was 88.33% and 56.67% respectively (P<0.05), showing significant difference between them. The frequency of ischemia attacking, paroxysmal cumulative time, motion related incidence were lower in the treated group after treatment than those in the control group. Besides, in the treated group after treatment, the level of blood lipids and hemorheologic parameters were significantly improved (P<0.05 or P<0.01), hematocrit was unchanged and triglyceride, red blood cell agglutination index and erythrocyte deformability index were obviously different to those in the control group (P<0.05). While in the control group after treatment, except the improving of whole blood viscosity (P<0.05), no significant change was found in the other indices. ConclusionMHWD has effects in improving myocardial ischemia, bettering hemorheologic condition and reducing blood lipids.

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