通脉方对2型糖尿病早期下肢动脉血管病变患者动脉粥样硬化的影响

作者	单位
左光亮	复旦大学附属华山医院中西医结合科
陈剑秋	复旦大学附属华山医院中西医结合科
马杰	复旦大学附属华山医院中西医结合科
傅晓东	复旦大学附属华山医院中西医结合科
王轶宇	复旦大学附属华山医院中西医结合科

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中文摘要:

目的观察通脉方对2型糖尿病(T2DM)早期下肢动脉血管病变(LEAD)患者动脉粥样硬化(AS)的影响。方法将患者随机分为治疗组和对照组,治疗组23例服用中药汤剂通脉方,对照组22例服用西洛他唑,疗程3个月,治疗前后分别检测患者下肢血管多普勒超声、血糖、胰岛素、血清基质金属蛋白酶-9(MMP-9)及白介素-6(IL-6)水平等。结果治疗后,治疗组下肢动脉斑块厚度较治疗前有显著的减少(P<0.01),动脉内中膜厚度改善明显(P<0.05),胰岛素敏感性显著改善(P<0.01),血清MMP-9、IL-6水平较治疗前减少(P<0.05),而对照组变化无统计学意义。结论通脉方有减少斑块厚度、改善动脉内中膜增厚及稳定斑块的作用,其作用机制可能是通过改善胰岛素敏感性、抗炎症反应及降低血清MMP-9水平实现的。

英文摘要:

Objective To observe the effect of Tongmai Recipe(TMR) on atherosclerosis(AS) in patients with early lower extremity arteriopathy disease(LEAD) caused by type 2 diabetes mellitus(T2DM).Methods Patients were randomly assigned to two groups.The 23 patients in the treatment group were treated by TMR and the 22 in the control group were given Cilostazo,all for 3 months.Before and after treatment,lower extremity vascular color Doppler image,blood levels of glucose,insulin,serum matrix metalloproteinase-9(MMP-9) and interleukin-6(IL-6) were measured.Results The thickness of AS plaque and that of arterial intima-media obviously reduced(P<0.01 and P<0.05),insulin sensitivity improved noticeably(P<0.01),and serum levels of MMP-9 and IL-6 lowered obviously(P<0.05) in the treatment group after treatment,but these indexes were unchanged in the control group statistically.Conclusion TMR has remarkable action in reducing the thickness of AS plaque and intima-media of artery,its mechanism might be related with improving of insulin sensitivity and anti-inflammatory reaction,and reducing of serum MMP-9 level as well in patients.

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