三芪丹颗粒治疗2型糖尿病合并高血压病的临床观察

目的评价益气养阴、活血化瘀法对2型糖尿病(T2DM)合并高血压病患者胰岛素抵抗的影响。方法选取本院糖尿病专科门诊患者45例,采取随机方法分为试验组(20例)和对照组(25例)。两组患者均口服降糖药物格列吡嗪缓释片、吡格列酮及盐酸二甲双胍;降压药物为硝苯地平缓释片。试验组在对照组治疗基础上加服中成药制剂三芪丹颗粒,两组疗程均为8周。观察两组中医证候疗效,袖带血压,糖尿病相关指标及血脂。结果试验组较对照组中医证候疗效比较,差异有统计学意义(P<0.05)。治疗后试验组除空腹胰岛素(FINS)、甘油三酯(TG)外,其余指标与治疗前比较,差异均有统计学意义(P<0.01);对照组仅空腹血糖(FBG)、糖化血红蛋白(HbA1c)、收缩压(SBP)、高密度脂蛋白胆固醇(HDL-C)差异有统计学意义(P<0.01);与对照组治疗后比较,试验组FBG、HbA1c、SBP的下降、HDL-C的提高,差异有统计学意义(P<0.05);ISI有改善趋势,但差异无统计学意义(P=0.230)。结论三芪丹颗粒能有效改善气阴两虚、血瘀内阻证患者临床症状,提高胰岛素敏感性,减轻胰岛素抵抗状态,从而降低FBG、血压和HbA1c;同时能提高HDL-C水平,降低胆固醇(TC)、LDL-C水平,有利于抗动脉粥样硬化。

英文摘要:

Objective To evaluate the effect of treatment for tonifying qi,nourishing yin,activating blood circulation and removing stasis on insulin resistance (IR) in patients of type 2 diabetes mellitus (T2DM) complicated with hypertension. Methods Forty-five patients of T2DM with hypertension enrolled from authors′ special clinics were equally randomized into two groups: the test group (20 patients) and the control group (25 patients). Both groups received orally hypoglycemic drugs,such as glipizide sustained-release tablets,pioglitazone,and metformin,and antihypertensive drug as nifedipine sustained-release tablets as well. Additionally,Sanqidan Granules (SQD),a Chinese patent medicine was given to the test group. The course of treatment lasted for 8 weeks. The clinical efficacy of Chinese medicine syndromes,blood pressure,T2DM related indices and blood lipids in the two groups were observed. Results The effect in improving Chinese medicine syndromes in the test group was better than that in the control group significantly (P<0.05). After treatment,all the indices were examined,except FINS and TG were improved in the test group,showing significant difference as compared with those before treatment;while in the control group,significant difference was only shown in terms of fasting blood glucose (FBG),HbA1c,systolic blood pressure (SBP) and HDL-C (P<0.01). Comparison between groups showed that the effect in the former was better than that in the latter group in terms of decreasing FBG,HbA1c,SBP and increasing of HDL-C (P<0.05),while a downward trend of ISI in the test group was shown but with no statistical significance (P=0.230). Conclusions SQD can relieve the clinical symptoms in patients of syndrome of qi-yin deficiency and inner blockage of blood stasis,increase the insulin sensitivity and reduce the IR in patients,so as to decrease their FBG,blood pressure and HbA1c. It also can increase HDL-C level,and lower TC and LDL-C levels,which is beneficial to anti-atherosclerosis.

关闭