复方丹参滴丸对2型糖尿病患者颈动脉内中膜的影响

作者	单位
马荣炜	第二军医大学长海医院内分泌科武警河北总队医院内一科
邹大进	武警河北总队医院内一科
王奇金	武警河北总队医院内一科
丁长花	武警河北总队医院内一科
王鸿燕	武警河北总队医院内一科
高从容	武警河北总队医院内一科
李慧	武警河北总队医院内一科
冯正康	武警河北总队医院内一科
鲁瑾	武警河北总队医院内一科
徐茂锦	武警河北总队医院内一科
黄勤	武警河北总队医院内一科

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中文摘要:

目的观察复方丹参滴丸对2型糖尿病(T2DM)患者大血管病变的影响。方法 130例(T2DM)患者,随机分为4组:A组血糖和血压控制组(简称对照组,32例),B组血糖、血压和血脂控制组(32例),C组血糖、血压、血脂控制加维生素E组(32例)和D组血糖、血压、血脂控制加复方丹参滴丸组(34例)。其中D组按中医辨证分为阴虚热盛证8例、气阴两虚证5例、阴阳两虚证8例及血瘀气滞证13例。定期检测空腹血糖(FBG)、血脂、血压(BP),治疗前及治疗后1、3、5年时均行超声检查颈动脉内中膜厚度(IMT),以动态观察颈动脉IMT及斑块形成情况,并分析与FBG、血脂和BP等关系。结果共有105例患者完成了5年随访。4组患者总胆固醇(TC)水平呈降低趋势,高密度脂蛋白胆固醇(HDL-C)水平呈升高之势,C组和D组略优于B组,但明显优于A组;5年间,各组患者FBG和糖化血红蛋白(HbA1c)水平波动不明显。病程中4组患者颈动脉IMT均逐渐增厚,且斑块数量逐渐增多,各组内及组间比较,差异均有统计学意义(P<0.01),但D组增厚的程度明显小于其他3组(均P<0.01)。糖尿病患者IMT与HbA1c、HDL-C、LDL-C、TC和TG密切相关,尤其是D组。结论复方丹参滴丸治疗有延缓糖尿病大血管病变的发生及发展的作用。

英文摘要:

Objective To investigate the effect of compound Danshen Dripping Pill(DSP) on carotid arterial intima-media thickness(IMT) in patients with type 2 diabetes mellitus(T2DM) .Methods One hundred and thirty T2DM patients were assigned to four groups,32 in the Group A,the control group treated with blood glucose(BG) and blood pressure(BP) controlling;32 in the Group B,with BG,BP and blood lipid(BL) controlling,32 in Group C with BG,BP,BL controlling and vitmin E administration,and 34 in Group D with BG,BP,BL controlling and DSP administration.Patients in Group D were subdivided by Chinese medicine syndrome differentiation into four types,8 of Yin-deficiency with flourishing heat type(YDFH),5 of both qi-yin deficient type(BQYD),8 of both yin-yang deficient type(BYYD) and 13 of blood-stasis and qi-stagnant type(BSQS) .Fasting blood glucose(FBG),BP and BL in patients were observed periodically,and IMT in them were measured by ultrasonography before treatment,as well as at the end of the 1st,3rd,and 5th year of treatment to dynamically observe the changes of IMT and condition of plaque formation,and analyze the relation between them with FBG,BP and BL.Results The 5-year follow-up was performed in 105 patients.In the observation period,level of total cholesterol(TC) showed a decreasing trend and level of high density cholesterol(HDL-C) showed an increasing trend in all the 4 groups,the improvements in Group C and D were slightly better than those in Group B,while significantly superior to those in Group A;the changes of FBG and glycosylated hemoglobin(HbA1c) were insignificant in the 4 groups.IMT and numbers of atheroma plaque increased gradually in all groups in the observation period,however,the changes in Group D were lesser than those in other groups,showing significant difference(P <0.01) .It was showed that the increasing of cervical carotid IMT in T2DM patients was correlated with levels of HbA1c,HDL-C,LDL-C,triglyceride and TC,especially in Group D.Conclusion DSP might delay the occur-rence and development of diabetic macro-vascular disease.

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