中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
25期
107-111
,共5页
徐小娟%刘丹%张炜宁%唐新征
徐小娟%劉丹%張煒寧%唐新徵
서소연%류단%장위저%당신정
2型糖尿病%颈动脉粥样硬化%健脾祛瘀方
2型糖尿病%頸動脈粥樣硬化%健脾祛瘀方
2형당뇨병%경동맥죽양경화%건비거어방
Type 2 diabetes mellitus%Carotid atherosclerosis%Strengthening Spleen and Removing Blood Stasis Pre-scription
目的：观察自拟健脾祛瘀方治疗2型糖尿病伴颈动脉粥样硬化的效果。方法全部病例均为2014年5~12月在深圳市福田区中医院就诊的患者，选取明确诊断为2型糖尿病伴颈动脉粥样硬化患者60例(脾虚型)，随机分为治疗组(30例)和对照组(30例)。两组均采用常规降糖治疗，在此基础上，治疗组给予自拟健脾祛瘀方，对照组给予辛伐他汀片口服，疗程均为12周。观察两组治疗前后血脂水平[三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、颈动脉内膜-中层厚度(IMT)以及丙氨酸氨基转移酶(ALT)的变化情况。结果治疗组和对照组治疗后TG[(1.51±0.18)、(1.44±0.25)mmol/L]、LDL-C[(2.51±0.34)、(2.62±0.32)mmol/L]水平均较治疗前[TG：(3.21±1.52)、(3.32±1.63)mmol/L；LDL-C：(4.83±1.52)、(4.75±1.61)mmol/L]显著降低，HDL-C[(2.32±0.46)、(1.26±0.32)mmol/L]较治疗前[(0.83±0.51)、(0.92±0.62)mmol/L]显著升高，差异均有统计学意义(均 P <0.05)。两组治疗后TG、LDL-C比较，差异无统计学意义(均P>0.05)。治疗组治疗后HDL-C水平显著高于对照组，差异有统计学意义(P<0.05)。治疗组治疗后IMT[(1.27±0.64)mm]显著低于对照组[(1.50±0.80)mm]，差异有统计学意义(P<0.05)。对照组治疗后ALT[(68.92±10.27)U/L]显著高于治疗组[(24.80±4.39)U/L]，差异有统计学意义(P<0.05)。结论自拟健脾祛瘀方能有效调节2型糖尿病伴颈动脉粥样硬化患者血脂水平，具有和西药辛伐他汀类似的作用，部分作用甚至优于西药，同时可延缓颈动脉粥样硬化进程，且副作用少，安全可靠。
目的：觀察自擬健脾祛瘀方治療2型糖尿病伴頸動脈粥樣硬化的效果。方法全部病例均為2014年5~12月在深圳市福田區中醫院就診的患者，選取明確診斷為2型糖尿病伴頸動脈粥樣硬化患者60例(脾虛型)，隨機分為治療組(30例)和對照組(30例)。兩組均採用常規降糖治療，在此基礎上，治療組給予自擬健脾祛瘀方，對照組給予辛伐他汀片口服，療程均為12週。觀察兩組治療前後血脂水平[三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)]、頸動脈內膜-中層厚度(IMT)以及丙氨痠氨基轉移酶(ALT)的變化情況。結果治療組和對照組治療後TG[(1.51±0.18)、(1.44±0.25)mmol/L]、LDL-C[(2.51±0.34)、(2.62±0.32)mmol/L]水平均較治療前[TG：(3.21±1.52)、(3.32±1.63)mmol/L；LDL-C：(4.83±1.52)、(4.75±1.61)mmol/L]顯著降低，HDL-C[(2.32±0.46)、(1.26±0.32)mmol/L]較治療前[(0.83±0.51)、(0.92±0.62)mmol/L]顯著升高，差異均有統計學意義(均 P <0.05)。兩組治療後TG、LDL-C比較，差異無統計學意義(均P>0.05)。治療組治療後HDL-C水平顯著高于對照組，差異有統計學意義(P<0.05)。治療組治療後IMT[(1.27±0.64)mm]顯著低于對照組[(1.50±0.80)mm]，差異有統計學意義(P<0.05)。對照組治療後ALT[(68.92±10.27)U/L]顯著高于治療組[(24.80±4.39)U/L]，差異有統計學意義(P<0.05)。結論自擬健脾祛瘀方能有效調節2型糖尿病伴頸動脈粥樣硬化患者血脂水平，具有和西藥辛伐他汀類似的作用，部分作用甚至優于西藥，同時可延緩頸動脈粥樣硬化進程，且副作用少，安全可靠。
목적：관찰자의건비거어방치료2형당뇨병반경동맥죽양경화적효과。방법전부병례균위2014년5~12월재심수시복전구중의원취진적환자，선취명학진단위2형당뇨병반경동맥죽양경화환자60례(비허형)，수궤분위치료조(30례)화대조조(30례)。량조균채용상규강당치료，재차기출상，치료조급여자의건비거어방，대조조급여신벌타정편구복，료정균위12주。관찰량조치료전후혈지수평[삼선감유(TG)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)]、경동맥내막-중층후도(IMT)이급병안산안기전이매(ALT)적변화정황。결과치료조화대조조치료후TG[(1.51±0.18)、(1.44±0.25)mmol/L]、LDL-C[(2.51±0.34)、(2.62±0.32)mmol/L]수평균교치료전[TG：(3.21±1.52)、(3.32±1.63)mmol/L；LDL-C：(4.83±1.52)、(4.75±1.61)mmol/L]현저강저，HDL-C[(2.32±0.46)、(1.26±0.32)mmol/L]교치료전[(0.83±0.51)、(0.92±0.62)mmol/L]현저승고，차이균유통계학의의(균 P <0.05)。량조치료후TG、LDL-C비교，차이무통계학의의(균P>0.05)。치료조치료후HDL-C수평현저고우대조조，차이유통계학의의(P<0.05)。치료조치료후IMT[(1.27±0.64)mm]현저저우대조조[(1.50±0.80)mm]，차이유통계학의의(P<0.05)。대조조치료후ALT[(68.92±10.27)U/L]현저고우치료조[(24.80±4.39)U/L]，차이유통계학의의(P<0.05)。결론자의건비거어방능유효조절2형당뇨병반경동맥죽양경화환자혈지수평，구유화서약신벌타정유사적작용，부분작용심지우우서약，동시가연완경동맥죽양경화진정，차부작용소，안전가고。
Objective To observe the clinical effect of self-made Strengthening Spleen and Removing Blood Stasis Pre-scription in the treatment of type 2 diabetes mellitus combined with carotid atherosclerosis. Methods All cases were the patients visiting Futian TCM Hospital of Shenzhen City from May to December 2014, 60 patients diagnosed as type 2 diabetes mellitus combined with carotid atherosclerosis (insufficiency of the spleen) were chosen and randomly divid-ed into treatment group (30 cases) and control group (30 cases). Both groups were given standard reducing blood glu-cose treatment, on basis of which, the treatment group was given self-made Strengthening Spleen and Removing Blood Stasis Prescription, the control group was given Simvastatin Tablet orally. Course of treatment in both groups was 12 weeks. The changes of serum lipid levels [triacylglycerol (TG), low density lipoprotein cholesterin (LDL-C), high density lipoprotein cholesterol (HDL-C)], carotid intima-media thickness (IMT) and alanine aminotransferase (ALT) before and after treatment in the two groups were observed. Results The levels of TG [(1.51±0.18), (1.44±0.25) mmol/L], LDL-C [(2.51±0.34), (2.62±0.32) mmol/L] after treatment in the treatment group and control group were all decreased compared with those before treatment [TG: (3.21±1.52), (3.32±1.63) mmol/L; LDL-C: (4.83±1.52), (4.75±1.61) mmol/L], the levels of HDL-C [(2.32±0.46), (1.26±0.32) mmol/L] were increased compared with those before treatment [(0.83±0.51), (0.92±0.62) mmol/L], the differences were all statistically sig-nificant (all P < 0.05). The levels of TG, LDL-C after treatment in the two groups had no statistically signifi-cant differences (all P>0.05). The level of HDL-C after treatment in the treatment group was higher than that of control group, the difference was statistically significant (P<0.05). The level of IMT [(1.27±0.64) mm] after treatment in the treatment group was lower than that of control group [(1.50±0.80) mm], the difference was statistically significant (P< 0.05). The level of ALT [(68.92±10.27) U/L] after treatment in the control group was higher than that of treatment group [(24.80±4.39) U/L], the difference was statistical-ly significant (P<0.05). Conclusion The self-made Strengthening Spleen and Removing Blood Stasis Prescription can effectively adjust the serum lipid levels of patients of type 2 diabetes mellitus combined with carotid atherosclerosis, which has a similar effect to Simvastatin, and some effects are even much better, at the same time, it can put off the progress of carotid atherosclerosis, with less side effects, which is safe and reliable.
