【摘要】 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(LDLC)、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。更多还原

【Abstract】 Objective To observe the clinical effect of self-made Strengthening Spleen and Removing Blood Stasis Prescription 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 type2 diabetes mellitus combined with carotid atherosclerosis(insufficiency of the spleen) were chosen and randomly divided into treatment group(30 cases) and control group(30 cases). Both groups were given standard reducing blood glucose 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 significant(all P < 0.05). The levels of TG, LDL-C after treatment in the two groups had no statistically significant 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 statistically 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.更多还原