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目的:观察益气养阴活血汤联合西药治疗2型糖尿病合并冠心病患者的临床疗效。方法:纳入78例2型糖尿病合并冠心病气阴两虚证患者,随机分为2组各39例,2组均以门冬胰岛素30注射液、硝酸甘油片、阿托伐他汀钙片、盐酸曲美他嗪片治疗,观察组加用益气养阴活血汤。评价2组患者治疗前后的中医证候积分,检测2组患者治疗前后的血清脂肪因子(脂联素、内脂素、瘦素、抵抗素)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、炎症指标[急性时相血清淀粉样蛋白A(ASAA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左室射血分数(LVEF)],记录2组患者出现的不良反应情况。结果:治疗后,2组中医证候积分与FBG、HbA1c与ASAA、TNF-α、IL-6水平均较治疗前降低(P<0.01,P<0.05),观察组各项指标值均低于对照组(P<0.01,P<0.05)。2组脂联素均较治疗前升高,内脂素、瘦素及抵抗素均较治疗前下降,差异均有统计学意义(P<0.05);观察组4项指标与对照组比较,差异均有统计学意义(P<0.05)。观察组心功能指标LVEDD、LVESD、LVEF均优于对照组(P<0.01)。观察组不良反应发生率2.56%,对照组不良反应发生率15.38%,2组比较,差异有统计学意义(P<0.05)。结论:采用益气养阴活血汤联合西药治疗2型糖尿病合并冠心病可有效缓解症状、降低血糖、减轻炎症反应,改善患者的心功能及微循环,减少不良反应的发生,效果显著且安全。
Objective: To observe the clinical effects of Yiqi Yangyin Huoxue Decoction combined with western medicine in treating patients with type 2 diabetes and coronary heart disease. Methods: A total of 78 patients with type 2 diabetes mellitus and coronary heart disease with qi and yin-deficiency syndrome were enrolled and randomly divided into two groups (n = 39). The two groups were given insulin aspart 30 injection, nitroglycerin tablets, atorvastatin calcium tablets, Trimetazidine tablets treatment, observation group plus Qi Yangyinhuoxue soup. The TCM syndrome scores of two groups before and after treatment were evaluated. Serum adipokines (adiponectin, visfatin, leptin, resistin), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c) The indexes of inflammation (acute phase serum amyloid A (ASAA), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)], cardiac function [LVEDD] , Left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF)], the adverse reactions of two groups were recorded. Results: After treatment, the scores of TCM syndromes and the levels of FBG, HbA1c, ASAA, TNF-α and IL-6 in the two groups were lower than those before treatment (P <0.01, Control group (P <0.01, P <0.05). The levels of adiponectin in two groups were significantly higher than those before treatment, and the contents of visfatin, leptin and resistin decreased compared with those before treatment (P <0.05). The differences of the four indexes in the observation group and the control group were statistically significant All were statistically significant (P <0.05). The LVEDD, LVESD and LVEF in the observation group were better than those in the control group (P <0.01). The incidence of adverse reactions in the observation group was 2.56%, and the incidence of adverse reactions in the control group was 15.38%. There was significant difference between the two groups (P <0.05). Conclusion: The treatment of type 2 diabetes mellitus with coronary heart disease by Yiqi Yangyin Huoxue Decoction combined with western medicine can relieve the symptoms, reduce the blood sugar, relieve the inflammatory reaction, improve the patients’ cardiac function and microcirculation and reduce the occurrence of adverse reactions, the effect is significant and safe.