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目的:研究益气活血法对2型糖尿病(Type 2 diabetes mellitus,T2DM)亚临床血管病变患者颈动脉内膜中层厚度(intimal-medial thickness,IMT)、血浆血管性假血友病因子(von Willebrand factor,v WF)、纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor 1,PAI-1)的影响。方法:采用随机、对照试验设计,将符合纳入标准的T2DM亚临床动脉粥样硬化(athero sclerosis,AS)患者180例,所有患者均采取常规口服降糖治疗,治疗用药及剂量根据患者病情选择,在此基础上,将180例患者随机分为观察组及对照组,观察组加用益气活血法干预治疗,共计90例患者,剩余90例作为对照组不加用益气活血法。疗程为6个月。治疗前后分别测量颈动脉IMT并检测血脂、血糖、v WF及PAI-1等指标。结果:治疗后,两组颈动脉IMT、斑块积分、TC、TG、LDL-C、FPG、Hb A1c均有降低,差异有统计学意义(P<0.01,P<0.05),观察组降低颈动脉IMT、斑块积分、TC、LDL-C的作用更明显(P<0.01,P<0.05)。同时,观察组的不稳定斑块检出率、v WF、PAI-1与本组治疗前及对照组治疗后比较明显降低,差异有统计学意义(P<0.01,P<0.05),对照组不稳定斑块检出率、v WF、PAI-1有下降趋势,但差异无统计学意义(P>0.05)。结论:采用益气活血法治疗2型糖尿病亚临床血管病变患者,能够减轻颈动脉内膜中层厚度,缩小和稳定斑块,改善糖脂代谢,降低炎症因子表达,抑制炎症反应,保护血管内膜的作用。
Objective: To study the effects of Yiqi Huoxue method on carotid artery intimal-medial thickness (IMT), von Willebrand (MVD) in patients with type 2 diabetes mellitus (T2DM) factor, v WF) and plasminogen activator inhibitor 1 (PAI-1). Methods: A randomized controlled trial was designed to treat 180 patients with atherosclerotic atherosclerotic plaques (T2DM) complicated with T2DM in our hospital. All patients received conventional oral hypoglycemic therapy. The therapeutic dosage and dose were determined according to the patient’s condition, On this basis, 180 patients were randomly divided into observation group and control group. The observation group was treated with the method of supplementing qi and activating blood circulation, a total of 90 patients, the remaining 90 as the control group without the method of supplementing qi and activating blood circulation. The course of treatment is 6 months. Before and after treatment, carotid artery IMT were measured and serum lipid, blood glucose, v WF and PAI-1 and other indicators were measured. Results: After treatment, IMT, plaque score, TC, TG, LDL-C, FPG and Hb A1c in carotid arteries decreased in both groups (P <0.01, P < Arterial IMT, plaque score, TC, LDL-C more significantly (P <0.01, P <0.05). At the same time, the detection rate of unstable plaque in the observation group, v WF, PAI-1 and the treatment group before and after treatment were significantly lower, the difference was statistically significant (P <0.01, P <0.05), the control group The detection rate of unstable plaque, v WF, PAI-1 had a downward trend, but the difference was not statistically significant (P> 0.05). Conclusion: The treatment of type 2 diabetes mellitus and subclinical vascular disease by Yiqi Huoxue Therapy can reduce carotid artery intima-media thickness, reduce and stabilize the plaque, improve the metabolism of glucose and lipid, reduce the expression of inflammatory cytokines, inhibit the inflammatory reaction and protect the intima Role.