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目的:观察桃红四物汤对2型糖尿病患者心率变异性及炎性细胞因子脂联素、肿瘤坏死因子-α(TNF-α)以及转化生长因子-β1(TGF-β1)的影响。方法:选择60例本院2型糖尿病住院患者,按照就诊顺序,将其分为对照组和观察组,每组30例,两组患者均进行生活方式干预及常规降糖药物治疗。对照组服用曲美他嗪(20 mg,3次/d),观察组在对照组基础上,加用桃红四物汤治疗,每日1剂,煎汤400 m L,2次/d。两组均以4周为1个疗程,共治疗5个疗程。观察并比较治疗前后HRV时域指标、FBG、Hb Alc及炎性细胞因子脂联素、TNF-α及TGF-β1血清水平的变化。结果:治疗后观察组HRV时域各参数SDNN、SDANN、r MSSD及PNN50均显著高于对照组,差异有统计学意义(P<0.05)。治疗后两组FBG、Hb Alc均明显降低(P<0.05),与对照组治疗后比较,观察组FBG、Hb Alc降低更加明显(P<0.05)。与治疗前比较,观察组治疗后血清脂联素明显升高,血清TNF-α以及TGF-β1水平明显降低(P<0.05);与对照组治疗后比较,观察组治疗后血清脂联素明显升高,血清TNF-α以及TGF-β1水平明显降低(P<0.05)。结论:桃红四物汤能够显著改善2型糖尿病患者的心率变异性,其机制除了与血糖控制有关外,还可能与调节炎性细胞因子脂联素、肿瘤坏死因子-α(TNF-α)以及转化生长因子-β1(TGF-β1)的表达有关。
Objective: To observe the effect of Taohongsiwutang on heart rate variability, inflammatory cytokines adiponectin, tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in type 2 diabetic patients. Methods: Sixty hospitalized patients with type 2 diabetes mellitus were selected. According to the order of treatment, they were divided into control group and observation group, with 30 cases in each group. Both groups were given lifestyle interventions and conventional hypoglycemic drugs. The control group was treated with trimetazidine (20 mg, 3 times / d). The observation group was treated with Taohong Siwu Decoction on the basis of the control group. Two groups were 4 weeks for a course of treatment, a total of 5 courses of treatment. The changes of HRV time domain index, FBG, Hb Alc and inflammatory cytokines adiponectin, TNF-α and TGF-β1 serum levels before and after treatment were observed and compared. Results: After treatment, the parameters SDNN, SDANN, r MSSD and PNN50 of HRV in observation group were significantly higher than those in control group (P <0.05). After treatment, FBG and Hb Alc were significantly lower in both groups (P <0.05). Compared with the control group, FBG and Hb Alc in the observation group decreased more obviously (P <0.05). Compared with those before treatment, the levels of serum adiponectin, serum TNF-α and TGF-β1 in the observation group were significantly decreased (P <0.05). Compared with the control group, the levels of serum adiponectin in the observation group were significantly Elevated serum TNF-α and TGF-β1 levels were significantly lower (P <0.05). Conclusion: Taohongsiwutang can significantly improve the heart rate variability in type 2 diabetic patients. The mechanism may be related to the regulation of inflammatory cytokines adiponectin, tumor necrosis factor-α (TNF-α) Transforming growth factor-β1 (TGF-β1) expression.