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目的:观察降糖通脉胶囊治疗2型糖尿病大血管病变的疗效及对炎症反应和微循环的影响。方法:将144例患者随机按数字表法分为观察组73和对照组71例;给予糖尿病常规干预,控制血糖和血压到目标水平,并口服辛伐他汀片,40 mg/次,1次/d,和拜阿司匹林肠溶片,100 mg/次,1次/d。观察组在对照组治疗的的基础上加用降糖通脉胶囊,3粒/次,3次/d。两组疗程均为4个月。采用彩色多普勒超声诊断仪测量治疗前后颈动脉内膜中层厚度和斑块大小;检测治疗前后空腹血糖(FBG),餐后2 h血糖(PBG),糖化血清蛋白(GSP),肿瘤坏死因子α(TNF-α),高敏C-反应蛋白(hs-CRP),白细胞介数-6(IL-6),脂联素(APN),纤维蛋白原(FIB),血小板聚集率(MPAR)和D-二聚体(D-D)水平。结果:治疗后观察组颈动脉内膜中层增厚例数和斑块检出例数少于对照组,颈动脉内膜中层厚度和颈动脉斑面积也小于对照组(P<0.01);治疗后观察组GSP水平低于对照组(P<0.01),治疗后两组间FBG,PBG水平差异无统计学意义;治疗后观察组TNF-α,hs-CRP和IL-6水平低于对照组(P<0.01),APN水平高于对照组(P<0.01);治疗后观察组D-D,FIB和MPAR水平低于对照组(P<0.01)。结论:降糖通脉胶囊用于2型糖尿病大血管病变的治疗,能减少大血管病变的发生,减轻发生程度,其作用机制可能与减轻低度炎症反应,改善微循环有关。
Objective: To observe the therapeutic effect of Jiangtang Tongmai Capsule in the treatment of type 2 diabetic macroangiopathy and its effect on the inflammatory response and microcirculation. Methods: One hundred and forty-four patients were randomly divided into the observation group 73 and the control group 71 according to the digital table method. The patients were given routine intervention of diabetes to control the blood sugar and blood pressure to the target level. Simvastatin tablets 40 mg once daily, d, and thanks to aspirin enteric-coated tablets, 100 mg / time, 1 time / d. The observation group in the control group based on the treatment with jingtangtongmai capsules, 3/3 times / d. Two groups of treatment are 4 months. The carotid intima-media thickness and plaque size before and after treatment were measured by color Doppler sonography. Fasting plasma glucose (FBG), postprandial blood glucose (PBG), glycosylated serum protein (GSP), tumor necrosis factor α, TNF-α, hs-CRP, IL-6, APN, fibrinogen (FIB), platelet aggregation rate D-dimer (DD) level. Results: After treatment, the carotid intima-media thickness and the number of plaques in the observation group were less than those in the control group, and the carotid intima-media thickness and carotid plaque area were also less than those in the control group (P <0.01). After treatment The level of GSP in the observation group was lower than that in the control group (P <0.01). There was no significant difference in FBG and PBG levels between the two groups after treatment. The levels of TNF-α, hs-CRP and IL-6 in the observation group were lower than those in the control group P <0.01). The levels of APN in the observation group were lower than those in the control group (P <0.01). Conclusion: Jiangtangtongmai Capsule can be used in the treatment of type 2 diabetic macroangiopathy, which can reduce the occurrence of macrovascular disease and alleviate the occurrence of macrovascular disease. Its mechanism may be related to reducing the low inflammatory reaction and improving the microcirculation.