摘要
目的观察利拉鲁肽联合降糖养心方治疗气阴两虚兼血瘀型糖尿病心肌病患者的临床疗效及对炎症因子的影响。方法选取2020年12月—2021年5月河北省中医院诊治的86例气阴两虚兼夹血瘀型糖尿病心肌病患者,将其随机分成对照组、治疗组各43例。2组均给予降糖、调脂、降压、抗心力衰竭治疗,对照组在此基础上加用利拉鲁肽,治疗组在对照组治疗基础上加用降糖养心方。治疗12周后,观察2组中医症状评分、血糖[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、血脂[血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、心肌损伤标记物[肌钙蛋白I(cTnI)、肌钙蛋白T(cTnT)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、超声心动图[左室射血分数(LVEF)、舒张早期峰值速度E峰/舒张晚期峰值速度A峰(E/A)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)]变化情况,统计2组疗效及不良反应发生情况。结果治疗后,2组中医症状积分、血糖相关指标及TC、TG、LDL-C、cTnI、cTnT、IL-6、TNF-α水平均明显降低,超声心电图指标改善,且治疗组各指标较对照组改善更明显,差异均有统计学意义(P均<0.05);治疗组总有效率为90.7%(39/43),对照组为81.4%(35/43),治疗组显著高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论利拉鲁肽联合降糖养心方治疗糖尿病心肌病可协助降糖、调脂,减轻心肌细胞损伤,降低炎症因子水平,抑制心肌重构,提高左心室舒张功能,安全性良好。
Objective It is to observe the clinical efficacy of Lilalutide combined with Jiangtang Yangxin decoction in the treatment of diabetes cardiomyopathy with Qi-Yin deficiency and blood stasis and its influence on inflammatory factors.Methods Eighty six patients with diabetes cardiomyopathy with syndrome of Qi-Yin deficiency and blood stasis diagnosed and treated in Hebei Provincial Hospital of Traditional Chinese Medicine from December 2020 to May 2021 were selected and randomly divided into control group and treatment group,with 43 patients in each group.Both groups were treated with hypoglycemic,lipid-lowering,antihypertensive and anti heart failure.Additionally,the control group was treated with Liraglutide,and the treatment group was treated with Jiangtang Yangxin decoction plus Liraglutide.After 12 weeks of treatment,the changes of the TCM symptom scores,blood glucose[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)],blood lipid[serum total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],myocardial injury markers[troponin I(cTnI),troponin T(cTnT)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],ultrasonic cardiogram(left ventricular ejection fraction(LVEF),early diastolic peak velocity E peak/late diastolic peak velocity A peak(E/A),left ventricular end diastolic diameter(LVEDD),and left ventricular end diastolic volume(LVEDV)]were observed before and after treatment in the two groups,the efficacy and adverse reactions occurred were evaluated or calculated in the two groups.Results After treatment,TCM symptom scores,the levels of blood glucose related indexes and TC,TG,LDL-C,cTnI,cTnT,IL-6,TNF-αin the two groups were significantly reduced,and the indexes of ultrasonic electrocardiogram were significantly improved,and the indexes in the treatment group were improved more significantly than those in the control group,the differences were all statistically significant(all P<0.05).The total effective rate was 90.7%(39/43)in the treatment group and 81.4%(35/43)in the control group,the rate in the treatment group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Lilalutide combined with Jiangtang Yangxin decoction can help to reduce blood sugar and lipid,reduce myocardial cell damage,reduce the level of inflammatory factors,inhibit myocardial remodeling,and improve left ventricular diastolic function with good safety in the treatment of diabetes cardiomyopathy.
作者
邢巧琳
张庚良
XING Qiaolin;ZHANG Gengliang(Hebei College of Traditional Chinese Medicine,Shijiazhuang 050000,Hebei,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,Hebei,China)
出处
《现代中西医结合杂志》
CAS
2022年第21期2975-2979,3001,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省中医药管理局科研计划项目(2020055)
2018年河北省中医药防治重大疑难病项目(2018125571)。
关键词
糖尿病心肌病
气阴两虚
血瘀
降糖养心方
利拉鲁肽
diabetes cardiomyopathy
Qi-Yin deficiency
stasis of blood
Jiangtang Yangxin decoction
Lilalutide
