益气滋阴活血通络法治疗糖尿病合并冠心病的临床观察

发布时间：2018-03-12 23:21

本文选题：2型糖尿病　切入点：冠心病　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨益气滋阴活血通络法在治疗糖尿病合并冠心病方面的应用价值。方法:将我院内分泌科及心内科于2013年10月至2015年11月期间诊治的84例2型糖尿病合并冠心病患者,按照入院先后顺序随机分为观察组及对照组两组,每组各42例,其中对照组给予西医常规治疗,如生活方式改变、调节血糖、血脂水平、控制血压、改善心脏功能等治疗措施,观察组则在对照组治疗的基础上联合参芪地黄汤加减内服,连续应用4周后,检测分析两组患者的血糖水平、血脂水平、心电图变化、左心功能、炎性因子水平、中医症状积分、焦虑评分变化情况,总体疗效及不良反应发生情况。结果:经连续治疗4周后,两组患者的空腹血糖水平及餐后2h血糖水平均较治疗前有所改善,但观察组改善更为明显,且与对照组比较,差异具有统计学意义(P0.05)。观察组患者血脂水平均较治疗前明显改善,且差异具有统计学意义(P0.05),而对照组与治疗前比较改善不明显,差异无统计学意义(P0.05);组间比较显示,观察组HDL-C、LDL-C、TG及TC水平改善情况均明显优于对照组,且差异具有统计学意义(P0.05)。观察组的心电图评价有效率为88.1%,明显高于对照组(69.0%),差异明显(P0.05);在心功能方面,观察组患者的左心功能较对照组改善明显,其E/A比值与对照组比较,差异明显,具有统计学意义(P0.05);在炎性因子变化方面,两组患者治疗前后的IL-6无明显变化,而hs-CRP均较前明显改善,但观察组改善更为显著,且与对照组比较差异具有统计学意义(P0.05);中医症状积分改善情况明显优于对照组,且差异具有统计学意义(P0.05);焦虑评分方面,两组患者生活焦虑评分均有所改善,但观察组患者改善尤为明显,与对照组比较差异具有统计学意义(P0.05);在总体疗效方面,观察组总体有效率为92.8%,明显优于对照组(76.2%),差异亦具有统计学意义(P0.05);不良反应发生率方面,观察组与对照组均出现轻微不良反应,观察组不良反应发生率虽略高,但与对照组比较,无明显差异(P0.05)。结论:益气滋阴活血通络法(参芪地黄汤加减)治疗2型糖尿病合并冠心病临床效果较为显著,可有效改善患者的血糖、血脂水平,改善心功能及临床症状,抑制机体的非特异性炎症,改善患者心理状态,提高临床治疗有效率;同时不良反应较为轻微,患者可耐受,安全性好。
[Abstract]:Objective: To explore the application value of Invigorating Qi and nourishing yin and activating blood and collaterals in the treatment of diabetes mellitus complicated with coronary heart disease. Methods: Patients with type 2 diabetes mellitus patients with coronary heart disease in our hospital department of Endocrinology and Department of Cardiology in the diagnosis and treatment of 84 cases during the period from October 2013 to November 2015, according to the order of admission randomly divided into observation group and control group two groups, 42 cases in each group, including the control group received conventional treatment, such as lifestyle changes, adjusting blood glucose, blood lipid level, blood pressure control, improve heart function and other treatment measures, the observation group based on the control group treatment combined with Shenqi decoction to Decoction taken orally, after 4 weeks of continuous application, detection and analysis of two groups of patients with blood glucose levels, blood lipid levels. Changes of ECG, left ventricular function, the levels of inflammatory factors, TCM symptom score, anxiety score changes, and the incidence of adverse reaction of overall curative effect. Results: after 4 weeks of continuous treatment, two The fasting blood glucose level and the meal group 2H blood sugar levels were improved compared with before treatment, but the observation group improved more obviously, and compared with the control group, the difference was statistically significant (P0.05). Patients in the observation group blood lipid levels were significantly improved after treatment, and the difference was statistically significant (P0.05). While the control group compared with before treatment improved significantly, the difference was not statistically significant (P0.05); group comparison showed that the observation group HDL-C, LDL-C, TG and TC level of improvement were significantly better than the control group, and the difference was statistically significant (P0.05). The concept of ECG in the evaluation of observation group was 88.1%, significantly higher than the control group (69%), significant difference (P0.05); the cardiac function, left ventricular function in patients with observation group than the control group improved significantly, compared to the E/A ratio was significantly different from control, with statistical significance (P0.05); the changes of inflammatory factors, two groups of patients Before and after treatment there was no significant change in IL-6, and hs-CRP were significantly improved, but the observation group improved significantly, and the difference was statistically significant compared with the control group (P0.05); TCM symptoms improved significantly better than the control group, and the difference was statistically significant (P0.05); anxiety score, two groups of life the anxiety scores were improved, but the observation group were improved obviously, the difference was statistically significant compared with the control group (P0.05); in general treatment, the observation group total effective rate was 92.8%, significantly better than the control group (76.2%), the differences were statistically significant (P0.05); the incidence of adverse reactions in observation group. And the control group had mild adverse reaction, the incidence of adverse reactions is slightly high, but compared with the control group, no significant difference (P0.05). Conclusion: Supplementing Qi and nourishing yin and activating blood and collaterals (Shenqi Dihuang Decoction) in treating type 2 The clinical effect of diabetes mellitus complicated with coronary heart disease is significant, which can effectively improve the patient's blood glucose, blood lipid levels, improve heart function and clinical symptoms, nonspecific inflammation and inhibit the body, improve the psychological status of patients, improve clinical efficiency; at the same time relatively minor adverse reactions, patients can be tolerated, good safety.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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