丹蛭降糖胶囊治疗老年2型糖尿病患者的临床疗效及其对颈动脉的保护作用

摘要

目的 观察丹蛭降糖胶囊治疗老年2型糖尿病(T2DM)患者的临床疗效,并探讨其对颈动脉的保护作用.方法 选取2014年11月-2016年11月郑州大学第一附属医院收治的老年T2DM患者94例,随机分为对照组和观察组,每组47例.对照组患者采用常规治疗,观察组患者在常规治疗基础上加服丹蛭降糖胶囊;两组患者均连续治疗2个月.比较两组患者临床疗效,治疗前后糖代谢指标[包括空腹血糖(FPG)、餐后2h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、脂代谢指标[包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及颈动脉超声检查指标[包括颈总动脉后壁内-中膜厚度(IMT)、颈总动脉血流阻力指数(RI)、斑块检出率、斑块面积、斑块稳定性].结果 观察组患者临床疗效优于对照组(P＜0.05).治疗前两组患者FPG、2 hPG、HbA1c、FINS、HOMA-IR比较,差异无统计学意义(P＞0.05);治疗后观察组患者FPG、2 hPG、HbA1c、HOMA-IR低于对照组,HNS高于对照组(P＜0.05).治疗前两组患者TC、TG、LDL-C、HDL-C比较,差异无统计学意义(P＞0.05);治疗后观察组患者TC、TG、LDL-C低于对照组,HDL-C高于对照组(P＜0.05).治疗前两组患者颈总动脉后壁IMT、颈总动脉RI、斑块检出率、斑块面积比较,差异无统计学意义(P＞0.05);治疗后观察组患者颈总动脉后壁IMT和斑块面积小于对照组,颈总动脉RI和斑块检出率低于对照组(P＜0.05).治疗前两组患者检出斑块中稳定性斑块所占比例比较,差异无统计学意义(P＞0.05);治疗后观察组患者检出斑块中稳定性斑块所占比例高于对照组(P＜0.05).结论 在常规治疗基础上加用丹蛭降糖胶囊可有效提高老年T2DM患者临床疗效,改善患者糖脂代谢,减轻颈动脉粥样硬化程度并增加斑块稳定性,具有一定的颈动脉保护作用.%Objective To observe the clinical effect of danzhi jiangtang capsule in treating elderly patients with type 2 diabetes mellitus (T2DM),to explore the protective effect on carotid artery.Methods A total of 94 elderly patients with T2DM were selected in the First Affiliated Hospital of Zhengzhou University from November 2014 to November 2016,and they were randomly divided into control group and observation group,each of 47 cases.Patients of control group received conventional treatment,while patients of observation group were received extra danzhi jiangtang capsule based on conventional treatment;both groups continuously treated for 2 months.Clinical effect,index of glucose metabolism [including FPG,2 h PG,HbA1c,FINS and HOMA-IR],blood lipids index [including TG,TC,LDL-C and HDL-C] and carotid artery ultrasonography examination results [including IMT of posterior wall of carotid artery,RI of common carotid artery,detection rate of plaque,plaque area and plaque stability] before and after treatme nt were compared between the two groups.Results Clinical effect of observation group was statistically significantly better than that of control group (P ＜ 0.05).No statistically significant differences of FPG,2 h PG,HbA1c,FINS or HOMA-IR was found():new en the two groups before treatment (P ＞0.05);after treatment,FPG,2 h PG,HbA1c and HOMA-IR of observation group were statistically significantly lower than those of control group,while FINS of observation group was statistically significantly higher than that of control group (P ＜ 0.05).No statistically significant differences of TG,TC,LDL-C or HDL-C was found between the two groups before treatment (P ＞ 0.05);after treatment,TG,TC and LDL-C of observation group were statistically significantly lower than those of control group,while HDL-C of observation group was statistically significantly higher than that of control group (P ＜ 0.05).No statistically significant differences of IMT of posterior wall of carotid artery,RI of common carotid artery,detection rate of plaque or plaque area was found between the two groups before treatment (P ＞ 0.05);after treatment,IMT of posterior wall of carotid artery and plaque area of observation group were statistically significantly smaller than those of control group,while RI of common carotid artery and detection rate of plaque of observation group were statistically significantly lower than those of control group (P ＜ 0.05).No statistically significant differences of proportion of stable plaque was found between the two groups before treatment (P ＞ 0.05),while proportion of stable plaque of observation group was statistically significantly higher than that of control group after treatment (P ＜ 0.05).Conclusion Based on conventional treatment,danzhi jiangtang capsule can effectively improve the clinical effect in treating elderly patients with T2DM,adjust the glucose and lipid metabolism,relieve the severity of atherosclerosis and increase the plaque stability,has certain protective effect on carotid artery.