通心络对2型糖尿病合并冠心病患者胰岛素抵抗、血管内皮功能的影响

摘要

目的 观察通心络对2型糖尿病合并冠心病(CHD)患者胰岛素敏感性及血管内皮功能的影响.方法 120例2型糖尿病并发冠心病患者随机分为常规治疗组(对照组)和常规治疗加通心络组(治疗组),每组60例,另60例健康人为正常组,采用化学发光法和多普勒超声测定3组血清空腹胰岛素水平、肱动脉充气加压及舌下含服硝酸甘油前后血管内径的变化.用空腹血糖(FBG)和空腹胰岛素的数值计算胰岛素抵抗指数(HOMA-IR).结果 对照组和治疗组治疗前血清胰岛素、HOMA-IR显著高于正常组(P<0.05),血管内皮依赖性舒张功能显著低于正常组(P<0.05);2组治疗后以上指标均较治疗前有所改善(P<0.05),且治疗组治疗后改善作用更为明显(P<0.05).结论 通心络可在常规治疗基础上改善患者的胰岛素抵抗和血管内皮功能.%Objective To explore the effect of Tongxinluo on insulin sensitivity and vascular endothelial function in patients with DM2 complicated by coronary heart disease ( CHD ). Methods The 120 patients with type 2 diabetes mellitus complicated by coronary heart disease were randomly divided into Tongxinluo group and routine treatment group,meanwhile,the 60 healthy subjects were used as controls ( control group ). The 60 patients in routine treatment group were treated with routine western medicine, however, the other 60 patients in Tongxinluo group,on the basis of routine western medicine, were treated with Tongxinluo,with a treatment course of 12 weeks for both groups. The levels of fasting insulin were detected before and after treatment by chemical luminescence method for the three groups. EDDF was assessed by Doppler ultrasound for observing the changes in diameter of brachial artery during reactive hyperemia and after taking in nitroglycerin. The insulin resistance index ( HOMA-IR ) was calculated according to the numerical value of fasting blood glucose ( FBG ) and fasting insulin. Results Before treatment the serum levels of insulin and HOMA-IR in Tongxinluo group and routine treatment group were significantly higher than those of control group ( P < 0. 05 ), however, the vascular endothelial dependent diastolic function was significantly lower than that in control group ( P < 0. 05 ). As compared with those before treatment, the two indexes after treatment were obviously improved in Tongxinluo group and routine treatment group ( P <0. 05 ), furthermore, the improvement effect in Tongxinluo group was more obvious than that in routine treatment group ( P < 0. 05 ) Conclusion Tongxinluo can improve insulin resistance and vascular endothelial function, on the basis of routine treatment.