丹蛭降糖胶囊联合阿托伐他汀钙对糖尿病不伴有高血压病患者颈动脉内膜中层厚度的影响

摘要

目的：观察丹蛭降糖胶囊联合阿托伐他汀钙对糖尿病不伴有高血压病患者颈动脉内膜中层厚度（IMT）的疗效及安全性。方法：196例颈动脉IMT增厚的糖尿病不伴有高血压病患者，随机分为对照组（98例）和治疗组（98例）。2组均给予常规糖尿病治疗，对照组给予阿托伐他汀钙20 mg/晚，治疗组在对照组基础上加用丹蛭降糖胶囊9.0 g/晚，治疗12个月。分别于治疗前后检测2组颈动脉IMT、斑块面积和空腹血糖（FPG）、空腹胰岛素（FIns）、胰岛紊抵抗指数（HOMA-IR）、糖化血红蛋白（HbA1c）、血脂、肝肾功能等。结果：颈动脉IMT与FIns、HOMA-IR、HbA1c、低密度脂蛋白（LDL-C）呈显著正相关。治疗12个月后，治疗组总有效率为85.87豫，与对照组比较有显著性差异（孕<0.05）；治疗组FPG、FIns、HOMA-IR、HbA1c与对照组比较无差异；与对照组相比，治疗组 TC、LDL-C明显降低（孕<0.05）， HDL-C明显升高（孕<0.05）；治疗组颈动脉IMT由（0.11±0.01）cm减少为（0.08±0.01）cm，与对照组比较差异有统计学意义（孕<0.05）；治疗组58例颈动脉粥样硬化斑块面积由（0.37±0.56）cm2降为（0.21±0.25）cm2，与对照组比较差异无统计学意义；对照组发生不良事件5例，治疗组9例，2组间比较无差异。结论：丹蛭降糖胶囊联合阿托伐他汀钙可以调节脂代谢，降低颈动脉IMT。%This study was aimed to observe the curative effect and safety of Danzhi Jiangtang Capsule ( DJC ) combined with atorvastatin on carotid artery intima-media thickness (IMT) in diabetes patients without hyper-tension . A total of 196 diabetes patients without hypertension with incrassate carotid artery IMT were randomly divided into the control group ( 98 cases ) and the treatment group ( 98 cases ) . The conventional diabetes thera-py was given to both groups . The atorvastatin of 20 mgight was given to the control group . And the atorvas-tatin 20 mgight added with DJC 9 . 0 gight were given to the treatment group . The treatment course was 12 months . Carotid artery IMT , carotid atherosclerotic plaque area , FPG , FIns , HOMA-IR , HbA1c , blood lipids , hepatorenal function and etc . were examined before and after the treatment respectively . The results showed that there was a significant positive correlation between carotid artery IMT and FIns , HOMA-IR , HbAlc , LDL-C . After 12-month treatment , the total effectiveness is 85 . 87% in the treatment group . And there was significant difference compared with the control group ( P < 0 . 05 ) . The levels of FPG , FIns , HOMA-IR , HbAlc of the treatment group had no difference compared with the control group . Compared with the control group, TC and LDL-C of the treatment group was obviously decreased (P < 0.05). And HDL-C was significantly increased ( P < 0 . 05 ) . The carotid artery IMT of the treatment group decreased from ( 0 . 11 ±0 . 01 ) cm to ( 0 . 08 ± 0 . 01 ) cm . And compared with the control group , there was statistical significance ( P <0 . 05 ) . The carotid atherosclerotic plaque area of 58 cases in the treatment group decreased from ( 0 . 37 ±0.56) cm2 to (0.21 ± 0.25) cm2. However, there was no statistical significance compared to the control group. There were 5 adverse events in the control group and 9 adverse events in the treatment group . And there was no difference between two groups. It was concluded that DJC combined with atorvastatin can regulate lipid metabolism and reduce carotid artery IMT .