中西医结合治疗对T2DM合并CHD患者血糖、血脂及血管内皮功能的影响

摘要

目的:探讨中西医结合治疗对2型糖尿病(T2DM)合并冠心病(CHD)患者血糖、血脂及血管内皮功能的影响.方法:将120例T2DM合并CHD患者上随机分为研究组与对照组各60例,在原饮食、运动疗法及降压、降糖治疗方案不变的条件下,对照组加用阿托伐他汀钙片治疗,研究组加用阿托伐他汀钙片与降脂通脉胶囊治疗.检测和比较两组治疗前后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、餐后2h血糖(2hPBG)、一氧化氮(NO)及内皮素(CE)-1水平的变化.结果:两组治疗后FBG、2hPBG水平均较治疗前明显下降(P＜0.05),而组间比较差异无统计学意义(P＞0.05).两组治疗后TG、TC、LDL-C水平均较治疗前明显下降(P＜0.05),HDL-C水平均较治疗前明显升高(P＜0.05),且研究组TG、TC、LDL-C水平显著低于对照组(P＜0.05),HDL-C水平显著高于对照组(P＜0.05).两组治疗后血清NO水平均较治疗前明显升高(P＜0.05),血清CE水平均较治疗前明显下降(P＜0.05),且研究组血清NO水平明显高于对照组(P＜0.05),血清CE水平明显低于对照组(P＜0.05).两组治疗过程中均未见明显不良反应.结论:降脂通脉胶囊联合阿托伐他汀可显著改善T2DM合并CHD患者的血脂和血管内皮功能,但不会进一步降低血糖.%Objective:To explore the effects of integrated traditional Chinese and Western Medicine on the blood glucose,blood lipid and vascular endothelial function of patients with T2DM complicated with coronary heart disease(CHD).Methods:120 cases of patients with T2DM combined with CHD were randomly divided into the study group and the control group with 60 cases in each group.In the original diet,exercise therapy and antihypertensive treatment,hypoglycemic treatment under the same conditions,the control group was treated with Atorvastatin Calcium Tablets treatment,and the study group was treated with Atorvastatin Calcium Tablets and Jiangzhi Tongmai Capsule.The changes of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),fasting blood glucose (FPG),2h postprandial blood glucose (2hPG) and nitric oxide (NO) and endothelin (CE)-1 levels were measured and compared between two groups before and after treatment.Results:The FBG and 2hPG levels of both groups were dramatically reduced after treatment compared with those before treatment (P＜0.05),while no statistically significant difference was found between two groups (P＞0.05).The TG,TC and LDL-C levels of both groups after treatment were dramatically reduced compared with that before treatment(P＜0.05),while the HDL-C levels were remarkedly increased compared with that before treatment (P＜0.05).Additionally,the levels ofTG,TC and LDL-C in study group were remarkedly reduced compared with those in the control group(P＜0.05),while the level of HDL-C in study group was remarkedly enhanced compared with that of the control group(P＜0.05).The serum NO levels of both groups after treatment were dramatically increased compared with those before treatment (P＜0.05),the serum CE levels after treatment were dramatically reduced compared with those before treatment (P＜0.05),and level of serum NO in study group was remarkedly increased compared with that in the control group (P＜0.05),the level of serum CE in study group was remarkedly reduced compared with that in the control group (P＜0.05).The patients in both groups showed no significant adverse reactions during treatment.Conclusions:Jiangzhi Tongmai Capsule combined with atorvastatin can significantly improve the blood lipid and vascular endothelial function of patients with T2DM complicated with CHD,which no further reduce the blood glucose.