荷芪散治疗痰瘀互结证2型糖尿病合并冠心病的临床疗效及对血清TMAO水平的影响

[目的]观察荷芪散治疗痰瘀互结证2型糖尿病(T2DM)合并冠心病(CHD)的临床疗效及其对血清氧化三甲胺(TMAO)水平的影响.[方法]将40例痰瘀互结证T2DM合并CHD患者随机分为观察组和对照组,每组各20例.2组患者均给予降压、调脂及抗血小板聚集等西医基础治疗,在此基础上,对照组给予利拉鲁肽治疗,观察组在对照组的...

Clinical Efficacy of Heqi Powder on Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease and Differentiated as Phlegm Blended with Blood Stasis Syndrome and Its Influence on Serum Level of Trimethylamine N-Oxide

Objective To investigate the clinical efficacy of Heqi Powder on type 2 diabetes mellitus(T2 DM)complicated with coronary heart disease(CHD)differentiated as phlegm blended with blood stasis syndrome,and to observe its effect on serum trimethylamine N-oxide(TMAO). Methods Forty T2 DM patients complicated with CHD and differentiated as phlegm blended with blood stasis syndrome were randomly divided into the observation group and the control group,with 20 patients in each group. The patients of both groups were given basic western medicine treatment for lowering blood pressure, regulating blood lipids and counteracting platelet aggregation,and additionally,the control group was given subcutaneous injection of Liraglutide Injection,and the observation group was given Heqi Powder orally together with subcutaneous injection of Liraglutide Injection. The course of treatment for the two groups lasted for one month. The changes of traditional Chinese medicine(TCM)syndrome scores, glucose metabolism indexes, lipid metabolism indexes, left ventricular function related indexes,inflammatory factors,endothelin 1(ET-1)and intestinal microflora metabolite TMAO level in the two groups were observed before and after treatment. After treatment, the clinical efficacy and safety of the two groups were evaluated. Results(1)Clinical efficacy:after one month of treatment,the total effective rate of the observation group was 95.0%(19/20),and that of the control group was 70.0%(14/20). The intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)TCM syndrome scores:after treatment,the TCM syndrome scores of both groups were significantly decreased compared with those before treatment(P<0.01),and the effect of the observation group on the decline of TCM syndrome scores was significantly superior to that of the control group(P<0.01).(3)Glucose metabolism related indicators: after treatment, the levels of fasting plasma glucose(FPG), 2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1 c),fasting insulin(FINS)and insulin resistance index(HOMA-IR)in the two groups were significantly decreased compared with those before treatment(P<0.01). And the effects on decreasing FPG,2 hPG,HbAlc,FINS and HOMA-IR in the observation group were significantly superior to those in the control group(P<0.05 or P<0.01).(4)Lipid metabolism related indexes:after treatment,the levels of total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the two groups were significantly decreased compared with those before treatment(P<0.01),and the lowering effect on TC,TG and LDL-C in the observation group was significantly superior to that in the control group(P<0.05).(5)Inflammatory factors,vascular endothelial factors and intestinal microflora metabolites:after treatment,the levels of serum interleukin 6(IL-6),hypersensitive C-reactive protein(hs-CRP),ET-1 and TMAO in the two groups were significantly decreased compared with those before treatment(P<0.01),and the effects on decreasing the levels of serum IL-6, hs-CRP, ET-1 and TMAO in the observation group were significantly superior to those in the control group(P<0.05).(6)Echocardiography:after treatment,the left ventricular ejection fraction(LVEF)and the ratio of early diastolic E-peak velocity to late diastolic A-peak velocity(E/A)in the two groups were increased compared with those before treatment(P<0.01),and the effect on increasing LVEF and E/A in the observation group was significantly superior to that in the control group(P<0.05).(7)During the treatment,there were no related complications or adverse drug reactions occurred in the two groups. Conclusion For the treatment of T2 DM patients complicated with CHD and differentiated as phlegm blended with blood stasis syndrome, Heqi Powder combined with Lilaclutide is effective on enhancing clinical efficacy,reducing TCM syndrome scores,improving glucolipid metabolism and insulin resistance, improving left ventricular function, reducing the expression of inflammatory factors and ET-1 as well as the serum TMAO level. And its efficacy is superior to using Lilaclutide alone.