丹蛭降糖胶囊联合生活方式干预2型糖尿病患者颈动脉斑块的临床观察

目的：使用颈动脉超声评价丹蛭降糖胶囊联合生活方式干预2型糖尿病患者服药前后颈动脉内中膜厚度（IMT）及斑块面积的改变，并评价丹蛭降糖胶囊对肝脏及肾脏的安全作用。方法：应用安徽省中医院彩色超声多普勒仪，检查2型糖尿病患者的颈动脉，选取有颈动脉粥样硬化斑块形成的患者64例为研究对象，随机分为治疗组42例，对照组22例。在颈动脉部位，测量其斑块最大面积及颈动脉IMT取平均值。2组患者于干预前后检查相应生化指标并评估其临床意义。治疗组患者给予丹蛭降糖胶囊2粒／次，3次/d口服，共1年，并根据人体能量需求计算饮食量，同时鼓励患者1w内3-4次散步（不少于40min）和2次八段锦锻炼（30min）。干预期间所出现的不良反应及时告知及评估，出现严重肝肾功能失调的情况时及时停药。结果：在药物治疗时间内患者均未出现与药物相关的不良反应。治疗组患者颈动脉斑块面积及IMT干预半年后明显减小（P〈0．05）；干预1年后颈动脉斑块面积及IMT较用药前有明显差异（P〈0．01）。干预前后相关血脂及血糖情况均有所明显好转（P〈0．05或P〈0．01），肝肾功能等生化指标无明显差异。结论：丹蛭降糖胶囊药物及饮食运动治疗，可以改善2型糖尿病患者的血脂情况，从而进一步达到稳定与消退斑块的作用。

Clinical Observation of Dan-Zhi-Jiang-Tang Capsule Union Lifestyle on Treatment of Type 2 Diabetes Patients with Carotid Plaques

Objective： The carotid ultrasound evaluate the change of carotid intima-media thickness （IMT） and plaque area u- sing Dan-zhi-jiang-tang capsule joint lifestyle intervention in patients with type 2 diabetes before and after treatment. And we evaluate the safety of the liver and kidney function after using Dan-zhi-jiang-tang capsule. Methods： Application of Anhui province Chinese medicine hospital color ultrasonic Doppler examination instrument check the carotid artery in patients with type 2 diabetes. We had se-leeted 64 patients with carotid atherosclerotic plaque as the research object who were randomly divided into treatment group 42 cases and control group 22 eases. We had selected the most widespread of carotid plaques and averaged IMT in carotid artery place. Two groups of patients were examined the corresponding biochemical indexes before and after in the intervention and evaluated its clinical significance. Treatment group patients were given Dan-zhi-jiang-tang capsule two tablets each time, orally three times a day, a total of one year, and calculated the amount of food according to the human body needs energy. At the same time, we encouraged patients to get three or four times walking （ not less than 40 minutes） and the twice Eight-brocade Exercise （ 30 minutes ） every week. The ad- verse reactions during the intervention should be informed and evaluated. If the patient has severe liver and kidney dysfunction situation promptly discontinued medicine. Results： In the treatment time the patients were no adverse reactions related to the drug. The treat- ment group of patients with carotid artery plaque area and IMT after intervention half a year significantly reduced （ P 〈 0.05 ） ; One year intervention of carotid plaque area and IMT compared with those before treatment were significantly different （ P 〈 0. 01 ） . Before and after the intervention of blood lipid and glucose were significantly improved （ P 〈0. 05 or P 〈0. 01 ） , no significant differences in biochemical indicators such as liver and kidney function. Conclusion： The use of Dan-zhi-jiang-tang capsule and lifestyle therapy, can ameliorate blood glucose and lipid in type 2 diabetes, so as to achieve stabling and reducing the plaque.