糖脉通络汤联合常规疗法治疗老年2型糖尿病下肢血管病变45例临床研究

目的:观察糖脉通络汤联合现代医学常规疗法治疗老年2型糖尿病下肢血管病变(LEAD)患者的临床疗效。方法:将90例气阴两虚兼血瘀证患者按随机数字表法分为对照组和观察组各45例。2组均给予生活方式干预、3级预防措施和阿司匹林肠溶片、西洛他唑片、前列地尔注射液治疗,连续治疗15 d、不用药15 d为1个疗程,共治疗3个疗程。观察组加用糖脉通络汤内服,疗程为3个月。治疗前后测量踝肱指数(ABI),检测足背动脉血管内径、峰值流速和平均血流速度,记录无痛行走距离(PWD)和最大行走距离(MWD),评定主要症状、体征评分。结果:治疗后,观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。2组ABI均较治疗前升高,症状、体征评分均较治疗前下降,差异均有统计学意义(P<0.01)。观察组ABI高于对照组,症状、体征评分低于对照组(P<0.01)。2组PWD和MWD均较治疗前增加(P<0.01),观察组PWD和MWD均多于对照组(P<0.01)。2组足背动脉血管内径均较治疗前扩大,峰值流速和平均血流速度均较治疗前增加,差异均有统计学意义(P<0.05)。观察组足背动脉血管内径大于对照组,峰值流速和平均血流速度均快于对照组,差异均有统计学意义(P<0.05)。结论:在常规治疗基础上给予糖脉通络汤内服,可减轻LEAD的临床症状,改善下肢血管功能和血流动力学,提升患者的运动能力,临床疗效优于单纯现代医学治疗。

Clinical Study on 45 Cases of Tangmai Tongluo Tang Combined with Routine Therapy for Lower Extremity Arterial Disease in Senile Patients with Type 2 Diabetes

Objective:To observe the clinical effect of Tangmai Tongluo tang combined with routine therapy in modern medicine for lower extremity arterial disease(LEAD)in senile patients with type 2 diabetes.Methods:Divided 90 cases of patients with qi-yin deficiency and blood stasis syndrome into the control group and the observation group randomly,45 cases in each group.Both groups received lifestyle interventions,tertiary prevention,aspirin enteric-coated tablets,cilostazol tablets,alprostadil injection.The treatment lasted for three courses,15 days of continuous treatment and 15 days of no medication as one course.The observation group additionally received the oral administration of Tangmai Tongluo tang.Before and after treatment,measured ankle brachial index(ABI),detected the vascular inner diameter in dorsalis pedis artery,peak velocity and mean blood flow velocity,recorded pain-free walking distance(PWD)and maximal walking distance(MWD),and assessed the scores of main symptoms and physical signs.Results:After treatment,the clinical effect in the observation group was better than that in the control group,difference being significant(P<0.05).ABI in the two groups were increased when compared with those before treatment,and the scores of symptoms and physical signs were declined when compared with those before treatment,differences being significant(P<0.05).ABI in the observation group was higher than that in the control group,while the scores of symptoms and syndromes were lower than those in the control group(P<0.01).PWD and MWD in the two groups were increased when compared with those before treatment(P<0.01).PWD and MWD in the observation group were more than the control group(P<0.01).The vascular inner diameters in dorsalis pedis artery in the two groups were enlarged when compared with those before treatment,and peak velocity and mean blood flow velocity were increased when compared with those before treatment,differences being significant(P<0.05).The vascular inner diameter in dorsalis pedis artery in the observation group was larger than that in the control group,and peak velocity and mean blood flow velocity were higher than those in the control group,differences being significant(P<0.05).Conclusion:The application of oral Tangmai Tongluo tang based on routine therapy can relieve clinical symptoms of LEAD,improve lower extremity arterial function and hemodynamics,and promote athletic ability of patients.It has better clinical effect than simple modern medicine therapy.