摘要
目的:观察益本活血方联合氯吡格雷治疗冠状动脉粥样硬化性心脏病(简称冠心病)合并2型糖尿病患者的临床疗效,并观察其对患者认知功能和血管内皮功能的影响。方法:92例冠心病合并2型糖尿病患者随机分为对照组和观察组各46例。对照组给予氯吡格雷治疗,观察组在对照组治疗基础上加用益本活血方。治疗后,比较两组患者临床疗效、中医证候积分、认知功能、血管内皮功能,同时记录不良反应。结果:治疗前,观察组与对照组中医证候积分比较,差异无统计学意义(P>0.05);治疗后两组中医证候积分均显著降低(P<0.05),且观察组治疗后显著低于对照组(P<0.05)。观察组有效率为95.65%,对照组有效率为71.74%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗前轻度认知障碍认知功能量表(montreal cognitive assessment,Mo CA)评分比较,差异无统计学意义(P>0.05);治疗后观察组MoCA评分显著升高(P<0.05),对照组无显著变化(P>0.05),观察组治疗后显著高于对照组(P<0.05)。两组患者治疗前血浆内皮素-1(endothelin-1,ET-1)、血管性血友病因子(von willebrand factor,vWF)、NO比较,差异无统计学意义(P>0.05);两组患者治疗后均显著改善(P<0.05);治疗后观察组ET-1、vWF显著高于对照组(P<0.05),NO显著低于对照组(P<0.05)。对照组不良反应率为6.52%,观察组为10.87%,两组比较,差异无统计学意义(P>0.05)。结论:益本活血方联合氯吡格雷可显著改善冠心病合并2型糖尿病患者认知功能和血管内皮功能,提高临床疗效。
Objective： To explore the clinical effect of Yiben Huoxue Formula combined with Clopidogrel on the cognitive function and vascular endothelial function in patients with coronary heart disease complicated with type 2 diabetes mellitus. Methods： Ninety-two cases of patients with coronary heart disease complicated with type 2 diabetes mellitus treated in our hospital were randomly divided into control group（46 cases） and study group（46 cases）. The control group was treated with Clopidogrel,while the study group was treated with Yiben Huoxue Formula in addition to that of the control group. The clinical effect and the changes of TCM syndrome integral scores,cognitive function,and vascular endothelial function were compared between the two groups,and the adverse reactions were recorded in the process. Results： The difference in the TCM syndrome integral scores between the two groups was not statistically significant before treatment（P〈 0. 05）,and that was significantly decreased after treatment（P〈 0. 05） and the score of the former was significantly lower than that of the latter（P〈 0. 05）. The difference in the level comparison of clinical effect between the two groups was statistically significant（P〈 0. 05）. The total effective rate in the study group was 95. 65%,which was significantly higher than that of 71. 74% in the control group（P〈 0. 05）. There was no significant difference in the Mo CA scores between the two groups before treatment（P〈 0. 05） and after treatment that in the study group were significantly increased（P〈 0. 05）. The scores in the control group had no obvious changes（P〈 0. 05）. The scores in the study group were significantly higher than those in the control group（P〈 0. 05）. The differences in the levels of ET,vWF and NO between the two groups were not statistically significant before treatment（P〈 0. 05） and that was significantly improved after treatment respectively（P〈 0. 05）. The levels in the study group were significantly better than those in the control group（P〈 0. 05）. The incidence rate of adverse reactions in the control group was 6. 52%,which was lower than that of 10. 87% in the control group,and the difference was not statistically significant（P〈 0. 05）. Conclusion： Yiben Huoxue Formula combined with Clopidogrel can significantly improve the cognitive function and vascular endothelial function of patients with coronary heart disease complicated with type 2 diabetes,which can improve the treatment total effective rate with less adverse reactions,and is worthy of promotion and application.
作者
刘中华
LIU Zhonghua(Traditional Chinese Medicine Hospital of Xiangyang City,Xiangyang Hubei China 44100)
出处
《中医学报》
CAS
2018年第3期382-386,共5页
Acta Chinese Medicine
基金
湖北省卫生厅科研基金项目(JX2873)
关键词
益本活血方
氯吡格雷
冠心病合并2型糖尿病
认知功能
血管内皮功能
中医证候
轻度认知障碍认知功能量表评分
内皮素-1
血管性血友病因子
一氧化氮
中西医结合
Yiben Huoxue Formula
Clopidogrel
Coronary heart disease complicated with Type 2 diabetes
Cognitive function
Vascular endothelial function
TCM Syndrome
cognitive function scale of mild cognitive impairment
endothelin-1
yon Willebrand factor
Nitric oxide
Integrative medicine
