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目的:观察益气养阴活血解毒汤联合西药治疗糖尿病合并冠心病的临床疗效,及其对患者血糖、血脂、C-反应蛋白(CRP)、同型半胱氨酸(Hcy)及糖化血红蛋白(Hb A1c)水平的影响。方法:选取94例糖尿病合并冠心病患者为研究对象,根据患者的就诊序号将其随机分为对照组与治疗组各47例。对照组给予降糖及扩张冠脉等治疗,治疗组在对照组用药基础上加用益气养阴活血解毒汤治疗。治疗后观察2组心电图疗效和临床疗效;比较2组治疗前后的血糖[包括空腹血糖(FBG)、餐后2 h血糖(P2h BG)]和血脂指标[包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDLC)]水平的变化;观察2组治疗前后的CRP、Hcy及Hb A1c水平的变化。结果:2组心电图疗效和临床疗效比较,差异均有统计学意义(P<0.01,P<0.05)。治疗前,2组FBG、P2h BG水平比较,差异均无统计学意义(P>0.05)。治疗后,2组FBG、P2h BG水平均较治疗前降低(P<0.01),治疗组的2项血糖指标水平均低于对照组(P<0.01,P<0.05)。治疗前,2组TG、TC、LDL-C及HDL-C水平比较,差异均无统计学意义(P>0.05)。治疗后,2组TG、TC、LDL-C水平均较治疗前降低(P<0.01);HDL-C水平均较治疗前升高(P<0.01),治疗组的TG、TC、LDL-C水平均低于对照组(P<0.01,P<0.05);HDL-C水平高于对照组(P<0.01)。结论:益气养阴活血解毒汤联合西药治疗可提高糖尿病合并冠心病临床疗效,对改善患者的症状,恢复患者的血糖、血脂、CRP、Hcy及Hb Alc水平具有重要意义。
Objective: To observe the clinical efficacy of Yiqi Yangyin Huoxue Jiedu Decoction combined with western medicine in the treatment of diabetic patients with coronary heart disease (CHD) and its effects on blood glucose, blood lipids, C-reactive protein (CRP), homocysteine (Hcy) and glycosylated hemoglobin A1c) level of influence. Methods: Ninety-four patients with diabetes mellitus and coronary heart disease were selected as study subjects, and randomly divided into control group and treatment group according to the patient’s treatment number. The control group was given hypoglycemic and dilation of coronary artery treatment, the treatment group in the control group on the basis of medication plus Yiqi Yangyin Huoxue Jiedu Decoction treatment. Blood glucose (including fasting blood glucose (FBG) and postprandial 2h blood glucose (P2h BG)] and blood lipid (including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDLC). The changes of CRP, Hcy and Hb A1c in two groups before and after treatment were observed. Results: There were significant differences between two groups in the curative effect and clinical curative effect (P <0.01, P <0.05). Before treatment, there was no significant difference in FBG and P2h BG levels between the two groups (P> 0.05). After treatment, the levels of FBG and P2h BG in both groups were significantly lower than those before treatment (P <0.01). The two blood glucose levels in the two groups were lower than those in the control group (P <0.01, P <0.05). Before treatment, there was no significant difference in TG, TC, LDL-C and HDL-C levels between the two groups (P> 0.05). After treatment, the levels of TG, TC and LDL-C in two groups were significantly lower than those before treatment (P <0.01); HDL-C levels were significantly higher than those before treatment (P <0.01) (P <0.01, P <0.05), and the level of HDL-C in control group was higher than that in control group (P <0.01). Conclusion: Yiqi Yangyin Huoxue Jiedu Decoction combined with western medicine can improve the clinical efficacy of diabetes mellitus combined with coronary heart disease, and is of great significance to improve the symptoms of patients and restore the blood glucose, blood lipids, CRP, Hcy and Hb Alc levels in patients.