丹斛通痹汤对2型糖尿病合并冠心病心绞痛患者糖脂代谢和心功能改善作用的研究

郏丽丽; 陈艳

doi:10.16766/j.cnki.issn.1674-4152.003878

丹斛通痹汤对2型糖尿病合并冠心病心绞痛患者糖脂代谢和心功能改善作用的研究

doi: 10.16766/j.cnki.issn.1674-4152.003878

郏丽丽^,,
陈艳

温岭市中医院糖尿病科(内七病区)，浙江台州 317500

基金项目:

浙江省中医药科技计划项目 2019ZB143

详细信息

通讯作者:
郏丽丽，E-mail: jialili5151@126.com

中图分类号: R587.1 R541.4
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- 文章访问数: 13
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- 被引次数: 0
出版历程
- 收稿日期: 2024-09-06
- 网络出版日期: 2025-03-27

Study on the effect of Danhu Tongbi Decoction on the improvement of glucose and lipid metabolism and heart function in type 2 diabetes patients with angina pectoris of coronary heart disease

JIA Lili^,,
CHEN Yan

Department of Diabetes, Wenling Traditional Chinese Medicine Hospital (the Seven Ward of Internal Medicine), Taizhou, Zhejiang 317500, China

摘要

摘要: 目的探讨丹斛通痹汤治疗2型糖尿病合并冠心病(CHD)心绞痛(伴气阴两虚兼心血瘀阻证)的临床效果, 及对患者糖脂代谢和心功能的影响。方法纳入2021年3月-2024年3月温岭市中医院收治的90例2型糖尿病合并CHD心绞痛(伴气阴两虚兼心血瘀阻证)患者, 采用随机数表法分为对照组(45例)和观察组(45例), 对照组予以西医药物治疗, 观察组增加丹斛通痹汤治疗。评价中医证候疗效, 记录心绞痛发作频率和发作持续时间, 检测血糖、血脂、心肌损伤和心功能指标变化, 观察治疗期间药物不良反应。结果观察组中医证候治疗总有效率[93.33%(42/45)]高于对照组[73.33%(33/45), P < 0.05]。观察组治疗后心绞痛发作频率较对照组降低, 单次发作持续时间[(3.23±0.54) min]较对照组[(4.18±0.69) min, F=16.134, P < 0.001]缩短。观察组治疗后空腹血糖(FPG)、餐后2 h血糖(PBG)和糖化血红蛋白(HbA1c)均低于对照组(P < 0.001)。观察组治疗后总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL)均低于对照组(P < 0.001)。观察组治疗后左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)均低于对照组, 而左心室射血分数(LVEF)高于对照组(P < 0.001)。观察组治疗后血清N-末端脑钠肽前体(NT-proBNP)和同型半胱氨酸(Hcy)均低于对照组(P < 0.001)。结论在西医药物基础上增加丹斛通痹汤治疗, 能有效缓解2型糖尿病合并CHD心绞痛患者中医证候及心绞痛临床症状, 改善糖脂代谢和心功能水平。
- 2型糖尿病 /
- 冠心病 /
- 稳定型心绞痛 /
- 丹斛通痹汤 /
- 气阴两虚证 /
- 心血瘀阻证
Abstract: Objective To explore the clinical effect of Danhu Tongbi Decoction in the treatment of type 2 diabetes with coronary heart disease (CHD) angina pectoris (accompanied by qi and yin deficiency and heart blood stasis syndrome), and its effect on the metabolism of glucose and lipid and heart function of patients. Methods Ninety cases of type 2 diabetes patients with CHD angina pectoris (accompanied by qi and yin deficiency and heart blood stasis syndrome) admitted from March 2021 to March 2024 were randomly divided into the control group (45 cases) and the observation group (45 cases).The control group was given Western medicine, and the observation group was given Danhu Tongbi Decoction, the efficacy of traditional Chinese medicine syndromes after treatment were evaluated, the frequency and duration of angina pectoris were recorded, the changes of blood glucose, blood lipids, myocardial injury and cardiac function indicators before and after treatment were detected, and the adverse drug reactions during treatment were observed. Results The overall effective rate of traditional Chinese medicine syndrome treatment in the observation group[93.33%(42/45)]was higher than the control group[73.33%(33/45), P < 0.05].After treatment, the frequency of angina attacks in the observation group decreased compared to the control group, and the duration of a single attack[(3.23±0.54) min]was shortened compared to the control group[(4.18±0.69) min, F=16.134, P < 0.001].After treatment, the fasting blood glucose (FPG), 2-hour postprandial blood glucose (PBG), and glycated hemoglobin (HbA1c) in the observation group were all lower than those in the control group (P < 0.001).After treatment, the total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) in the observation group were all lower than those in the control group (P < 0.001).After treatment, the left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in the observation group were lower than those in the control group, while the left ventricular ejection fraction (LVEF) was higher than that in the control group (P < 0.001).After treatment, the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and homocysteine (Hcy) in the observation group were lower than those in the control group (P < 0.001). Conclusion On the basis of Western medicine, Danhu Tongbi Decoction can effectively relieve the traditional Chinese medicine syndromes and clinical symptoms of angina pectoris in type 2 diabetes patients with CHD angina pectoris, and improve the level of glucose lipid metabolism and cardiac function.
- Type 2 diabetes /
- Coronary heart disease /
- Stable angina pectoris /
- Danhu Tongbi Decoction /
- Qi and Yin deficiency syndrome /
- Heart blood stasis syndrome

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表 1 2组2型糖尿病合并CHD心绞痛患者中医证候总有效率比较[例(%)]

Table 1. Comparison of total effective rate of TCM syndromes in 2 groups of type 2 diabetes patients with CHD angina pectoris[cases (%)]

组别	例数	痊愈	显效	有效	无效	总有效
对照组	45	7(15.56)	12(26.67)	14(31.11)	12(26.67)	33(73.33)
观察组	45	12(26.67)	17(37.78)	13(28.89)	3(6.67)	42(93.33)
注：2组总有效率比较，χ²=6.480，P=0.011。

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表 2 2组2型糖尿病合并CHD心绞痛患者心绞痛症状比较(x±s)

Table 2. Comparison of symptoms of angina pectoris in 2 groups of type 2 diabetes patients with CHD(x±s)

组别	例数	发作频率(次/90 d)		单次发作持续时间(min)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	45	8.23±1.33	4.37±0.68^b	5.41±0.82	4.18±0.69^b
观察组	45	8.19±1.27	2.85±0.51^b	5.52±0.86	3.23±0.54^b
统计量		0.152^a	18.625^c	0.621^a	16.134^c
P值		0.879	＜0.001	0.536	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP < 0.05。

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表 3 2组2型糖尿病合并CHD心绞痛患者糖代谢指标比较(x±s)

Table 3. Comparison of glucose metabolism indexes in 2 groups of type 2 diabetes patients with CHD angina pectoris(x±s)

组别	例数	FPG(mmol/L)		PBG(mmol/L)		HbA1c(%)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	45	8.27±1.14	6.54±0.76^b	13.49±1.52	10.25±1.23^b	8.63±0.89	7.71±0.74^b
观察组	45	8.35±1.19	5.87±0.69^b	13.68±1.61	9.14±1.17^b	8.54±0.87	6.93±0.68^b
统计量		0.326^a	21.472^c	0.576^a	17.634^c	0.485^a	19.185^c
P值		0.745	＜0.001	0.566	＜0.001	0.629	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP < 0.05。

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表 4 2组2型糖尿病合并CHD心绞痛患者脂代谢指标比较(x±s)

Table 4. Comparison of lipid metabolism indexes in 2 groups of type 2 diabetes patients with CHD angina pectoris(x±s)

组别	例数	TC(mmol/L)		TG(mmol/L)		LDL(mmol/L)		HDL(mmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	45	6.56±0.88	5.72±0.79^b	2.93±0.51	2.17±0.49^b	4.25±0.79	2.51±0.53^b	0.86±0.24	0.89±0.23
观察组	45	6.62±0.91	4.96±0.76^b	2.89±0.54	1.76±0.45^b	4.31±0.76	2.03±0.46^b	0.84±0.23	0.91±0.25
统计量		0.318^a	22.347^c	0.361^a	16.473^c	0.367^a	21.026^c	0.404^a	0.721^c
P值		0.751	＜0.001	0.719	＜0.001	0.714	＜0.001	0.687	0.462
注：^a为t值，^c为F值；与同组治疗前比较，^bP < 0.05。

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表 5 2组2型糖尿病合并CHD心绞痛患者心功能指标比较(x±s)

Table 5. Comparison of cardiac function indexes in 2 groups of type 2 diabetes mellitus patients with CHD angina pectoris

组别	例数	LVESD(mm)		LVEDD(mm)		LVEF(%)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	45	50.86±4.59	45.23±4.24^b	65.19±5.35	59.45±5.06^b	46.21±3.79	50.73±4.02^b
观察组	45	51.25±4.63	40.56±3.96^b	65.47±5.49	50.73±4.86^b	45.98±3.65	54.96±4.13^b
统计量		0.418^a	28.451^c	0.245^a	34.026^c	0.293^a	25.831^c
P值		0.647	< 0.001	0.807	< 0.001	0.770	< 0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP < 0.05。

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表 6 2组2型糖尿病合并CHD心绞痛患者心肌损伤指标比较(x±s)

Table 6. Comparison of myocardial injury indexes in 2 groups of type 2 diabetes mellitus patients with CHD angina pectoris(x±s)

组别	例数	NT-proBNP(pg/mL)		Hcy(μmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	45	423.41±16.82	359.28±14.59^b	30.86±2.85	21.08±1.78^b
观察组	45	425.63±16.97	276.35±12.84^b	31.24±2.91	16.71±1.56^b
统计量		0.623^a	41.253^c	0.626^a	36.471^c
P值		0.535	＜0.001	0.533	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP < 0.05。

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