本文關(guān)鍵詞：化瘀通痹方對糖尿病合并下肢動脈硬化閉塞癥患者血清CRP、IL-6水平的療效觀察　出處：《山西中醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 糖尿病并發(fā)下肢動脈硬化閉塞證 化瘀通痹方 血糖 血流變 炎性因子

【摘要】：目的通過觀察驗(yàn)方化瘀通痹方對糖尿病并發(fā)下肢動脈硬化閉塞癥患者早期臨床癥候積分、各項臨床客觀指標(biāo)的影響及療效,探討其作用機(jī)制。為化瘀通痹方可以降低患者血清炎性因子CRP、IL-6水平,抑制血栓形成,緩解患者臨床癥狀提供依據(jù),指導(dǎo)患者臨床用藥。方法將75名糖尿病并發(fā)下肢動脈硬化閉塞癥患者隨機(jī)分為治療組(40例),對照組(35例),兩組在降糖、調(diào)脂、降壓、抗血小板聚集的基礎(chǔ)上,同時分別給予患者治療組化瘀通痹方加前列地爾注射液,對照組單獨(dú)前列地爾注射液治療,療程31天,觀察患者治療前后的臨床癥候積分和療效,檢測患者部分血清炎性因子C反應(yīng)蛋白(CRP)、白細(xì)胞介素6(IL—6)及糖化血紅蛋白(Hb Ac)、空腹血糖(FPG)、餐后兩小時血糖(2hPG)、血脂(TG、TC、LDL-C、HDL-C)、血液流變學(xué)指標(biāo)、雙下肢動脈血管內(nèi)徑及血液流動峰速的變化。結(jié)果1治療組臨床總有效率92.1%,明顯優(yōu)于對照組總有效率的75%。2與各自治療前相比兩組治療后能有效改善患者的糖化血紅蛋白、空腹血糖、餐后2h血糖、血脂(TC、TG、LDL-C、HDL-C)、血流變、炎性因子(CRP、IL-6)、雙下肢動脈的血管內(nèi)徑和血流峰速水平,P0.05,差異有統(tǒng)計學(xué)意義。3兩組治療后比較炎性因子、血流變系列、雙下肢動脈的血管內(nèi)徑和血流峰速水平,P0.05,差異有統(tǒng)計學(xué)意義,且治療組療效優(yōu)于對照組。4兩組患者治療前后血常規(guī)、尿常規(guī),肝功、腎功比較,P0.05,無統(tǒng)計學(xué)差異。所有入選病例未發(fā)生藥物不良反應(yīng)和不良事件。結(jié)論以益氣養(yǎng)陰,活血通絡(luò)為治療法則的驗(yàn)方化瘀通痹方,對糖尿病合并下肢動脈硬化閉塞癥的早期干預(yù)及預(yù)防進(jìn)一步發(fā)展有重要意義,可以降低患者的血糖,降低血清炎性因子,調(diào)節(jié)患者的脂代謝,輔助改善患者的血流變水平,降低患者雙下肢動脈血流峰值速度,增寬血管內(nèi)徑,進(jìn)而增加斑塊穩(wěn)定,減少血栓形成而栓塞、壞死�；鐾ū苑铰�(lián)合前列地爾對于早期糖尿病并發(fā)下肢動脈粥樣硬化閉塞癥的治療是安全可行地。
[Abstract]:Objective To observe the experience of Huayu Tongbi early clinical symptoms points in patients with occlusion of the lower extremity diabetic atherosclerosis, effects of various clinical indexes and curative effect, to explore the mechanism of Tongbi. For removing blood stasis can reduce serum inflammatory factors in patients with CRP, IL-6 level, inhibit thrombosis, alleviate the clinical symptoms of the patients and provide the basis and the medication guide. Methods 75 diabetic patients with lower extremity arterial occlusive disease were randomly divided into treatment group (40 cases) and control group (35 cases), two groups in hypoglycemic, lipid-lowering, antihypertensive, anti platelet aggregation, while patients in treatment group were given Tongbi Huayu with Alprostadil Injection, the control group alone Alprostadil Injection treatment course of 31 days, to observe the clinical symptoms and curative effect of the patients before and after treatment, detection of patients serum inflammatory factors of C reaction protein (CRP), interleukin - 6 (IL - 6) and glycosylated hemoglobin (Hb Ac), fasting blood glucose (FPG), two hour postprandial blood glucose (2hPG), blood lipids (TG, TC, LDL-C, HDL-C), blood rheology, changes in the lower limbs artery diameter and blood flow velocity peak. Results of the 1 clinical treatment group the total efficiency of 92.1%, significantly better than the control group the total efficiency of 75%.2 before treatment compared with respective two groups after treatment can effectively improve HbA1c, fasting glucose, 2h postprandial blood glucose, blood lipids (TC, TG, LDL-C, HDL-C), blood rheology, inflammatory factors (CRP, IL-6), blood vessel diameter and the peak flow velocity level, lower extremity artery P0.05, there was a significant difference between the two groups of.3 after treatment of inflammatory factors, blood rheology, blood vessel diameter and blood flow velocity peak level, lower extremity artery P0.05, the difference was statistically significant, and the effect of the treatment group than the control group before and after.4 treatment in two groups of blood. Urine routine, liver function, kidney Power, P0.05, there was no significant difference in all patients without adverse drug reactions and adverse events. Conclusion to Yiqi, Huoxue Tongluo Huayu treatment for inspection law of Tongbi, has important significance of lower extremity arterial occlusive disease of diabetic patients for early intervention and prevention of further development, can reduce the patients blood glucose, serum inflammatory factor, regulate lipid metabolism of patients, improve the patient's blood level of auxiliary variable, reduce the patients with lower extremity artery blood flow velocity, widened vessel diameter, and increase plaque stability, reduce thrombosis and embolism, necrosis. Blood stasis Tongbi combined with alprostadil is safe and feasible for the treatment of early diabetic patients with lower extremity atherosclerotic occlusive disease.

【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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