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目的:观察祛痰散瘀方联合西药治疗2型糖尿病的临床疗效及对患者肿瘤坏死因子-α(TNF-α)等的影响。方法:将2型糖尿病患者88例随机分为2组各44例,对照组予以盐酸二甲双胍片等西药常规治疗,治疗组在对照组的基础上加用祛痰散瘀方治疗,观察2组患者临床疗效,记录其治疗前后中医证候积分、TNF-α水平及全血黏度低切、全血黏度高切、血小板黏附率、红细胞积压等血液流变学指标的变化。结果:总有效率治疗组为88.6%,对照组为70.5%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候各项积分及总积分均较治疗前降低(P<0.05),且治疗组各项积分降低较对照组更显著(P<0.05)。治疗后,2组TNF-α、全血黏度低切、全血黏度高切及红细胞积压均较治疗前下降(P<0.05),且治疗组治上述指标改善较对照组更显著(P<0.05)。2组患者血小板黏附率治疗前后变化不大(P>0.05)。结论:祛痰散瘀方辅助治疗痰瘀证2型糖尿病疗效显著,可有效调节TNF-α水平,改善血液流变学指标,效果优于单纯西药治疗。
Objective: To observe the curative effect of Qutan Sanyu Decoction combined with western medicine on type 2 diabetes mellitus and its effect on tumor necrosis factor-α (TNF-α) and so on. Methods: 88 cases of type 2 diabetic patients were randomly divided into two groups of 44 cases, the control group was treated with metformin hydrochloride tablets and other conventional Western medicine treatment group on the basis of the control group plus expectorant stasis prescription treatment was observed in two groups of patients The clinical curative effect was recorded, and the change of hemorrheological indexes such as TCM syndrome score, TNF-α level and low whole blood viscosity, high whole blood viscosity, platelet adhesion rate and red blood cell backlog before and after treatment were recorded. Results: The total effective rate was 88.6% in the treatment group and 70.5% in the control group. There was significant difference between the two groups (P <0.05). After treatment, the scores of all TCM syndromes in two groups were lower than those before treatment (P <0.05), and all the scores in the treatment group were significantly lower than those in the control group (P <0.05). After treatment, the levels of TNF-α, low whole blood viscosity, high whole blood viscosity and erythrocyte backlog decreased compared with those before treatment (P <0.05), and the improvement of these indexes in the treatment group was more significant than that in the control group (P <0.05 ). The adhesion rate of platelet in two groups changed little before and after treatment (P> 0.05). Conclusion: QTTF is a effective adjuvant therapy for type 2 diabetes mellitus with phlegm and blood stasis, which can effectively regulate the level of TNF-α and improve the indexes of hemorrheology, which is better than that of western medicine alone.