摘要
目的 分析麝香保心丸联合普罗布考对老年冠心病合并糖尿病患者血脂代谢及血管内皮功能的影响.方法 前瞻性选取北京市朝阳区双桥医院2021年1月至2022年10月收治的老年冠心病合并糖尿病患者102例,按照随机数字表法分为观察组与对照组,每组各51例,对照组采用常规疗法+普罗布考治疗,观察组在对照组基础上采用麝香保心丸治疗.治疗3个月后,统计分析两组临床疗效、血脂代谢指标[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(Apo)A1和ApoB]、血管内皮功能指标(内皮素-1、血栓素B2、一氧化氮)、心功能指标[左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)和左室质量指数(LVMI)]、血糖指标[空腹血糖(FBG)、糖化血红蛋白(GHb)及餐后2 h血糖(2 h PBG)]水平.结果 观察组临床总有效率为94.12％,高于对照组(78.43％),差异有统计学意义(P＜0.05).治疗3个月后,观察组的总胆固醇、甘油三酯、LDL-C及ApoB水平分别为(5.15±0.88)mmol/L、(1.71±0.23)mmol/L、(3.33±0.71)mmol/L、(0.81±0.17)g/L,均低于对照组[(5.86±0.91)mmol/L、(2.13±0.26)mmol/L、(3.97±0.85)mmol/L、(1.08±0.18)g/L],HDL-C 和 ApoA1 水平分别为(1.18±0.25)mmol/L、(1.44±0.25)g/L,均高于对照组[(0.96±0.22)mmol/L、(1.21±0.22)g/L],差异均有统计学意义(P＜0.05).治疗3个月后,观察组的内皮素-1及血栓素B2水平分别为(58.31±4.13)、(163.11±10.06)ng/L,均低于对照组[(62.11±4.41)、(179.31±11.11)ng/L],一氧化氮水平为(71.22±6.55)μmol/L,高于对照组[(67.58±5.61)μmol/L],差异均有统计学意义(P＜0.05).治疗3个月后,观察组的LVESD及LVMI分别为(35.13±2.23)mm、(109.85±11.29)g/m2,均低于对照组[(38.42±2.47)mm、(121.31±12.84)g/m2],LVEDD、LVEF 分别为(55.84±4.36)mm、(60.05±6.14)％,均高于对照组[(51.21±4.43)mm、(55.25±5.38)％],差异均有统计学意义(P＜0.05).治疗 3 个月后,观察组的 FBG、GHb 及 2 h PBG 水平分别为(6.41±1.01)mmol/L、(5.37±0.74)％、(8.20±1.34)mmol/L,均低于对照组[(7.31±1.04)mmol/L、(6.12±0.57)％、(9.68±1.22)mmol/L],差异均有统计学意义(P＜0.05).结论 麝香保心丸联合普罗布考可有效改善老年冠心病合并糖尿病患者血脂代谢、血管内皮功能、心功能、血糖水平,临床综合疗效显著,值得临床予以推广应用.
Abstract
Objective To analyze the effects of Shexiang Baoxin pills combined with probucol on blood lipid metabolism and vascular en-dothelial function in elderly patients with coronary heart disease and diabetes.Methods A total of 102 elderly patients with coronary heart disease and diabetes mellitus admitted to Beijing Chaoyang District Shuangqiao Hospital from January 2021 to October 2022 were prospectively selected as research objects.According to random number table method,they were divided into the observation group and the control group,with 51 cases in each group.The control group received conventional therapy+probucol treatment,the observation group received Shexiang Baoxin pills on the ba-sis of the control group.After 3 months of treatment,the clinical efficacy,blood lipid metabolism indexes[total cholesterol,triglyceride,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein(Apo)A1 and ApoB],vascular en-dothelial function indexes(endothelin-1,thromboxane B2,nitric oxide),cardiac function indexes[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and left ventricular mass index(LVMI)],blood glucose indexes[fasting blood glucose(FBG),glycosylated hemoglobin(GHb)and 2 h postprandial blood glucose(2 h PBG)]levels of the two groups were statistically analyzed.Results The total clinical effective rate of the observation group was 94.12％,which was higher than that of the control group(78.43％),the difference was statistically significant(P＜0.05).After 3 months of treatment,the total cholesterol,triglycerides,LDL-C,and ApoB levels in the observation group were(5.15±0.88)mmol/L,(1.71±0.23)mmol/L,(3.33±0.71)mmol/L,and(0.81±0.17)g/L,respectively,which were lower than those in the control group[(5.86±0.91)mmol/L,(2.13±0.26)mmol/L,(3.97±0.85)mmol/L,and(1.08±0.18)g/L],the HDL-C and ApoA1 levels were(1.18±0.25)mmol/L,(1.48±0.25)mmol/L,and(1.48±0.18)g/L,(1.44±0.25)g/]L,respectively,which were higher than those in the control group[(0.96±0.22)mmol/L,(1.21±0.22)g/L],the differences were statistically significant(P＜0.05).After 3 months of treatment,the levels of endothelin-1 and thromboxane B2 in the observation group were(58.31±4.13)and(163.11±10.06)ng/L,respectively,which were lower than those in the control group[(62.11±4.41)and(179.31±11.11)ng/L],and the levels of nitric oxide were(71.22±6.55)μmol/L,which was higher than that in the control group[(67.58±5.61)μmol/L],the differences were statistically significant(P＜0.05).After 3 months of treatment,the LVESD and LVMI of the observation group were(35.13±2.23)mm and(109.85±11.29)g/m2,respectively,which were lower than those of the control group[(38.42±2.47)mm and(121.31±12.84)g/m2].The LVEDD and LVEF were(55.84±4.36)mm and(60.05±6.14)％,respectively,which were higher than those of the control group[(51.21±4.43)mm and(55.25±5.38)％],and the differences were statistically significant(P＜0.05).After 3 months of treatment,the FBG,GHb,and 2-hour PBG levels in the observation group were(6.41±1.01)mmol/L,(5.37±0.74)％,and(8.20±1.34)mmol/L,respectively,which were lower than those in the control group[(7.31±1.04)mmol/L,(6.12±0.57)％,and(9.68±1.22)mmol/L],and the differences were statistically significant(P＜0.05).Conclusion Shexiang Baoxin pills combined with probukol can effectively improve blood lipid metabolism,vascular endothelial function,heart function and blood glucose level in elderly patients with coronary heart disease and diabetes mellitus.The comprehensive clinical effect is significant,and it is worthy of clinical promotion and application.
基金项目
北京医卫健康公益基金(YWJKJJHKYJJ-B183063)
维普
万方数据