首页|序贯服法对2型糖尿病合并稳定型心绞痛患者的疗效观察

序贯服法对2型糖尿病合并稳定型心绞痛患者的疗效观察

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目的 探讨中药常规服法与序贯服法对气虚血瘀型2型糖尿病合并稳定型心绞痛在临床效果上的差异.方法 选择2型糖尿病合并稳定型心绞痛患者,随机分成对照组、整方组和序贯组,对照组80例,整方组和序贯组各40例,维持现有的化药治疗方式不变,对照组服用安慰剂,整方组与序贯组每日服用中药一致,序贯组早上用补阳还五汤加减,中午用泽泻汤加味,晚上用四妙勇安汤加减,疗程24周,比较治疗前后以及停药后的心绞痛1周发作次数、心绞痛单次发作持续时间和硝酸甘油1周消耗量,中医证候积分,FPG、HbA1c以及100 g和200 g馒头餐负荷后2 h-PG变化.结果 治疗前后,心绞痛相关指标、中医证候积分和血糖相关指标,整方组和序贯组明显优于对照组(P<0.05),治疗后序贯组馒头餐负荷后2 h-PG波动幅度较整方组更小,差异无统计学意义(P>0.05);停药后回访,整方组相关数值反弹明显,与对照组比较差异无统计学意义(P>0.05),序贯组则较为稳定(P>0.05),与对照组和整方组比较差异有显著性意义(P<0.05).结论 中药整方服法和序贯服法均能有效改善T2DM-SAP患者心绞痛相关指标、中医证候积分和血糖相关指标,序贯服法在停药后的疾病稳定上效果更优.
Effect of Sequential Administration on Type 2 Diabetes Patients with Stable Angina Pectoris
Objective To explore the difference in clinical efficacy between conventional administration and sequential admin-istration of traditional Chinese medicine in patients with type 2 diabetes mellitus complicated with stable angina pectoris of Qi de-ficiency and blood stasis type.Methods The patients with T2DM-SAP were randomly divided into a control group,a whole pre-scription group and a sequential group.The control group consisted of 80 cases,while the whole prescription group and the sequen-tial group each consisted of 40 cases.The existing pharmacological treatment was maintained unchanged in all groups.The control group received a placebo,while the whole prescription group and the sequential group received the daily Chinese herbal medicine.The sequential group took Buyang Huanwu Decoction(补阳还五汤)with modifications in the morning,Zexie Decoction(泽泻汤)with modifications at noon,and Simiao Yong'an Decoction(四妙勇安汤)with modifications in the evening.The treatment lasted for 24 weeks.The number of angina attacks per week,duration of a single angina attack,consumption of nitroglycerin per week,traditional Chinese medicine syndrome scores,fasting plasma glucose(FPG),glycated hemoglobin(HbA1c)and changes in 2-hour postprandial plasma glucose(2 h-PG)after 100 g and 200 g steamed bun meal were compared before and after treat-ment as well as after discontinuation of medication.Results Before and after treatment,the indicators related to angina,TCM syn-drome scores and blood glucose were significantly better in the integrated and sequential treatment groups than those in the control group(P<0.05).After treatment,the amplitude of 2-hour postprandial blood glucose fluctuation after steamed bun meal in the sequential group was smaller than that in the whole prescription group,but there was no significant difference between the two groups(P>0.05).During the follow-up after discontinuation of medication,the relevant values in the whole prescription group rebounded significantly and showed no significant difference compared with those in the control group(P>0.05),while those in the sequential group were more stable(P>0.05)and showed significant differences compared with those in the control and whole prescription group(P<0.05).Conclusion Both the whole prescription method and the sequential method of Chinese herbal medi-cine administration can effectively improve angina-related indicators,traditional Chinese medicine syndrome scores and blood glucose-related indicators in patients with T2DM-SAP.The sequential method shows superior effectiveness in maintaining dis-ease stability after discontinuation of medication.

type 2 diabetes mellitus complicated with stable angina pectorisQi deficiency and blood stasis syndromese-quential method of administration

刘峰、刘星、吕炳鑫、王毅盟、李继光

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河北中石油中心医院健康管理科,河北廊坊 065000

2型糖尿病合并稳定型心绞痛 气虚血瘀证 序贯服法

2025

辽宁中医杂志
辽宁中医药大学,辽宁省中医药学会

辽宁中医杂志

北大核心
影响因子:0.815
ISSN:1000-1719
年,卷(期):2025.52(1)