Ma Rong-Wei, Zou Da-jin, Wang Qi-jin
Department of Endocrinology, Shanghai Changhai Hospital, Shanghai.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2010 Aug;30(8):833-7.
To investigate the effect of compound Danshen Dripping Pill (DSP) on carotid arterial intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).
One hundred and thirty T2DM patients were assigned to four groups, 32 in the Group A, the control group treated with blood glucose (BG) and blood pressure (BP) controlling; 32 in the Group B, with BG, BP and blood lipid (BL) controlling, 32 in Group C with BG, BP, BL controlling and vitamin E administration, and 34 in Group D with BG, BP, BL controlling and DSP administration. Patients in Group D were subdivided by Chinese medicine syndrome differentiation into four types, 8 of Yin-deficiency with flourishing heat type (YDFH), 5 of both qi-yin deficient type (BQYD), 8 of both yin-yang deficient type (BYYD) and 13 of blood-stasis and qi-stagnant type (BSQS). Fasting blood glucose (FBG), BP and BL in patients were observed periodically, and IMT in them were measured by ultrasonography before treatment, as well as at the end of the 1st, 3rd, and 5th year of treatment to dynamically observe the changes of IMT and condition of plaque formation, and analyze the relation between them with FBG, BP and BL.
The 5-year follow-up was performed in 105 patients. In the observation period, level of total cholesterol (TC) showed a decreasing trend and level of high density cholesterol (HDL-C) showed an increasing trend in all the 4 groups, the improvements in Group C and D were slightly better than those in Group B, while significantly superior to those in Group A; the changes of FBG and glycosylated hemoglobin (HbAlc) were insignificant in the 4 groups. IMT and numbers of atheroma plaque increased gradually in all groups in the observation period, however, the changes in Group D were lesser than those in other groups, showing significant difference (P < 0.01). It was showed that the increasing of cervical carotid IMT in T2DM patients was correlated with levels of HbAlc, HDL-C, LDL-C, triglyceride and TC, especially in Group D.
DSP might delay the occurrence and development of diabetic macro-vascular disease.
探讨复方丹参滴丸（DSP）对2型糖尿病（T2DM）患者颈动脉内膜中层厚度（IMT）的影响。
将130例T2DM患者分为4组，A组32例，为血糖（BG）及血压（BP）控制的对照组；B组32例，进行BG、BP及血脂（BL）控制；C组32例，在BG、BP、BL控制的基础上给予维生素E；D组34例，在BG、BP、BL控制的基础上给予DSP。D组患者按中医辨证分为4型，阴虚热盛型（YDFH）8例，气阴两虚型（BQYD）5例，阴阳两虚型（BYYD）8例，血瘀气滞型（BSQS）13例。定期观察患者的空腹血糖（FBG）、BP及BL，并于治疗前及治疗第1、3、5年末采用超声检查测量IMT，动态观察IMT变化及斑块形成情况，分析其与FBG、BP及BL的关系。
105例患者进行了5年随访。观察期间，4组患者总胆固醇（TC）水平呈下降趋势，高密度胆固醇（HDL-C）水平呈上升趋势，C组和D组改善情况略优于B组，显著优于A组；4组患者FBG及糖化血红蛋白（HbAlc）变化不明显。观察期间，各组IMT及动脉粥样斑块数量均逐渐增加，但D组变化小于其他组，差异有统计学意义（P<0.01）。结果表明，T2DM患者颈总动脉IMT增加与HbAlc、HDL-C、低密度脂蛋白胆固醇（LDL-C）、甘油三酯及TC水平有关，尤其在D组。
DSP可能延缓糖尿病大血管病变的发生与发展。
