Cheng Sen-Hua, Wang Jun, Xu Geng-Hua, Sun Guo-Xiang, Tao Xiao-Jian, Yang Xiao-Cui, Zhu Yue-Jiao, Chen Yin-Wei
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Dec;36(12):1439-1444.
Objective To observe the effect of Naoxintong Capsule (NC) on carotid artery vas- cular remodeling (VR) in type 2 diabetes mellitus (T2DM) patients with subclinical vascular disease. Methods A total of 180 T2DM patients with subclinical atherosclerosis (AS) were randomly assigned to the observation group and the control group in the ratio of 1:1 , 90 in each group. All patients took conven- tional hypoglycemic therapy, and the choices of therapeutic drugs and doses were selected according to patients' conditions. Patients in the observation group additionally took NC (3 pills each time, three times per day) , while those in the control group took no interventional drug. The therapeutic course for all was 6 months. The size and nature of bilateral carotid artery plaque were measured before and after treatment using color Doppler ultrasound diagnostic instrument. Bilateral carotid artery intimal-medial thickness (IMT) , plaque area (PA) , total vascular area (TVA) , lumen area (LA) , peak systolic velocity (PSV) , end diastolic velocity (EDV) , vascular resistance index (VRI) , and pulsatility index (PI) were measured. The total plaque score, unstable plaque detection rate, stenosis rate (S) , and refactoring index ( RI) were calculated. Levels of fasting plasma glucose (FPG) , glycated hemoglobin Al c (HbA1 c) , triglyceride (TG) , total cholesterol (TC) , high density lipoprotein cholesterol ( HDL-C) , and low density lipopro- tein cholesterol (LDL-C) were detected. Results Compared with before treatment in the same group, carotid artery IMT and plaque score decreased, levels of TC, TG, LDL-C, FPG, and HbAlc were reduced, PSV, EDV and PI increased, and VRI decreased in both two groups after treatment, with statisti- cal significance (P <0. 05). More obvious effects were shown in decreasing carotid artery IMT, plaque score, PA, and unstable plaque detection rate, reducing levels of TC, LDL-C and VRI, and increasing HDL-C, PSV, and EDV in the observation group, with statistical difference as compared with the control group (P <0. 05). After treatment the reconstruction rate and negative remodeling increased in the control group, with statistical difference as compared with before treatment (P <0. 05). Compared with the control group after treatment, the negative remodeling increased more in the observation group after treatment (X2 =6. 4615, P <0. 05). Conclusion NC could alleviate the carotid artery IMT, reduce and stabilize the plaque, improve blood flow parameters, and delay vascular reconstruction for treating T2DM patients with subclinical vascular disease.
目的 观察脑心通胶囊（NC）对2型糖尿病（T2DM）合并亚临床血管病变患者颈动脉血管重构（VR）的影响。方法 将180例T2DM合并亚临床动脉粥样硬化（AS）患者按1∶1随机分为观察组和对照组，每组90例。所有患者均接受常规降糖治疗，治疗药物及剂量根据患者病情选择。观察组患者加服NC（每次3粒，每日3次），对照组患者未加用干预药物。疗程均为6个月。采用彩色多普勒超声诊断仪测量治疗前后双侧颈动脉斑块大小及性质，测量双侧颈动脉内膜中层厚度（IMT）、斑块面积（PA）、总血管面积（TVA）、管腔面积（LA）、收缩期峰值流速（PSV）、舒张末期流速（EDV）、血管阻力指数（VRI）及搏动指数（PI），计算总斑块积分、不稳定斑块检出率、狭窄率（S）及重构指数（RI）。检测空腹血糖（FPG）、糖化血红蛋白Alc（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDL-C）水平。结果 与同组治疗前比较，两组治疗后颈动脉IMT及斑块积分降低，TC、TG、LDL-C、FPG及HbAlc水平降低，PSV、EDV及PI升高，VRI降低，差异有统计学意义（P<0.05）。观察组在降低颈动脉IMT、斑块积分、PA及不稳定斑块检出率，降低TC、LDL-C及VRI水平，升高HDL-C、PSV及EDV方面效果更明显，与对照组比较差异有统计学意义（P<0.05）。对照组治疗后重构率及负性重构增加，与治疗前比较差异有统计学意义（P<0.05）。与对照组治疗后比较，观察组治疗后负性重构增加更明显（X2=6.4615，P<0.05）。结论 NC可减轻T2DM合并亚临床血管病变患者的颈动脉IMT，缩小并稳定斑块，改善血流参数，延缓血管重构。
