益气温阳法治疗糖尿病心脏自主神经病变的临床视察.pdfVIP

提 要 目的：观察采用益气温阳法（生脉散合桂枝甘草龙骨牡蛎汤加减）治疗糖尿病心 脏自主神经病变在临床上的疗效，以及对患者心率变异性的影响，并初步探讨其作用 机制。方法：将确诊为糖尿病心脏自主神经病变的 60 例患者，随机分为两组，每组 各 30 例。治疗组和对照组在基础降糖治疗的同时，分别予以自拟方和西药弥可保， 共治疗12个周。分别观察两组患者治疗前后临床症状、空腹血糖、餐后2h血糖、糖 化血红蛋白、心率变异性等指标的变化，并进行对比分析。结果：治疗后，治疗组总 有效率为 93.3％，对照组总有效率为 66.7％，两组经统计学处理，有显著意义（p ＜0.05）。治疗组在改善患者临床症状，降低血糖，提高心率变异性方面较对照组有 明显优势，临床观察期间未发现明显不良反应。结论：采用益气温阳法治疗糖尿病心 脏自主神经病变有显著的临床疗效，可明显提高心率变异性，改善自主神经功能。 关键词 糖尿病心脏自主神经病变；心率变异性；益气温阳法；弥可保 The Clinical Observation of Replenishing Qi,Warming Yang Therapy on Diabetic Cardiac Autonomic Neuropathy Speciality：Internal medicine of TCM Author ：Xu Chunfang Tutor：Professor. Yang Wenjun Abstract Objective: To observe the clinical effect of replenishing Qi,warming Yang therapy （self-maked chinese decoction ）on treating diabetic cardiac autonomic neuropathy in patients with heart rate variability . And preliminary discussion mechanism. Methods: 60 patients with diabetic cardiac autonomic neuropathy were divided randomly into two groups(n=30) .The experiment group were treated with Hypoglycemic Drugs or insulin and Self-maked Chinese Decoction ,with a total course of treatment for 12 weeks.The control group were treated with Hypoglycemic Drugs,insulin and Methycobal,observed in clinical symptom changes,the blood glucose,glycated hemoglobin, blood rheology,heart rate variability index,before and after treatment.Result:After treatment,effective power in experiment group is 93.3%,and 66.7% in control group.the differences was statically significant(P0.05). Conclusion:Replenishing Qi,warming Yang therapy on diabetic cardiac autonomic neuropathy has significant effect and can improve heart variability. Key words Diabetic cardiac autonomic neuropathy;Heart rate variabili