中西医结合治疗老年2型糖病临床观察.docVIP

中西医结合治疗老年2型糖尿病临床观察 作者：路军章,唐果,刘毅,邓新立 【摘要】 目的 观察益气养阴活血中药配合降糖西药对老年2型糖尿病患者的临床症状及实验室指标的改善情况。方法 选择老年2型糖尿病患者60例,随机分为2组。试验组(30例)在常规降糖西药治疗的基础上加用益气养阴活血中药,对照组(30例)单纯用西药,治疗1个月,观察2组患者治疗前后临床症状、空腹血糖、餐后2 h血糖、全血粘度、甲襞微循环及血小板聚集率、D-二聚体的变化。结果 试验组显效11例,有效15例,无效4例,总有效率86.7%；对照组显效2例,有效12例,无效16例,总有效率为46.7%。2组总有效率比较差异有统计学意义(P＜0.01)。试验组全血粘度、血小板聚集率、D-二聚体均显著下降,甲襞微循环明显改善。结论 益气养阴活血中药配合降糖西药能全面改善老年2型糖尿病患者的临床症状及实验室指标。 【关键词】 益气养阴活血；老年；2型糖尿病；中西医结合疗法 Abstract：Objective To study the clinical effect of herbs of replenishing qi, nourishing yin and promoting blood combined with western medicine on symptoms and hemorrheology indexes of aged diabetic mellitus (DM). Methods Sixty cases with DM-2 were randomly divided into two groups. The treatment group was given herbs combined with western medicine and the control group was given western medicine treatment only. The treatment course was 1 month. The clinical symptoms, blood glucose and hemorrheology indexes were observed in both groups. Results There were 11 marked effective cases, 15 effective cases and 4 ineffective cases in treatment group, while 2, 12 and 16 cases in control group. The total effective rate was 86.7% in treatment group and 46.7% in control group. There was a significant difference between the two groups. The whole blood viscosity, platelet aggregation, D-dimer and fingernail microcirculation were significantly improved in the treatment group. Conclusion The herbs of replenishing qi, nour ishing yin and promoting blood combined with western medicine can improve the clinical symptoms and hemorrheology of aged DM. Key words：replenish qi, nourish yin and promote blood；aged；type2 diabetic mellitus；integrated treatment of western and traditional Chinese medicine 随着社会人口的老龄化,老年人糖尿病患病率逐年增加,虽然降糖西药层出不穷,疗效确切,但仍有部分糖尿病患者单纯运用西药得不到理想的控制。根据多年来的临床经验,我们发现单纯运用中药能改善临床症状但却没有可靠的降糖作用,而中西医结合治疗则能收到理想的效果。中医认为,老年人糖尿病的基本病理特征为气阴两虚兼血瘀,因此,本研究选用益气养阴活血中药对经2种降糖药物联合治疗1年以上,血糖控制仍然不理想的老年2型糖尿病患者进行临床观察,现报道如下。 　　1 临床资料 　　1.1 一般资料 本研究入选病例共60例,均为2005年9月－2008年4月中国人民解放军总医院高干门诊