| Diabetesmellitus is a frequent disease of the endocrine metabolic system, together with the increase of living standards and the accerlerating process of ageing of the society, the frequency of diabetes mellitus patient has a tendency to increase quickly, and is one important chronic not infective disease after heart circulation diseases and cancer that severely endanger the public health. Itsacute and chronic complications, especially chronic complications that involve several organs, have a high rate of leading to deformation and death, they severely affect the patients health of body and mind, and give the individual, the family and society a heavy burden. Heart circulation diseases are the main factor leading to deformation and death of diabetes patients and economic loss. The frequency of heart circulation disease occuring is evidentially higher in diabetes patients and in people without diabetes. The mortality number because of heart circulation disease is 80％of the mortality rate for diabetes patients, where of 70％die because of diabetic heart disease.Diabetic heart disease (DHD) is coronary heart disease (CHD) caused complication by diabetes or occur together with diabetes, In the early stage there can be no symptoms, with the process of the disease, the patient can have angina pectoris, arrhythmia and increasing cardiac insufficiency. Because its reasons are complicated and it has special pathological and biological changes, clinical research and treatment is difficult. Recent studies show that TCM has certain advantages in the treatment of diabetes and its complications like heart circulation diseases, and has reached primary results. In the aspect of pathogenic factor and pathogenesis the emphasis lies on lack of Xin Qi Yin and blood stasis obstructing the Luo-channels, which are the Common pathogenic basis of diabetic heart disease that has already become widely accepted. Clinical treatment includes treatment according to different types, specialized prescriptions and the combination of disease differentiation and constitution differentiation, which has obtained a certain treatment effect. As constitution differentiation strongly depends on individual experience there is a lack of statistically relevant data, research design and scientific comparison, which makes the results less convincing. This is severely obstructing the field and the development of TCM researchPrescriptions of the "Shang Han Lun" have certain treatment effect in the treatment of diabetes and its complications, this has opened a new field for the treatment of difficult diseases, the treatment of diabetes by Chinese herbs including San Huang Jiang Tang Pian and its functional mechanism often appears as multi directional, multi layered, multi target point. On the basic treatment by western medical lowering blood sugar, fat and blood pressure medication this study uses a combined model of TCM disease differentiation and constitution differentiation, the rule is established according to the pathogenesis, the prescription is made according to the rule, biochemical indexes and morphological research is combined, a standard for treatment effect and living quality and end incidence are combined, diabetes together with coronary heart disease is randomlycompared, a forward looking dynamic observation; according to empirical medical principles, to introduce mainstream medical research methods, to observe the treatment effect of San Huang Jiang Tang Pian for the treatment of diabetes.ObjectiveAccording to empirical medical principles, to investigate the clinical observation of San Huang Jiang Tang Pian and basic treatment methods combined with TCM disease differentiation and constitution differentiation in the treatment of diabetes with coronary heart disease. Methods1 Use random comparison (treatment group: basic treatment+TCM disease differentiation and constitution differentiation+San Huang Jiang Tang Pian; Control group: basic treatment+TCM disease differentiation and constitution differentiation), looking forward dynamic observation, complete followed with research for a period of 3 months.2 Blinded setting: Use single blinded research method, the practitioner knows the research process and objective, the recipient does not know the research process and objective.3 To observe the changes of the patient with diabetes and coronary heart disease in blood sugar and blood lipid levels, blood pressure, weight index, ECG, echocardiogram, clinical physical signs and symptoms, living quality, instances of side-effects and the frequency of other complementation and terminal happenings (heart failure, cardiac infarction, cerebral infarction) and the influence of San Huang Jiang Tang Pian on the mentioned indexes.ResultsThis study shows that San Huang Jiang Tang Pian through the functions of Yi Qi Yang Yin Xie Re Zhu Yu, not only improve the clinical symptoms of diabetes and coronary heart disease but also improve the condition of myocardial ischemia; evident decrease the E/A ratio, increase the value of the diastole of the left ventricle, increase the blood ejection mark and the condensation frequency of the left ventricle, increase the cardiac output, has a evident improving effect on the stretching of the left ventricle and also has a very good influence on the function of the contraction of the left ventricle; can correct the disturbance in lipid metabolism, can decrease serum levels of cholesterol, triglyceride, Apo- protein B, increases the high density lipoprotein-cholesterol and Apo-protein A1; decreases blood sugar, blood pressure and body weight. According to the set treatment effect measurement standard, through the treatment with San Huang Jiang Tang Plan of 30 patients with diabetes and coronary heart disease, evident clinical effect 8 cases, effective 18 cases, no effect 4 cases, the total efficiency rate is 86.67％, compared to the control group there is a evident difference (P＜0.05); the average of life quality and health standard shows an evident difference (P＜0.01), also compared to the control group there is an evident difference (P＜0.05). It shows that San Huang Jiang Tang Plan has an evident treatment effect for diabetes with coronary heart disease. It provides data for the research and exploitation of TCM herbal medicine in the treatment of diabetes and coronary heart disease and consequently increases the treatment and research level of TCM herbal medicine in diabetes and coronary heart disease treatment.San Huang Jiang Tang Pian is reaching its treatment effect through several approaches:1 Effectively of decreasing blood sugar2 Effectively correct disturbances in lipid metabolism and has the effect to decrease blood pressure3 Effectively prevents and treats diabetic heart disease4 Effectively improves clinical symptoms of diabetes and coronary heart disease5 Effectively improves life quality of diabetic heart disease patients6 Prolongs or prevents the frequency of complementation and terminal happenings (heart failure, cardiac infarction, cerebral infarction)... |
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