Clinical Study Of Huoxue Jiangtang Decoction In The Treatment Of Diabetic Lower Extremity Atherosclerotic Disease

ObjectiveThe purpose of this study was to observe the effects of Huoxue Jiangtang Decotion on body mass index(BMI),glucose and lipid metabolism,interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),apelin,ankle-brachialindex(ABI),the intima-media thickness(IMT)of lower extremity arteries,the ratio of the blood flow volume in the lower extremity arteries and the total score of TCM syndromes on both Qi and Yin deficiency with blood stasis in patients with diabetic lower extremity atherosclerotic disease,to explore clinical curative effect of Huoxue Jiangtang Decotion on diabetic lower extremity atherosclerotic disease with both Qi and Yin deficiency with blood stasis,to provide a theoretical basis for the treatment of diabetic lower extremity atherosclerotic disease with the combination of traditional Chinese and Western medicine.MethodsFrom June 2019 to November 2019,124 patients who visited the outpatient department and inpatient department of endocrinology department of Shenzhen Traditional Chinese Medicine Hospital and met the inclusion/exclusion criteria were randomly selected to be included,and divided into control group and treatment group by simple randomized grouping method,with 62 patients in each group.The control group was treated with basic treatment of diabetes and oral aspirin enteric-coated tablets,while the treatment group was treated with Huoxue Jiangtang decoction on the basis of the control group for 12 weeks.BMI,fasting plasma glucose(FPG),2 hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),IL-6,TNF-α,apelin,ABI,the intima-media thickness of popliteal arteryand,the intima-media thickness of dorsalis pedis artery,the ratio of the blood flow volume in the dorsalis pedis artery and popliteal arteryand,and the change of the total score of TCM syndromes were observed before and after treatment in the two groups.Collated the relevant data,and made statistical analysis.Results(1)During this study,four patients in the treatment group could not insist on taking traditional Chinese medicine and voluntarily withdrew from the trial,two patients were lost to follow-up and one patient was excluded from the trial due to poor compliance in the treatment group,three patient withdrew from the trial due to personal factors and three patients were lost to follow-up in the control group,the final number of patients included in the statistical analysis were 55 in the treatment group and 56 in the control group.(2)Compared with general data,there was no significant difference in sex ratio between the treatment group and the control group(P>0.05),and there was no significant difference in age and course of disease between the two groups(P>0.05).(3)Compared with efficacy indicators,before treatment,there was no significant difference in BMI,the total score of TCM syndrome,FPG,2hPG,HbAlc,TG,TC,LDL-C,HDL-C,IL-6,TNF-α,apelin,ABI,the intima-media thickness of popliteal arteryand,the intima-media thickness of dorsalis pedis artery,and the ratio of the blood flow volume inthe dorsalis pedis artery and popliteal arteryand between the two groups(P>0.05).After treatment,BMI,the total score of TCM syndroms,FPG,2hPG,HbAlc,TG,TC,LDL-C,IL-6,TNF-α,the intima-media thickness of popliteal arteryand and the intima-media thickness of dorsalis pedis artery in the two groups all decreased significantly compared with the previous treatment(P<0.05),while HDL-C,ABI,apelin and the ratio of the blood flow volume in the dorsalis pedis artery and popliteal arteryand all increased significantly compared with the previous treatment group(P<0.05).BMI,the total score of TCM syndroms,FPG,2hPG,LDL-C,IL-6,TNF-α,apelin,ABI,the intima-media thickness of popliteal arteryand,the intima-media thickness of dorsalis pedis artery in the treatment group were better than those in the control group(P<0.05).The difference of BMI,the total score of TCM syndromes,FPG,TC,LDL-C,IL-6,TNF-α,apelin,ABI,the intima-media thickness of popliteal arteryand,the intima-media thickness of dorsalis pedis artery,the ratio of the blood flow volume in the dorsalis pedis artery and popliteal arteryand before and after treatment was significantly higher than that in the control group(P<0.05).ConclusionsHuoxue Jiangtang Decotionin in the treatment of diabetic lower extremity atherosclerotic diseaseis with both Qi and Yin deficiency with blood stasis can effectively improve clinical symptoms and signs of patients,control blood glucose,improve vascular function,and has no obvious adverse reactions.Its mechanism may be related to regulating glycolipid metabolism,reducing inflammation level,alleviating vascular damage.