目的 探討通心絡(luò)膠囊聯(lián)合丁咯地爾治療2型糖尿病下肢血管病變的的臨床療效。方法 選取2015年3月-2016年3月在柳州市工人醫(yī)院接受治療的2型糖尿病下肢血管病變患者90例,根據(jù)治療方案的不同分為對(duì)照組和治療組,每組各45例。對(duì)照組靜脈滴注鹽酸丁咯地爾注射液,0.2 g加入5%葡萄糖溶液500 mL,1次/d。治療組在對(duì)照組治療的基礎(chǔ)上口服通心絡(luò)膠囊,4粒/次,3次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效,同時(shí)比較兩組治療前后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血紅蛋白(HbA1c)、血漿黏度(CP)、血細(xì)胞比容(HCT)、血小板聚集率(PAR)、纖維蛋白原(FIB)、轉(zhuǎn)化生長(zhǎng)因子α(TNF-α)、白細(xì)胞介素6(IL-6)、高敏C反應(yīng)蛋白(hs-CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、踝肱指數(shù)(ABI值)和足背動(dòng)脈管徑的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為82.22%、95.56%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者FPG、2 hPG、HbAlc、IL-6、TNF-α、hs-CRP、MDA、CP、HCT、PAR、FIB水平均低于同組治療前,SOD、ABI值、足背動(dòng)脈管徑高于同組治療前,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 通心絡(luò)膠囊聯(lián)合鹽酸丁咯地爾治療2型糖尿病下肢血管病變具有較好的臨床療效,可明顯改善患者足背血流量和血液流變學(xué)指標(biāo),并可減輕機(jī)體炎癥反應(yīng),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To compare the efficacy and toxicities of Bevacizumab Injection and Lobaplatin for injection by intraperitoneal perfusion in treatment of malignant ascites. Methods Patients (48 cases) with malignant ascites in Shengjing Hospital of China Medical University from October 2013 to October 2015 were randomly divided into control and treatment group, and each group had 24 cases. Patients in the control group were received intraperitoneal perfusion with Lobaplatin for injection, 30 mg/m² diluted with normal saline 50 mL, once weekly. Patients in the treatment group were received intraperitoneal perfusion with Bevacizumab Injection, 5 mg/kg diluted with normal saline 50 mL, once weekly. The patients in two groups were treated for 2 weeks, 3 times at most. After treatment, the efficacy was evaluated, and levels of VEGF and CEA in ascites were determined before treatment and treated for 3 d. Scores of life quality in two groups were compared, and adverse reactions between two groups were studied. Results After treatment, the clinical efficacies in the control and treatment groups were 50.0% and 79.2%, respectively, and there was difference between two groups (P < 0.05). After treatment, levels of VEGF and CEA in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the levels of VEGF in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, abdominal distension score and anorexia score in two groups were significantly decreased, and the difference was statistically significant between group (P < 0.05). No grade III - IV toxicities were found in two groups. Conclusion Bevacizumab Injection has better efficacy than Lobaplatin for injection in treatment of malignant ascites, and has good tolerance, which has a certain clinical application value.