Effect Of Qilian Sijunzi Decoction On Vascular Lesions In Elderly Patients With Type 2 Diabetes Mellitus

OBJECTIVE To observe the effect of Qilian Sijunzi Decoction on macrovascular disease in elderly patients with type 2 diabetes mellitus(T2DM),and to explore its possible mechanism by animal experiment.Methods(1)Clinical study:60 cases of senile T2 DM macroangiopathy patients with spleen deficiency and blood stasis type were randomly divided into treatment group(30 cases)and control group(30 cases).Both groups of patients were given standard diabetes treatment and routine treatment of western medicine,and the treatment group was treated with the Qilian Sijunzi Decoction,after 3 months of treatment,observe the change of symptoms and signs of selected patients,the experimental indicators and carotid ultrasound and lower extremity arterial ultrasound.(2)Animal experiment:Blank group,model group,control group and treatment group were Wistar male rats,the model group,control group and treatment group were made Diabetes model.The rats in the treatment group were treated with Qizhi Sijunzi Decoction,the control group was fed with metformin for 29 days,and the levels of advanced glycation end products(AGEs)and their receptors(RAGE)in the abdominal aorta were detected by enzyme-linked immunosorbent assay(ELISA).Results(1)Clinical study results:(1)There was no significant difference in general states,blood glucose and blood lipid between the two groups(P>0.05);(2)The symptom scores of the two groups were decreased(P<0.01),and thesymptoms of the treatment group were significantly lower than those of the control group(P<0.05);The total effective rate(90%)in the tretment group was significantly higher than that in the control group(70%),the difference was statistically significant(P<0.05);(3)The levels of hemoglobin,fibrinogen,plasma DD,hypersensitive C-reactive protein and homocysteine were decreased in both groups,and the treatment group was superior to the control group(P<0.05 or P<0.01);(4)Two groups of patients with carotid artery blood flow increased,after treatment,comparison between the groups were statistically significant(P<0.01);There was no statistically significant difference between plaque area after treatment(P>0.05);(5)The diameter of anterior tibial artery,Posterior tibial artery and foot dorsal artery of two groups increased,the artery blood flow speed,and the treatment group was better than the control group(P<0.05 或 P<0.01).(2)Animal experiment results:The level of AGEs and RAGE in the model group was higher than that in the blank group(P<0.01),The levels of AGEs and RAGE in the treatment group and the control group were lower than those in the model group,and the treatment group was lower than the control group(P<0.05 or P<0.01).Conclusion Qilian Sijunzi Decoction can significantly reduce the symptoms and signs of patients with type 2 diabetes mellitus macroangiopathy,Reduce blood viscosity and thrombosis risk,improve the body’s inflammatory status,improve arterial blood supply capacity,delay the progress of macrovascular diseases,its prevention and treatment of diabetic macrovascular disease may be related to the reduction of AGEs and RAGE levels.