Clinical Observation On Therapy Of Tonifying Qi And Nourishing Yin, And Activating Blood And Removing Stasis In Treating Type 2 Diabetes Mellitus Complicated With Hypertension

BackgroundDiabetes and hypertension are all the underlying diseases which are harmful to the health of human.The high risk of the two diseases is to accelerate the process of atherosis and increase the incidence of various complications.Therefore,Chinese and Western medical scholars are seeking to explore the effective treatment of diabetic patients with hypertension.The results Of some research showed that the incidence of diabetic patients with hypertension was significantly higher than that of non-diabetic patients.Till now, insulin resistance is considered as the common basic pathogenesis of diabetes and hypertension and improving insulin sensitivity and relieving insulin resistance are the focus of clinical research.For the pathogenesis of diabetes and hypertension in the theory of traditional Chinese medicine(TCM),most scholars believed that it should be deficiency of Qi and yin,and blockage of blood stasis.Hence the therapeutic principle is tonifying Qi and nourishing yin,and activating blood and removing stasis.Relieving symptoms and improving insulin resistance are the efforts of treatment.ObjectiveTo evaluate the effect of therapy oftonifying Qi and nourishing yin,and activating blood and removing stasis on insulin resistance in type 2 diabetic patients with hypertension.MethodsSixty type 2 diabetic outpatients with hypertension from the Second Guangdong Provincial Hospital of Traditional Chinese Medicine were equally randomized into two groups:the test group(10 lost)and the control group(5 lost).Both groups received oral use of hypoglycemic drugs such as sulfonylurea of glipizide sustained-release tablets,insulin sensitizer of pioglitazone,metformin,orα-glucosidase inhibitor of acarbose.Meanwhile, antihypertensive drug of nifedipine sustained-release tablets were also used.Additionally, the test group was given Chinese patent medicine named Sanqidan Granules,which has the actions of tonifying Qi and nourishing yin,and activating blood and removing stasis.The course of treatment lasted eight weeks.The scores of TCM syndrome and the changes of laboratory parameters were observed and compared before and after treatment.ResultsThe therapeutic effect evaluated by scores of TCM syndrome were as follows:in the test group,the clinical cure rate was 70%,the excellent rate 5%,the effective rate 25%,the ineffective rate 0%,and the total effective rate was 100%;in the control group,the clinical cure rate was 0%,the excellent rate 28%,the effective rate 48%,the ineffective rate 28%, and the total effective rate was 72%.There exist significant differences between the two groups(p＜0.05),indicating that the therapy of tonifying Qi and nourishing yin,and activating blood and removing stasis is effective in relieving the clinical symptoms.After treatment,the fasting blood glucose(FPG),glycosylated hemoglobin Alc(HbAlc) and systolic blood pressure(SBP)were decreased and high-density lipoprotein(HDL)of the test group was increased as compared with the control group(p＜0.05).There existed an downward trend of insulin sensitivity index(IAI)(P value bing0.230).It was shown that the test group in improving the indicators of FPG,IAI,HbAlc,SBP and HDL was superior to the control group.However,there were no significant differences of the plasma insulin (INS),diastolic blood pressure(DBP),triglycerides(TG),cholesterol(TC)and low density lipoprotein(LDL)between the two groups(p＞0.05)have no.The results of intra-group comparison showed that in test group,there existed significant differences of the indicators except INS and TG(p＜0.01)before and after treatment.But in the control group,there existed only significant differences of FPG,HbAlc,SBP,and HDL (p＜0.01).It is suggested that the test group is superior to the control group in improving the indicators of IAI,LDL and TC.ConclusionIn this study,based on the pathogenesis of deficiency of Qi and yin,and blood stasis,a self-prepared Chinese patent medicine of Sanqidan Granules was prescribed for type 2 diabetic patients with hypertension The result has confirmed that the test group is superior to the control group in relieving clinical symptoms,and improving the indicators of FPG, HbAlc,SBP and HDL.Sanqidan Granules can relieve the clinical symptoms,increase insulin sensitivity,reduce insulin resistance,thus decrease fasting blood glucose,blood pressure and HbAlc.Meanwhile Sanqidan Granules can increase HDL levels,and lower TC and LDL levels,through which it has the anti-atherosclerosis effect and delay the incidence of complications.