The Effect Of Removing Phlegm And Blood-Stasis Together On Serum Levels Of TNF-a,CRP In T₂DM Patients With Syndrome Of Phlegm-Blood Stasis

Objective:To explore the effect of Chinese medicine Xionglou Tongmai decoction which was founded on the basis of removing phlegm and blood-stasis together on serum levels of tumor necrosis factor-a(TNF-a) and C- reactive protein(CRP) in T₂DM patients with syndrome of plegm-blood stasis.Methods:150 T₂DM patients with syndrome of plegm-blood stasis were selected and randomly divided into the treated group(n=98) and the control group(n=52).Patients attended to the education courses for diabetes and were treated with hypoglycemic agent in routine and reasonable diet.To those patients in treated group,Xionglou Tongmai decoction was given additionally with one dose taken twice per day,for a total 14 days' treatment.Assayed serum levels of TNF-a,CRP,fasting blood glucose(FBG) and clinical traditional Chinese medicine symptom score at the start and the end of the trial respectively.At the same time,some patients also received measurements of their level lipids and hemorrheology if possible.Results:1.Serum levels of TNF-a in the treated group decreased by 14.39%compared to base line, but there was no significantly difference compared with that of before treatment(P＞0.05). Serum levels of TNF-a in the control group increased by 7.43%compared to base line, but there was no significantly difference compared with that of before treatment(P＞0.05). TNF-a had no significantly difference between groups after treatment(P＞0.05).The variety of TNF-a had significant difference between groups(P＜0.05).2.Serum levels of CRP in the treated group decreased by 20.77%compared to base line,but there was no significantly difference compared with that of before treatment(P＞0.05). Serum levels of CRP in the control group decreased by 18.55%compared to base line,but there was no significantly difference compared with that of before treatment(P＞0.05). CRP had no significantly difference between groups after treatment(P＞0.05).The variety of CRP had no significant difference between groups(P＞0.05). 3.Serum levels of fasting blood glucose(FBG) decreased in both groups(the treated group: P＜0.01;the control group:P＜0.01),but FBG had no significantly difference between groups after treatment(P＞0.05).The variety of FBG had no significant difference between groups(P＞0.05).4.The clinical TCM symptom score dropped in both groups(the treated group:P＜0.01;the control group:P＜0.01),and it was lower in the treated group than that in the control group(P＜0.05).The variety had significant difference between groups(P＜0.05).The disease effective rate was significantly higher in the treated group compare with that in control group(P＜0.05).5.Serum levels of total cholesterol(TC),triglyceride(TG) and some indexes of hemorrheology decreased in the treated group(TG P＜0.01;others P＜0.05),but there was no significantly changes in the control group(P＞0.05).There was no significantly difference between groups(P＞0.05).The variety had no significant difference between groups(P＞0.05).Conclusions:Xionglou Tongmai decoction which was founded on the basis of removing phlegm and blood-stasis together could obviously lower serum levels of inflammatory cytokines TNF-a and conduce to lower the levels of CRP,ameliorate vascular chronic inflammation,and alleviate clinical symptoms of patients.It also could decrease TC,TG and improve hemokinesis,then could resist diabetic vascular injuries.