Effect Of Acarbose And Tongxinluo Capsule Treatment In Patients With Impaired Glucose Tolerance Accompanied By Coronary Heart Disease

Objective: To evaluate the effect of acarbose and Tongxinluo capsule treatment oncardiovascular events in patients with coronary heart disease combined with impaired glucosetolerance, so as to provide the basis for the clinical application of the two drugs.Methods:340Patients with impaired glucose tolerance accompanied by coronary heartdisease wich departed in Jining NO.1People,s Hospital from August2010to June2012wererandomized in four groups, acarbose group(84Patients),received oral acarbose on basis ofstandard CHD therapy; Tongxinluo capsule group(86Patients),received oral Tongxinluo capsuleon basis of standard CHD therapy; combination therapy group(83Patients),received oralacarbose and Tongxinluo capsule on basis of standard CHD therapy; the control group(87Patients), only received standard therapy without acarbose or Tongxinluo capsule. All of thepatients were dignosted coronary heart disease by CAG. And then statistic all the groups with thebasic situation, including gender,age,basal heart rate,body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol,low-density lipoprotein cholesterol,triglycerides esters,fasting blood glucose, oral glucose2h after the75g glucose(OGTT),urinary albunmin/creatinineratio(UACR),rate of retinopathy, conventional treatment of CHD, results of CAG.All the groupswere followed up for6months, and then evaluate the rates of each group cardiovascular eventsat the end of follow up.Results:319patients were followed-up for6months. Acarbose group include79patients, Tongxinluo capsule group include79patients, combination therapy group include80patients,the control group include81patients. A total of21patients with dropout due to loss of follow-upor gastrointestinal side effects. There is no difference of basic situation between them before theintervention (P＞0.05).After6months of drugs’ intervention, urinary albunmin/creatinine ratio(UACR) areobviously declined in acarbose group,Tongxinluo capsule group and combination therapy group,the combination therapy group is more effective than the single drug group,(Acarbose groupt=-3.980, P=0.000, Tongxinluo capsule group t=2.777,P=0.006, Combination therapy groupt=-4.927,P=0.000,Thecontrolgroupt=-0.486,P=0.628;after the treatment:compareacarbosegroup with Tongxinluo capsule groupt=-0.805,P=0.422, compare combination therapy groupwith acarbose t=2.215,P=0.028,compare combination therapy group with Tongxinluo capsulegroup t=2.909,P=0.004).There is no difference between4groups after the intervention at therate of retinopathy (P＞0.05),drug intervention groups has a lower trend compared with theprevious,(Acarbose groupχ~2=0.709,P=0.400, Tongxinluo capsule groupχ~2=1.190,P=0.275,Combination therapy groupχ~2=2.417,P=0.120, The control groupχ~2=0.086,P=0.769).During follow-up period cardiovascular events is23.46%(19/81) in the control group;acarbose group is10.13%(8/79),compared with control groupχ~2=5.066, P=0.024<0.05;Tongxinluo capsule group is11.39%(9/79),compared with control groupχ~2=4.032, P=0.045<0.05;combination therapy group is5.00%(4/80),compared with control groupχ~2=11.197,P=0.001<0.05;between drug intervention group comparedχ~2=2.269, P=0.323>0.05.Conclusions:Acarbose and Tongxinluo capsule can both reduce urinary albunmin/creatinineratio(UACR) in patients of coronary heart disease merged with impaired glucose tolerance,thecombination therapy group is more effective than the single drug group.Both two medicine cansignificantly reduce the incidence of cardiovascular events in patients of coronary heart diseasemerged with impaired glucose tolerance.