Clinical Observation Of Jianpi Xiaozhi Formula Intervens Carotid Artery Intima Media Thickness And MMP-9 Levels In The Type 2 Diabdetes Mellitus Complicated With Atherosclersis Patients

1 Objective:This thesis was aimed at probing into the action mechanism of Jianpi Xiaozhi Formula in postponing the AS progress of patients with T2 DM in a preliminary way through by applying this traditional Chinese prescription to patients with T2 DM and AS in order to observe related biochemical indexes and TCM clinical effect of Jianpi Xiaozhi Formula on treating patients with phlegm stagnation as well as deficiency of both vital energy and yin. 2 Method: According to diagnosis and exclusion criteria of both western medicine and TCM, 90 patients with T2 DM and AS were selected and randomly divided into 3 groups: TCM group, western medicine group and group receiving combination treatment of TCM and western medicine. The patients of three groups were respectively treated with Jianpi Xiaozhi Formula, atorvastatin calcium and combination of Jianpi Xiaozhi Formula and atorvastatin calcium. In addition to medicine treatment, their diets and sports were adjusted. After 6 months of treatment, the curative effect was observed and compared among 3 groups based on the record of physical indicators, including Carotid intima media thickness(CIMT), Matrix metalloproteinase-9(MM-9),type CollagenⅣ(Col IV), Interleukin-1β(IL-1β), blood fat and TCM syndrome. Other security indicators recorded included liver function, renal function, creatine kinase, electrocardiogram, etc. 3 Results:(1) All the 3 groups presented decrease in MMP-9, Col IV and IL-1β(P<0.01).The decrease of MMP-9 in TCM group was undifferentiated(P > 0.05) and Col IV decreased more evidently compared with western medicine group. Group receiving combination treatment of TCM and western medicine presented decrease in all the 3 indicators above after treatment compared with western medicine group(P<0.01).(2) All the 3 groups presented decrease in FPG and FINS(P<0.01). TCM group and group receiving combination treatment of TCM and western medicine decreased more in FPG and FINS(P <0.01) compared with western medicine group.(3) All the 3 groups presented decrease in HOMA-IR(P<0.01) and the decrease of HOMA-IR in TCM group and western medicine group after treatment was undifferentiated(P>0.05), group receiving combination treatment of TCM and western medicine decreased more evidently in HOMA-IR after treatment(P<0.05).(4) All the 3 groups presented decrease in TC, TG and LDL-C and increase in HDL-C(P<0.01), which was statistically significant. The decrease of TC and LDL-C in TCM group was statistically undifferentiated(P>0.05、P>0.05) compared with western medicine group, TG decreased more evidently(P<0.05) and HDL-C increased more than western medicine group, but the indicator was statistically insignificant. Group receiving combination treatment of TCM and western medicine presented evident decrease in TC, TG and LDL-C(P<0.01) and evident increase in LDL-C(P<0.01),which was statistically significant.(5) CIMT of all the 3 groups was statistically insignificant before and after treatment(P>0.05).(6) All the 3 groups presented decrease in TCM syndrome(P<0.01) and was statistically significant. TCM group and group receiving combination treatment of TCM and western medicinepresented more evident decrease compared with western medicine group(P <0.05,P <0.01).(7) Jianpi Xiaozhi Formula has no changes in hepatic and renal functions,creatine kinase and less adverse event. 4 Conclusion:Jianpi Xiaozhi Formula can remarkablydecrease LDL-C, TC, TG, MMP-9, Col IV, IL-1β, increase HDL-C and improve insulin resistance and TCM syndrome, which effectively helps postpone the progress of atherosclerosis and works better when combined with atorvastatin calcium. It seems that no changes have been detected in hepatic and renal functions,creatine kinase and less adverse event.