目的 探讨通心络胶囊联合丁咯地尔治疗2型糖尿病下肢血管病变的的临床疗效。方法 选取2015年3月-2016年3月在柳州市工人医院接受治疗的2型糖尿病下肢血管病变患者90例,根据治疗方案的不同分为对照组和治疗组,每组各45例。对照组静脉滴注盐酸丁咯地尔注射液,0.2 g加入5%葡萄糖溶液500 mL,1次/d。治疗组在对照组治疗的基础上口服通心络胶囊,4粒/次,3次/d。两组均连续治疗14 d。观察两组的临床疗效,同时比较两组治疗前后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、血浆黏度(CP)、血细胞比容(HCT)、血小板聚集率(PAR)、纤维蛋白原(FIB)、转化生长因子α(TNF-α)、白细胞介素6(IL-6)、高敏C反应蛋白(hs-CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、踝肱指数(ABI值)和足背动脉管径的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为82.22%、95.56%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者FPG、2 hPG、HbAlc、IL-6、TNF-α、hs-CRP、MDA、CP、HCT、PAR、FIB水平均低于同组治疗前,SOD、ABI值、足背动脉管径高于同组治疗前,同组治疗前后差异有统计学意义(P<0.05);治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 通心络胶囊联合盐酸丁咯地尔治疗2型糖尿病下肢血管病变具有较好的临床疗效,可明显改善患者足背血流量和血液流变学指标,并可减轻机体炎症反应,具有一定的临床推广应用价值。

Objective To compare the efficacy and toxicities of Bevacizumab Injection and Lobaplatin for injection by intraperitoneal perfusion in treatment of malignant ascites. Methods Patients (48 cases) with malignant ascites in Shengjing Hospital of China Medical University from October 2013 to October 2015 were randomly divided into control and treatment group, and each group had 24 cases. Patients in the control group were received intraperitoneal perfusion with Lobaplatin for injection, 30 mg/m² diluted with normal saline 50 mL, once weekly. Patients in the treatment group were received intraperitoneal perfusion with Bevacizumab Injection, 5 mg/kg diluted with normal saline 50 mL, once weekly. The patients in two groups were treated for 2 weeks, 3 times at most. After treatment, the efficacy was evaluated, and levels of VEGF and CEA in ascites were determined before treatment and treated for 3 d. Scores of life quality in two groups were compared, and adverse reactions between two groups were studied. Results After treatment, the clinical efficacies in the control and treatment groups were 50.0% and 79.2%, respectively, and there was difference between two groups (P < 0.05). After treatment, levels of VEGF and CEA in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the levels of VEGF in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, abdominal distension score and anorexia score in two groups were significantly decreased, and the difference was statistically significant between group (P < 0.05). No grade III - IV toxicities were found in two groups. Conclusion Bevacizumab Injection has better efficacy than Lobaplatin for injection in treatment of malignant ascites, and has good tolerance, which has a certain clinical application value.