尚香玉 赵卫株 吴妍 周江

[摘要] 目的 觀察麝香保心丸联合替罗非班治疗急性冠脉综合征（ACS）合并2型糖尿病（T2DM）患者的疗效及影响。 方法 选择2019年10月至2021年1月在台州市中心医院治疗的142例ACS合并T2DM患者为研究对象，依据随机数字表法分为对照组与观察组，每组各71例。对照组选择替罗非班实施治疗，观察组在对照组的基础上选择麝香保心丸实施治疗。治疗15 d后，对比分析两组临床疗效、糖化血清蛋白（GSP）、糖化血红蛋白（HbA1c）、空腹血糖（FPG）及不良心脑血管疾病发生率。 结果 观察组总有效率为91.55%，明显高于对照组的76.06%，差异有统计学意义（P<0.05）;治疗前，观察组的GSP、HbA1c、FPG分别为（261.17±13.05）μmol/L、（7.49±1.02）%、（7.83±1.04）mmol/L，与对照组的（260.73±14.86）μmol/L、（7.47±1.05）%、（7.81±1.08）mmol/L比较，差异无统计学意义（P>0.05）;治疗后，观察组GSP、HbA1c、FPG分别为（201.73±8.91）μmol/L、（7.01±0.88）%、（6.00±1.11）mmol/L，明显低于对照组的（229.85±9.83）μmol/L、（7.34±0.98）%、（6.64±1.32）mmol/L，差异有统计学意义（P<0.05）;观察组不良心脑血管疾病总发生率为2.82%，明显低于对照组的15.50%，差异有统计学意义（P<0.05）。 结论 麝香保心丸联合替罗非班治疗ACS合并T2DM患者疗效显著，能明显改善患者血糖水平，同时能降低不良心脑血管疾病发生率，值得应用推广。

[关键词] 急性冠脉综合征;2型糖尿病;麝香保心丸;替罗非班;血糖水平;不良心脑血管疾病

[中图分类号] R541.4          [文献标识码] B          [文章编号] 1673-9701（2021）35-0113-04

Efficacy and influence of Shexiang Baoxin Wan combined with tirofiban in the treatment of patients with acute coronary syndrome and type 2 diabetes

SHANG Xiangyu1   ZHAO Weizhu2   WU Yan3   ZHOU Jiang1

1.Department of Cardiology， Taizhou Central Hospital （Taizhou University Hospital）， Taizhou   318000， China; 2.Department of Paediatrics， Taizhou Hospital of Zhejiang Province affiliated to Wenzhou University， Taizhou   317000， China; 3.Department of Endocrinology， Zhejiang Greentown Cardiovascular Hospital， Hangzhou   310012， China

[Abstract] Objective To observe the efficacy and influence of Shexiang Baoxin Wan combined with tirofiban in the treatment of patients with the acute coronary syndrome （ACS） and type 2 diabetes （T2DM）. Methods A total of 142 patients with ACS and T2DM treated in Taizhou Central Hospital from October 2019 to January 2021 were selected as the research objects. According to the random number table method， they were divided into the control group and the observation group， with 71 cases in each group. The control group received tirofiban for treatment， and the observation group received Shexiang Baoxin Wan for treatment based on the control group. After 15 days of treatment， the clinical efficacy， glycosylated serum protein （GSP），glycosylated hemoglobin （HbA1c）， fasting blood glucose （FPG）， and incidence of adverse cardiovascular and cerebrovascular diseases were compared and analyzed between the two groups. Results The total effective rate of the observation group was 91.55%，which was statistically significantly higher than 76.06% of the control group（P<0.05）. Before treatment，the GSP，HbA1c，and FPG of the observation group were （261.17±13.05）μmol/L， （7.49±1.02）%，（7.83±1.04）mmol/L，and the difference was not statistically significant from the control group （260.73±14.86）μmol/L， （7.47±1.05）%，（7.81±1.08）mmol/L（P>0.05）.After treatment， the GSP， HbA1c， FPG of the observation group were （201.73±8.91）μmol/L， （7.01±0.88）%，（6.00±1.11）mmol/L，respectively，which were significantly lower than （229.85±9.83）μmol/L，（7.34±0.98）%， （6.64±1.32） mmol/L in the control group，and the difference was statistically significant（P<0.05）. The total incidence of adverse cardiovascular and cerebrovascular diseases in the observation group was 2.82%， significantly lower than 15.50% of the control group， and the difference was statistically significant（P<0.05）. Conclusion The combination of Shexiang Baoxin Wan and tirofiban has a significant effect in treating patients with ACS and T2DM. It can significantly improve patients′ blood glucose level and reduce the incidence of adverse cardiovascular and cerebrovascular diseases.It is worthy of application and promotion.

[Key words] Acute coronary syndrome; Type 2 diabetes; Shexiang Baoxin Wan; Tirofiban; Blood glucose level; Adverse cardiovascular and cerebrovascular diseases

随着国内人群生活习惯的快速转变、日益严重的环境污染、社会老龄化的加剧，人们患2型糖尿病（Diabetes mellitus type 2，T2DM）的发生率也在逐渐增加[1]。急性冠脉综合征（Acute coronary syndrome，ACS）在T2DM并发症中十分常见，同时也是导致T2DM病患死亡的主要原因之一[2-3]。所以，对T2DM合并ACS患者来说，及时、有效的治疗十分重要[4]。祖国医学中将ACS归属……