健脾清化方对代谢综合征合并糖调节受损患者临床指标及花生四烯酸代谢物的影响  

Effects of Jianpi Qinghua recipe on clinical indicators and arachidonic acid metabolism in patients suffering from metabolic syndrome with impaired glucose regulation

作　　者：张妍 陈淑雯 张顺宵 李园园 程雯 ZHANG Yan;CHEN Shuwen;ZHANG Shunxiao;LI Yuanyuan;CHENG Wen(Department of Endocrinology,Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海市宝山区中西医结合医院内分泌科,上海201900

出　　处：《上海中医药杂志》2020年第2期65-69,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(81804020);上海市宝山区科委课题(16-E-14);上海市科委医学引导类(中、西医)科技支撑项目(17401931700);上海市宝山区医学特色专科和社区项目建设计划资助项目(BSZK-2018-A02).

摘　　要：目的探讨健脾清化方对代谢综合征合并糖调节受损患者临床指标及花生四烯酸代谢物的影响。方法将60例代谢综合征合并糖调节受损患者随机分为对照组和治疗组,每组30例。对照组仅给予生活方式干预,治疗组在对照组基础上加用健脾清化方口服治疗。两组疗程均为6个月,观察腰围(WC)、体质量指数(BMI)、糖化血红蛋白(HbA1c)、血脂(TC、TG、LDL)、颈总动脉内膜厚度(IMT)以及花生四烯酸代谢物的变化情况。结果①治疗前后组内比较,治疗组WC、BMI、HbA1c、TG水平均下降(P<0.05),对照组各项指标无明显变化(P>0.05);组间治疗后比较,治疗组WC、HbA1c较对照组明显下降(P<0.05)。②治疗前后组内比较,治疗组颈动脉内膜厚度下降(P<0.05),对照组颈动脉内膜厚度无明显变化(P>0.05);组间治疗后比较,两组颈动脉内膜厚度差异无统计学意义(P>0.05)。③治疗前后组内比较,治疗组11-脱氢血栓烷素B2(11-dehydroTXB2)、11-dehydroTXB2/6-酮前列腺素F1a(6-ketoPGF1a)、12-羟基二十碳四烯酸(12-HETE)水平均下降(P<0.05),对照组各代谢物水平无明显变化(P>0.05);组间治疗后比较,治疗组11-dehydroTXB2、11-dehydroTXB2/6-ketoPGF1a、12-HETE、9-羟十八碳二烯醇(9-HODE)、13-羟十八碳二烯醇(13-HODE)水平较对照组明显下降(P<0.05)。结论健脾清化方可减轻代谢综合征合并糖调节受损患者的体质量,改善血糖代谢,延缓动脉硬化发生发展,其作用机制可能与调节花生四烯酸的不同代谢通路有关。Objective To investigate the effects of Jianpi Qinghua recipe on clinical indicators and arachidonic acid metabolism in patients suffering from metabolic syndrome(MetS)with impaired glucose regulation(IGR).Methods Sixty Met S patients with IGR were randomly assigned into control group and treatment group,30 patients in each group.The control group received only lifestyle intervention and the treatment group were given oral treatment with Jianpi Qinghua recipe in addition to lifestyle intervention.The treatment course was 6 months in both groups.Changes were observed in waist circumference(WC),body mass index(BMI),glycosylated hemoglobin(HbA1c),blood lipid(TC,TG and LDL),carotid artery intima-media thickness(IMT)and arachidonic acid metabolites.Results①After treatment,the levels of WC,BMI,HbAlc and TG decreased in the treatment group(P<0.05),whereas there were no significant changes of indicators in the control group(P>0.05).The levels of WC and HbAlc decreased significantly in the treatment group compared to those in the control group(P<0.05).②After treatment,IMT decreased in the treatment group(P<0.05),whereas there were no significant changes in the control group(P>0.05).The difference in IMT between the groups had no statistical significance(P>0.05).③After treatment,the levels of 11-dehydroTXB2,11-dehydroTXB2/6-ketoPGF1a and 12-HETE decreased(P<0.05),whereas there were no significant changes in the control group(P>0.05).After treatment,11-dehydro TXB2,11-dehydro TXB2/6-ketoPGF1a,12-HETE,9-HODE and 13-HODE decreased significantly in the treatment group compared to those in the control group(P<0.05).Conclusion Jianpi Qinghua recipe reduces body weight,improves blood sugar metabolism and delays the development of atherosclerosis.Its effect may be related to the regulation of different metabolic pathways of arachidonic acid in patients suffering from metabolic syndrome with impaired glucose regulation.

关 键 词：糖调节受损 代谢综合征 健脾清化方 颈动脉内膜厚度 花生四烯酸 

分 类 号：R259[医药卫生—中西医结合]