血脂清联合阿托伐他汀对高血压合并代谢综合征患者血清炎症因子和胰岛素抵抗的影响  

Effect of Xuezhiqing combined with Atorvastatin to serum inflammatory factors and insulin resistance in hypertension patients with metabolic syndrome

作　　者：刘德桓[1] 陈文鑫 叶靖[1] 吴志阳[1] 欧凌君[1] 苏齐[2] 庄清芬[1] 

机构地区：[1]福建中医药大学附属泉州市中医院内一科,福建泉州362000 [2]福建省泉州市医药研究所,福建泉州362000

出　　处：《中国医药导报》2013年第24期79-82,共4页China Medical Herald

基　　金：福建省泉州市第一批技术研究与开发计划项目(编号2009Z40)

摘　　要：目的观察中药血脂清颗粒联合阿托伐他汀钙片对高血压合并代谢综合征(MS)患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、胰岛素抵抗指数(HOMA-IR)和血脂的影响。方法将90例患者按随机数字表法分为三组(A组:阿托伐他汀钙片组;B组:血脂清组;C组:阿托伐他汀钙片加血脂清组),每组各30例。A组:阿托伐他汀钙片10 mg/次,qn;B组:血脂清颗粒1包/次,tid;C组:阿托伐他汀钙片10 mg/次,qn,加血脂清颗粒1包/次,tid。疗程8周,观察治疗前后血清hs-CRP、TNF-α、HOMA-IR水平和血脂参数的变化。结果①治疗8周后,A组三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)分别由(1.88±0.67)、(5.31±1.15)、(3.97±0.98)mmol/L下降为(1.70±0.55)、(3.26±0.59)、(2.13±0.61)mmol/L,高密度脂蛋白胆固醇(HDL-C)由(1.18±0.28)mmol/L下降为(1.12±0.25)mmol/L;B组TG、TC、LDL-C分别由(1.90±0.65)、(5.29±1.03)、(3.89±1.10)mmol/L下降为(1.42±0.79)、(3.98±0.77)、(2.23±0.79)mmol/L,HDL-C由(1.11±0.26)mmol/L上升为(1.27±0.25)mmol/L;C组TG、TC、LDL-C分别由(1.93±0.54)、(5.33±0.96)、(4.12±0.96)mmol/L下降为(1.47±0.53)、(3.22±0.70)、(2.06±0.68)mmol/L,HDL-C由(1.12±0.25)mmol/L上升为(1.42±0.22)mmol/L。三组TC、LDL-C均较治疗前显著下降(P<0.01);B组及C组TG降低,HDL-C升高,差异均有统计学意义(P<0.05或P<0.01)。A组与B组、C组与B组治疗后TC差异均有统计学意义(均P=0.000),A组与C组比较差异无统计学意义(P=0.811);HDL-C比较,A组与B组、A组与C组、B组与C组差异均有统计学意义(P=0.016、0.000、0.021)。②治疗8周后,A组HOMA-IR、TNF-α、hs-CRP分别由(3.33±0.58)下降至(2.64±0.42),(20.20±3.72)ng/L下降至(18.50±2.68)ng/L,(3.21±0.46)mg/L下降至(2.82±0.36)mg/L;B组分别由(3.19±0.33)下降至(2.97±0.37),(20.17±3.11)ng/L下降至(18.96±2.77)ng/L,(3.15±0.44)mg/L下降至(2.77±0.34)mg/L;C组分别由(3.37±0.51)下降至(2.33±0.41),(19.87±2.63)ng/L下降至(15.94±Objective To observe the therapeutic effect of Xuezhiqing combined with Atorvastatin to serum high sen sitivity C reactive protein（hs-CRP）,tumor necrosis factor α（TNF-α）,insulin resistance index（HOMA-IR）,and blood lipid in hypertension patients with metabolic syndrome（MS）.Methods 90 patients were divided into three groups by random number,each group had 30 patients.Group A was given Lipitor 10 mg once,qn;the group B was given Xuezhiqing Granule once a package,3 times a day;the group C was given Lipitor once 10 mg once,qn,with Xuezhiqing Granule once a package,3 times a day.After treatment for 8 weeks,serum levels of hs-CRP,TNF-α,HOMA-IR and blood lipid of patients were measured and compared before and after treatment.Results ①After treatment for 8 weeks,serum levels of TG,TC,and LDL-C in the group B were reduced from（1.90 ±0.65）,（5.29±1.03）,（3.89±1.10） mmol/L to（1.42±0.79）,（3.98±0.77）,（2.23±0.79） mmol/L respectively,HDL-C was evaluated from（1.11±0.26） mmol/L to（1.27±0.25） mmol/L.Serum levels of TG,TC,and LDL-C in the group A were reduced from（1.88±0.67）,（5.31±1.15）,（3.97±0.98） mmol/L to（1.70± 0.55）,（3.26 ±0.59）,（2.13 ±0.61） mmol/L respectively,HDL-C was reduced from（1.18 ±0.28） mmol/L to（1.12 ±0.25） mmol/L.Serum levels of TG,TC,and LDL-C in the group C were reduced from（1.93 ±0.54）,（5.33±0.96）,（4.12±0.96） mmol/L to（1.47 ±0.53）,（3.22±0.70）,（2.06±0.68） mmol/L,HDL-C was evaluated from（1.12 ±0.25） mmol/L to（1.42 ± 0.22） mmol/L.Serum levels of TC,LDL-C in these three groups after treatment were significantly lower than those be fore treatment（P〈0.01）;the reduction of TG and evaluation of HDL-C in the group B and group C after treatment both had significant differences（P〈0.05,P〈0.01）.For serum TC level after treatment,it had significant difference between group A and group B,as well as between the group C and the group B（both P = 0.000）,but had no significant dif

关 键 词：高血压病 代谢综合征 C反应蛋白 肿瘤坏死因子 胰岛素抵抗指数 血脂水平 血脂清 阿托伐他汀 

分 类 号：R589.5[医药卫生—内分泌] R544.1[医药卫生—内科学]