中西医结合治疗代谢综合征临床研究  

Clinical Study on the Treatment of Metabolic Syndrome with Integrated Traditional Chinese and Western Medicine

作　　者：谭娟[1] 杨晶[2] 

机构地区：[1]延安大学附属医院,陕西延安716000 [2]延安市人民医院,陕西延安716000

出　　处：《中医学报》2016年第10期1569-1572,1577,共5页Acta Chinese Medicine

基　　金：陕西省中医药管理局科技计划项目(20140375)

摘　　要：目的:观察二陈五苓汤配合西医常规疗法治疗代谢综合征痰浊阻遏证的临床疗效及对血清白细胞介素(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factors-α,TNF-α)、脂联素((adiponectin,APN)和瘦素(leptin,LP)水平的影响。方法:将110例患者随机按数字法分为对照组和观察组,每组55例。对照组给予生活方式干预,并给予降血压和降血糖治疗;降血脂采用阿托伐他汀钙片治疗,每次10 mg,每天1次,口服。观察组在对照组治疗基础上加服二陈五苓汤治疗,每天1剂。两组患者疗程均为2个月。检测治疗前后空腹血糖(fasting blood sugar,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycated hemoglobin,Hb A1c)、空腹胰岛素(fasting insulin,FINS)水平,计算胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛素抵抗指数(insulin resistance index,HOMA-IR);测量体质量、腰围和臀围,计算WHR和BMI;检测治疗前后三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL-C)和低密度脂蛋白(low density lipoprotein,LDL-C)水平;检测治疗前后IL-6、TNF-α、APN和LP水平;进行治疗前后痰浊阻遏证证候评分。结果:观察组有效率为92.73%,对照组有效率为78.18%,两组比较,差异有统计学意义(χ2=4.681,P<0.05);治疗后观察组体质量、腰围、WHR和BMI均低于对照组,但组间比较差异无统计学意义(P>0.05);治疗后观察组FBG、2 h PBG和Hb A1c水平均低于对照组,差异有统计学意义(P<0.05);治疗后观察组FINS和HOMA-IR低于对照组,ISI高于对照组,差异有统计学意义(P<0.01);治疗后观察组TG水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.01),治疗后两组TC和LDL-C水平比较,差异无统计学意义(P>0.05);治疗后观察组APN高于对照组,LP、IL-6和TNF-α水平低于对照组,差异有统计学意义(P<0.01)。结论:在西医常规治疗的基础上加�Objective： To observe the clinical effect of Erchen Wuling Tang combined with routine western medicine therapy in the treatment of metabolic syndrome with sputum stasis obstruction syndrome,and its effect on serum interleukin-6（ IL-6）,tumor alpha necrosis factors-α（ TNF-α）,adiponectin（ APN） and leptin（ LP） level. Methods： 110 cases were randomly divided into thecontrol group and the observation group,55 cases in each group. The control group was given lifestyle intervention,and given antihypertensive and hypoglycemic lipid-lowering therapy; treatment by Atorvastatin Calcium Tablets,10 mg each time,one time a day,oral. The observation group was additionally given Erchen Wuling Tang,daily 1 agent. The courses of two groups were 2months. Detected the fasting blood glucose（ FBG）,2-hour postprandial blood glucose（ 2 h PBG）,glycated hemoglobin（ HbA 1c）,fasting insulin（ FINS） level,calculated the insulin sensitivity index（ ISI）,insulin resistance index（ HOMA-IR）; measured of body weight,waist and hip circumference,calculated of WHR and BMI; detected triglyceride（ TG） and total cholesterol（ TC）,highdensity lipoprotein（ HDL-C） and low density lipoprotein（ LDL-C） level before and after treatment. Detected the levels of IL-6,TNF-α,APN and LP before and after treatment; and scored sputum stasis syndrome before and after treatment. Results： The effective rate of observation group was 92. 73%,the control group was 78. 18%,and the difference was statistically significant（ χ^2=4. 681,P〈0. 05）; after treatment,the body mass,waist circumference,WHR and BMI were lower than the control group,but there was no significant difference between the two groups（ P〉0. 05）; after treatment,FBG,2 hP G and HbA 1c levels of the observation group were lower than that of the control group,and the difference was statistically significant（ P〈0. 05）; after treatment,the FINS and HOMA-IR in the observation group were lower than the control group,ISI was higher than the

关 键 词：代谢综合征 痰浊阻遏证 二陈五苓汤 白细胞介素 肿瘤坏死因子-Α 中医疗法 中西医结合 

分 类 号：R259.892[医药卫生—中西医结合]