小檗碱治疗代谢综合征合并肾损害的临床观察  

Therapeutic Effect of Berberine on Metabolic Syndrome Combined with Renal Damage

作　　者：陈小青[1] 付婷婷[1] 王丽萍[1] 张勇[1] 庄永泽[1] 

机构地区：[1]南京军区福州总医院肾内科,福建医科大学福总临床医学院,福州350025

出　　处：《中国中西医结合肾病杂志》2017年第4期320-324,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然基金面上项目(No.81373837);福建省自然科学基金资助项目(No.2014J01371)

摘　　要：目的:观察小檗治疗热盛证代谢综合征合并肾损害患者的临床疗效。方法:将20例代谢综合征合并肾损害热盛证的患者随机分为治疗组和对照组,治疗组10例给予盐酸小檗碱300 mg,3次/d治疗,对照组10例采用常规西药治疗,疗程8周,观察两组治疗前后中医热盛证证候积分、BMI、腰围、空腹血糖(FPG)、餐后2 h血糖(2HPG)、空腹胰岛素水平(FINS)、血脂(TG、HDL-C)、收缩压(SBP)、舒张压(DSP)、尿微量白蛋白/肌酐比值(U-m Alb/C)、血肌酐(Scr)、尿素氮(BUN)的变化及不良事件等安全性指标。结果:两组病人临床资料差异无统计学意义。(1)治疗8周后,治疗组BMI值、2HPG、TG较治疗前下降,治疗组下降显著,差异有统计学意义(P<0.05),治疗4周、8周之间差异有统计学意义(P<0.05)。对照组TG较治疗前下降显著,差异有统计学意义(P<0.05)。而在腰围、FINS、FPG、HDL-C、血压(包括收缩压及舒张压)等指标上两组治疗前后比较及组间比较差异均无统计学意义(均P>0.05)。(2)治疗8周后对照组和治疗组U-m Alb/C分别较治疗前下降(7.37±3.14)mg/mmol和(24.74±19.29)mg/mmol(均P<0.05)。两组下降幅度差异有统计学意义(P<0.05)。(3)对照组和治疗组热盛证积分分别下降(1.80±0.79)和(0.80±0.84)(P<0.05),两组证候积分下降幅度差异有统计学意义(P<0.05)。(4)治疗组中医症状有效率80%,对照组20%,两组比较差异有统计学意义(P<0.05)。(5)治疗8周中两组不良事件发生率差异无统计学意义,且均未发生严重不良事件。结论:小檗碱可以减少热盛证代谢综合征合并肾损害患者的尿蛋白,降低其BMI、餐后血糖及三酰甘油水平,同时明显改善中医热盛证临床症状,且无严重不良反应。Objective：To observe the clinical effects of BBR（Berberine） on the treatment of metabolic syndrome combined with renal damage of heat hyperactivity syndrome. Methods： Twenty patients were assigned randomly into two groups ： treatment group in which 10 cases were treated with BBR（ ） , and control group, in which 10 canse were treated with basic treatment. The therapeutic course for both groups was 8 weeks. The indexes of efficacy, including heat syndrome scores, BMI, waist circumerence, fasting plasma glucose （FPG） , 2 h postprandial blood glucose （2HPG） , fasting insulin （FINS） , lipids （TG, HDL- C ） , systolic blood pressure （SBP） , diastolic blood pressure （DSP） , microalbuminuria / creatinine ratio （U -mAlb / C） and occurrence of adverse eventswere observed. Results ：There was no significant statistical difference between the two group s in aspects of baseline clinical figures. （ 1 ） After 8 weeks of treatment, In treatment group, BMI, 2HPG, TG than before treatment had statistical significance （ P 〈 0.05 ） , differences in treatment for 4 weeks, 8 weeks had statistical significance （ P 〈 0.05 ）. In control group, TG was significantly decreased compared with before treatment, there are significant differences （ P 〈 0.05 ）. There was no significant differences of waist circumference, FINS, FPG, HDL - C and blood pressure before and after treatment in two groups （P 〉 0. 05）. （2） After 8 weeks of treatment, the content of urine trace albumin/creatinine ratio significantly decreased by （7.37 ± 3.14 ） mg/mmol and （24.74 ± 19.29 ） mg/mmol respectively in the two groups, showing significant difference in comparing with baseline, and in comparison between groups （ P 〈 0.05 ）. （ 3 ） The seores of heat syndrome in the two groups decreased by（ 1. 80 ± 0.79 ） scores and （ 0.80 ± 0.84 ） scores respectively with significant difference as compared with base line （P 〈 0.05 ）, and in comparison between groups （P �

关 键 词：代谢综合征 肾损害 热盛证 小檗碱 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]