健脾祛湿膏干预痰湿体质代谢综合征的效果及其对血浆脂蛋白磷脂酶A2的影响  

Efficacy of Jianpi Qushi Soft Extract on Phlegm-dampness Constitution Patients with Metabolic Syndrome and Its Influence on Plasma Lipoprotein-associated Phospholipase A2

作　　者：庄晓鸣 龙艳 毕小丽 ZHUANG Xiao-Ming;LONG Yan;BI Xiao-Li(Preventive Treatment Center,Guangzhou Integrated Chinese and Western Medicine Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510800 Guangdong,China;Dept.of Endocrinology,Guangzhou Integrated Chinese and Western Medicine Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510800 Guangdong,China)

机构地区：[1]广州中医药大学附属广州中西医结合医院治未病中心,广东广州510800 [2]广州中医药大学附属广州中西医结合医院内分泌科,广东广州510800

出　　处：《广州中医药大学学报》2020年第4期605-611,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20182117)。

摘　　要：【目的】观察健脾祛湿膏干预痰湿体质代谢综合征(MS)患者的临床疗效及其对血浆脂蛋白磷脂酶A2(Lp-PLA2)的影响。【方法】将90例痰湿体质MS患者按治疗意愿分为治疗组和对照组,每组各45例。2组患者均给予统一的基础治疗(包括饮食、运动指导及健康宣教),在此基础上,对照组给予阿卡波糖口服(餐时嚼服)治疗,治疗组给予健脾祛湿膏口服治疗,疗程为90 d。观察2组患者治疗前后体质量指数(BMI)、腰臀比(WHR)、血压[收缩压(SBP)和舒张压(DBP)]、血糖[空腹血糖(FPG)和餐后2 h血糖(2 hPG)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]、胰岛素水平[空腹胰岛素(FINS)及餐后2 h胰岛素(2hFINS)]、胰岛素抵抗指数(HOMA-IR)及血浆Lp-PLA2水平的变化情况,并评价2组患者的中医证候疗效及安全性。【结果】(1)中医证候疗效方面:治疗后,治疗组的总有效率为93.33%,对照组为77.78%,治疗组的疗效明显优于对照组(P<0.05)。(2)临床及生化指标方面:治疗后,2组患者的BMI、血压(SBP和DBP)、血脂(TC、TG、LDL-C)、血糖(FPG和2h PG)、胰岛素水平(FINS和2hFINS)、HOMA-IR及Lp-PLA2水平均较治疗前明显改善(P<0.05或P<0.01),且除2 hPG外,治疗组的改善作用均明显优于对照组(P<0.05或P<0.01)。(3)安全性方面:观察过程中,2组患者均未发现明显的不良反应,血、尿、大便常规和心电图及肝肾功能检查均未发现与治疗有关的异常改变。【结论】健脾祛湿膏可改善痰湿体质代谢综合征患者的代谢性指标及胰岛素抵抗水平,其机理可能与调节炎症标志物Lp-PLA2的水平有关。Objective To observe the clinical efficacy of Jianpi Qushi Soft Extract,a Chinese patent medicine with the actions of invigorating spleen and dispelling dampness,on phlegm-dampness constitution patients with metabolic syndrome(MS),and to investigate its influence on plasma lipoprotein-associated phospholipase A2(LpPLA2).Methods Ninety phlegm-dampness MS constitution patients were divided into treatment group and control group according to the patients’intention to treat,45 cases in each group.The two groups were given conventional fundamental treatment such as guidance for diet,exercises and health training,and additionally the control group was given chewable administration with acarbose at meal time,and the treatment group was given oral use of Jianpi Qushi Soft Extract.The treatment course for the two groups covered 90 days.Before and after treatment,we monitored the body mass index(BMI),waist-hip ratio(WHR),blood pressure of systolic blood pressure(SBP)and diastolic blood pressure(DBP),blood sugar levels of fasting plasma glucose(FPG)and 2-hour postprandial glucose(2 hPG),blood lipid levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C),insulin levels of fasting insulin(FINS)and 2-hour fasting insulin(2 hFINS),homeostasis model assessment of insulin resistance(HOMA-IR),and plasma Lp-PLA2 level.After treatment,the clinical efficacy on traditional Chinese medicine(TCM)syndrome and clinical safety in the two groups were evaluated.Results(1)After treatment,the total effective rate for TCM syndrome efficacy in the treatment group was 93.33%,and that in the control group was 77.78%,the clinical efficacy of the treatment group being superior to that in the control group(P<0.05).(2)After treatment,BMI,blood pressure of SBP and DBP,blood lipid levels of TC,TG and LDL-C,blood sugar levels of FPG and 2 hPG,insulin levels of FINS and 2 hFINS,HOMA-IR,and Lp-PLA2 level in the two groups were obviously improved in comparison with those be

关 键 词：代谢综合征 痰湿体质 健脾祛湿膏 胰岛素抵抗 脂蛋白磷脂酶A2 

分 类 号：R259.89[医药卫生—中西医结合]