清热解毒方联合二甲双胍治疗代谢综合征合并胰岛素抵抗的临床研究  

The clinical research on treatment with Qing-re-jie-du-fang combined with Metformin Diabex for insulin resistance in the metabolic syndrome

作　　者：张意[1] 赵博 王飞 王林[3] 王淼[1] Zhang Yi;Zhao Bo;Wang Fei;Wang Lin;Wang Miao(Department of Internal Medicine of Traditional Chinese Medicine,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Xuhui Shanghai 200032,China;Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine,Jinshan Shanghai 200082,China;Shanghai Pudong New Area People's Hospital,Pudong Shanghai 200000,China)

机构地区：[1]上海中医药大学附属龙华医院中医经典病房,上海徐汇200032 [2]上海市金山区中西医结合医院,上海金山200082 [3]上海市浦东新区人民医院,上海浦东200000

出　　处：《遵义医科大学学报》2021年第2期212-217,223,共7页Journal of Zunyi Medical University

基　　金：上海市卫生和计划生育委员会科研课题(NO:20184Y0258);上海市进一步加快中医药事业发展三年行动计划(NO:ZY(2018-2020)-FWTX-6005)。

摘　　要：目的评估清热解毒方联合二甲双胍治疗代谢综合征合并胰岛素抵抗的临床疗效,观察清热解毒方治疗代谢综合征合并胰岛素抵抗患者的有效性、安全性。方法采用随机对照多中心研究方法,将收集到的66例新发诊断代谢综合征合并胰岛素抵抗患者,中医症候为湿热困脾型,按1∶1随机分组,对照组33例予常规二甲双胍治疗,试验组33例与二甲双胍加清热解毒方煎服,疗程8周,访视8周。治疗后观察评估:胰岛素抵抗指数(HOMAIR)、糖代谢指标(FPG、2hPG、FINS、2hPINS)、脂代谢指标(TG、HDL-C)、体重指数(BMI)、临床症状及不良反应发生率,比较治疗效果。结果经过干预后与对照组比较,试验组HOMAIR、糖代谢相关指标、脂代谢相关指标、BMI均得到明显改善;临床症状评分总有效率高于对照组,有显著性差异(P<0.05);治疗过程中,试验组不良反应发生率为6.1%,对照组为9.1%,无显著性差异(P>0.05)。结论清热解毒方联合二甲双胍可以明显改善代谢综合征患者的胰岛素抵抗状态及糖脂代谢水平,对减轻体重,改善临床症状有良好效果,且安全有效。Objective To evaluate the clinical efficacy of Qing-re-jie-du-fang combined with Metformin Diabex in the treatment of metabolic syndrome with insulin resistance.Methods We conducted randomized controlled multicenter study methods.Sixty-six newly diagnosed patients with metabolic syndrome with insulin resistance of dampness-heat trapped spleen type were randomly divided into two groups,33 cases in the control group treated with Metformin,and 33 cases in the treatment group treated with Qing-re-jie-du-fang and Metformin.The treatment lasted for 8 weeks,followed by visit of 8 weeks.Outcome indicators:HOMA-IR,FPG,2hPG,FINS,2hPINS,TG,HDL-C,BMI,clinical efficacy and incidence of adverse reactions.The therapeutic effect of the two groups was compared.Results Compared with the control group,in the treatment group,HOMA-IR,glucose,lipid metabolism indexes,BMI and clinical efficacy were significantly improved.There were significant differences(P<0.05).The incidence of adverse reactions was 6.1%in the treatment group and 9.1%in the control group,no significant difference between the two groups(P>0.05).Conclusion Qing-re-jie-du-fang combined with metformin can significantly improve insulin resistance and glucose,lipid metabolism of patients with metabolic syndrome,and have good effects on weight loss and clinical symptoms improvement.This combined treatment is safe and effective.

关 键 词：清热解毒方 代谢综合征 胰岛素抵抗 疗效 

分 类 号：R587.1[医药卫生—内分泌]