调气通路法结合西药治疗原发性高血压病胰岛素抵抗的临床研究  

Clinical effect of Tiaoqi Tonglu therapy combined with Western medicine in treatment of insulin resistance in primary hypertension

作　　者：陆新 云宇 LU Xin;YUN Yu(Guangxi International Zhuang Medicine Hospital,Nanning 530001,Guangxi,China)

机构地区：[1]广西国际壮医医院,广西南宁530001

出　　处：《湖南中医杂志》2021年第10期1-4,11,共5页Hunan Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区科技厅自然科学基金面上项目(2017GXNSFAA198143)。

摘　　要：目的:探讨调气通路法结合常规西药治疗原发性高血压病胰岛素抵抗(IR)气虚血瘀证的疗效及对脂代谢、C反应蛋白(CRP)、心血管危险因子的影响。方法:将120例高血压病IR气虚血瘀证患者随机分治疗组与对照组,每组各60例。对照组采用常规西药盐酸贝那普利治疗,治疗组在对照组的基础上加用调气通路汤治疗。比较2组降压疗效,中医证候疗效,体质量、体质量指数及腰围,空腹胰岛素(FINS)及胰岛素敏感指数(ISI),血脂指标[包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)]与CRP水平。结果:降压疗效总有效率、中医证候疗效总有效率、随访半年的血压达标率治疗组分别为96.67%(58/60)、98.33%(59/60)、68.33%(41/60),对照组分别为80.00%(48/60)、70.00%(42/60)、28.33%(17/60),组间比较,差异均有统计学意义(均P<0.01)。与本组治疗前比较,治疗组体质量、体质量指数、腰围、FINS、ISI、TC、TG、LDL-C、CRP均有明显改善(P<0.05或P<0.01),而对照组仅FINS、ISI、TC、TG、HDL-C有明显改善(P<0.05或P<0.01);2组治疗后比较,体质量、体质量指数、腰围、FINS、ISI、TC、TG、HDL-C、LDL-C、CRP差异均有统计学意义(P<0.05或P<0.01)。结论:调气通路法结合常规西药治疗原发性高血压病IR气虚血瘀证有较好的近期及远期降压疗效,并能改善临床症状体征及心血管病危险因子,其机制与改善胰岛素敏感性和调节患者血脂水平、稳定高密度脂蛋白、抑制炎症通路有关。Objective: To investigate the clinical effect of Tiaoqi Tonglu therapy combined with conventional Western medicine treatment in the treatment of insulin resistance(IR) with Qi deficiency and blood stasis syndrome in primary hypertension and its effect on lipid metabolism, C-reactive protein, and cardiovascular risk factors.Methods: A total of 120 patients with hypertension and IR with Qi deficiency and blood stasis syndrome were randomly divided into treatment group and control group, with 60 patients in each group.The patients in the control group were given conventional Western medicine benazepril, and those in the treatment group were given Tiaoqi Tonglu decoction in addition to the treatment in the control group.The two groups were compared in terms of response to antihypertensive treatment, treatment outcome of traditional Chinese medicine(TCM) syndrome, body weight, body mass index and waist circumference, fasting insulin(FINS) and insulin sensitivity index(ISI),blood lipid parameters [total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)],and C-reactive protein(CRP).Results: There were significant differences between the treatment group and the control group in the overall response rate of antihypertensive treatment [96.67%(58/60) vs 80.00%(48/60),P<0.01],the overall response rate of TCM syndrome [98.33%(59/60) vs 70.00%(42/60),P<0.01],and the rate of blood pressure reaching the standard after follow-up for half a year [68.33%(41/60) vs 28.33%(17/60),P<0.01].After treatment, the treatment group had significant improvements in body weight, body mass index, waist circumference, FINS,ISI,TC,TG,LDL-C,and CRP(P<0.05 or P<0.01),while the control group only had significant improvements in FINS,ISI,TC,TG,and HDL-C(P<0.05 or P<0.01),and there were significant differences between the two groups in body weight, body mass index, waist circumference, FINS,ISI,TC,TG,HDL-C,LDL-C,and CRP(P<0.05 or P<0.01).Conclusion: Tiaoqi Tonglu therapy combined

关 键 词：原发性高血压病 胰岛素抵抗 气虚血瘀证 中西医结合疗法 调气通路法 

分 类 号：R259.441.1[医药卫生—中西医结合] R259.873[医药卫生—中医内科学]