加味小承气汤联合穴位埋线治疗食源性肥胖胃热湿阻证的临床疗效  

Clinical Efficacy of Modified Xiao Chengqitang Combined with Acupoint Catgut Implantation in Treating Diet-induced Obesity Syndrome of Stomach Heat Dampness Obstruction

作　　者：商德俊 杜建明[2] 梁启军[3] 陶琦[4] SHANG De-jun;DU Jian-ming;LIANG Qi-jun;TAO Qi(Changzhou No.1 People's Hospital,Changzhou 213011,China;Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine,Wuxi 214177,China;Jiangxi Provincial Hospital of Chinese Medicine,Nanchang 330019,China;Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]常州市第七人民医院,江苏常州213011 [2]南京中医药大学无锡附属医院,江苏无锡214177 [3]江西省中医院,南昌330019 [4]江苏省中医院,南京210029

出　　处：《中国实验方剂学杂志》2021年第23期131-136,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：江苏省医学科技攻关计划项目(201703018)。

摘　　要：目的:观察加味小承气汤联合穴位埋线治疗食源性肥胖(DIO)胃热湿阻证的临床疗效与安全性。方法:将172例患者按随机数字表法分为对照组84例和观察组88例。两组患者均给予饮食和运动的生活方式调整,并进行穴位埋线,10 d进行1次,间隔5 d再行1次埋线,共埋6次。观察组服用加味小承气汤颗粒剂,10 g/次,分早晚2次温开水冲服;对照组服用加味小承气汤颗粒剂模拟剂,10 g/次,温开水冲服,2次/d。两组疗程均为4个月。测量治疗前后体质量指数(BMI),脂肪百分率(F%),肥胖度、腰臀比(WHR),采用彩色多普勒超声检查仪测量腹部脂肪厚度、肝前脂肪厚度(AHF),肾周脂肪囊厚度(PRF),并计算内脏脂肪指数(UVI);检测治疗前后空腹血糖(FBG),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),空腹胰岛素(FINS),瘦素(LP),脂联素(APN),并计算胰岛素抵抗指数(HOMA-IR);进行安全性评价。结果:观察组患者BMI,F%,肥胖度和WHR均低于对照组(P<0.05,P<0.01);观察组患者皮下脂肪厚度,AHF,PRF和UVI均低于对照组(P<0.01);观察组患者TG,TC,LDL-C和FINS均低于对照组(P<0.01);观察组患者LP和HOMA-IR均低于对照组(P<0.01),APN高于对照组(P<0.01);观察组的临床疗效总有效率为(71/80)88.75%,高于对照组的(57/75)76.00%(χ^(2)=4.374,P<0.05)。结论:加味小承气汤联合穴位埋线治疗胃热湿阻型DIO,可调节LP,APN等因子,改善糖、脂等能量代谢,能有效控制肥胖情况,且安全,值得临床使用。Objective:To observe the clinical efficacy and safety of modified Xiao Chengqitang combined with acupoint catgut implantation in treating diet-induced obesity(DIO)syndrome of stomach hea dampness obstruction.Method:One hundred and seventy-two patients were randomly divided into control group(84 cases)and observation group(88 cases).Both groups of patients received diet and exercise lifestyle adjustments,and acupoint catgut implantation was performed,10 days for 1 time,5 days intervals and then catgut implantation again,for a total of 6 times.Patients in observation group took modified Xiao Chengqitang granular powder,10 g/time,with lukewarm boiled water in morning and evening.Patients in control group took modified Xiao Chengqitang granular powder simulant,10 g/time,with lukewarm boiled water,2 times/day.The treatment courses continued 4 months in two groups.Then the body mass index(BMI),fat percentage(F%),obesity,waist to hip ratio(WHR)were measured before and after treatment.Color Doppler ultrasonography was used to measure abdominal fat thickness,prehepatic fat thickness(AHF),perirenal fat thickness(PRF),and visceral fat index(UVI).Fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),highdensity lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),fasting insulin(FINS),leptin(LP),and adiponectin(APN)were detected before and after treatment,and the homeostasis model assessment of insulin resistance(HOMA-IR)index was calculated.In addition,safety evaluation was also conducted.Result:The BMI,F%,obesity degree and WHR in observation group were all lower than those in control group(P<0.05 or P<0.01).Subcutaneous fat thickness,AHF,PRF and UVI in observation group were lower than those in control group(P<0.01).The TG,TC,LDL-C and FINS levels in observation group were lower than those in control group(P<0.01).The LP and HOMA-IR were also lower than those in control group(P<0.01),while the APN was higher than that in control group(P<0.01).The total effective rate in clinical applicatio

关 键 词：食源性肥胖症 胃热湿阻证 小承气汤 穴位埋线 脂肪细胞因子 

分 类 号：R289[医药卫生—方剂学] R584[医药卫生—中药学]