消脂方联合生活方式干预治疗肾元亏虚、痰瘀阻滞、热结在里型单纯性肥胖临床观察  

Clinical Observation of Xiaozhi Decoction(消脂方)Combined with Lifestyle Intervention in Treating Obesity Patients with Deficiency of Kidney Element and Stagnation of Phlegm and Blood Stasis

作　　者：孙怡婕[1] 冯强[1] 张栩[1,2] 李红 SUN Yijie;FENG Qiang;ZHANG Xu;LI Hong(Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China;Laboratory of Geriatric Care Techniques and Inheritance,Institute of Geriatrics,Fudan University Institute of Integrated Chinese and Western Medicine,Shanghai 200040,China;Longhua Hospital Affiliated to Shanghai University of traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]复旦大学附属华东医院,上海200040 [2]复旦大学中西医结合研究院老年医学研究所老年保健技术和传承研究室,上海200040 [3]上海中医药大学附属龙华医院,上海200032

出　　处：《辽宁中医药大学学报》2022年第2期75-79,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：上海市科委医学引导类(中医)科技支撑项目(18401902000、18401900800);上海市科学技术委员会“科技创新行动计划”(19140904600);上海市中医药事业发展三年行动计划(2018-2020-CCCX-2002-08)。

摘　　要：目的针对肾元亏虚、痰瘀阻滞、热结在里型单纯性肥胖的患者在生活方式干预的基础上配合中药消脂方治疗并观察其临床疗效。方法采用随机对照法,选择84例18~65岁肾元亏虚、痰瘀阻滞型单纯性肥胖患者,分为试验组(消脂方汤剂,n=42),对照组(荷丹片,n=42)进行治疗,疗程12周。观察两组治疗前后中医证候积分、体质量、BMI、WHR、BF%以及相关实验室指标(FPG、2 h PPG、HbA1c、C0、LDL、HDL、TG、TC)的变化情况,观察不良反应情况及停药后随访。结果消脂方试验组临床总有效率85.71%,中医有效率83.33%,荷丹片对照组分别为73.17%、56.10%,消脂方疗效更优。消脂方试验组及荷丹片对照组疗后、随访时体质量及BMI均低于疗前,消脂方试验组疗后降幅优于荷丹片对照组。两组WHR、BF%、LDL、TG、TC、2 h PPG均较治疗前下降,HDL较前升高,消脂方试验组HbA1c、C0较治疗前下降。治疗后消脂方试验组BF%、LDL、2 h PPG低于荷丹片对照组,?BF%、?2 h PPG高于荷丹片对照组,差异均具统计学意义(P<0.05或P<0.01)。消脂方试验组不良反应发生率21.43%,荷丹片对照组21.95%,两组差异无统计学意义(P>0.05)。结论消脂方联合生活方式干预可有效治疗肾元亏虚、痰瘀阻滞、热结在里型单纯性肥胖患者,显著改善中医证候及糖脂代谢,降低体质量、BMI、WHR、BF%水平,疗效优于荷丹片,安全有效,值得临床应用推广。Objective To observe the clinical effect of Xiaozhi Decoction(消脂方)combined with lifestyle intervention on obesity with deficiency of kidney element and stagnation of phlegm and blood stasis.Methods 84 obesity patients aged 18-65 years who were suffered from deficiency of kidney element,stagnation of phlegm and blood stasis were divided into experimental group(Xiaozhi Decoction,n=42)and control group[Hedan Tablet(荷丹片),n=42],and treated for 12 weeks.The changes of TCM symptom score,body weight,BMI,WHR,BF%,FPG,2 h PPG,Hb A1 c,C0,LDL,HDL,TG,TC were observed before and after treatment,and the adverse reactions were observed.The changes of body weight and BMI of the two groups were followed up after 12 weeks.Results The total clinical effective rate of Xiaozhi Decoction experimental group was 85.71%,and the effective rate of TCM was 83.33%.And those of Hedan Table control group were 73.17%and 56.10%.Xiaozhi Decoction was better than Hedan Tablet.After treatment,the body weight and BMI of Xiaozhi Decoction were lower than that of Hedan Tablet group;and lower than before treatment.After treatment WHR,BF%,LDL,TG,TC,2 h PPG,decreased and HDL increased in the two groups,while Hb A1 c and C0 decreased in the Xiaozhi Decoction(P<0.05 or P<0.01).BF%,LDL and 2 h PPG in Xiaozhi Decoction group were lower than those in Hedan Tablet group,and△BF%,△2 h PPG were higher than those in Hedan Tablet group after treatment(P<0.05 or P<0.01).The incidence of adverse reactions was 21.43%in Xiaozhi Decoction group and 21.95%in Hedan Tablet group(P>0.05).Conclusion Xiaozhi Decoction combined with lifestyle intervention can effectively treat obesity with kidney element and stagnation of phlegm and blood stasis,significantly improve TCM syndrome,glycolipid metabolism;reduce body weight,BMI,WHR,BF%,UA level;protect liver function;the effect is better than Hedan Tablet;the incidence of adverse reactions has no difference with Hedan Tablet,which is worthy of clinical application and promotion.

关 键 词：单纯性肥胖 消脂方 中医治疗 生活方式干预 

分 类 号：R259[医药卫生—中西医结合]