化浊解毒方治疗肥胖胰岛素抵抗浊毒内蕴证  

Huazhuo Jiedu Recipe in Treatment of Obesity Insulin Resistance with Turbid Toxicity Syndrome

作　　者：王晓璐 周静[2] 吴深涛[2] WANG Xiaolu;ZHOU Jing;WU Shentao(Jimo District Traditional Chinese Medicine Hospital of Qingdao City,Qingdao Shandong China 266200;The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin China 300193)

机构地区：[1]青岛市即墨区中医医院,山东青岛266200 [2]天津中医药大学第一附属医院,天津300193

出　　处：《中医学报》2022年第11期2434-2439,共6页Acta Chinese Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验继承项目{国中医药人教发[2017]29号}。

摘　　要：目的:观察化浊解毒方治疗肥胖胰岛素抵抗浊毒内蕴证患者的临床疗效。方法:选取60例肥胖胰岛素抵抗浊毒内蕴证患者,按照随机数字表法分为对照组和试验组各30例。对照组给予常规生活方式干预治疗,试验组在此基础上给予化浊解毒方。治疗12周后,比较两组患者体质量(body weight,W)、体质量指数(body mass index,BMI)、腰围、腰臀比(waist-to-hip ratio,WHR)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及中医证候积分。结果:肥胖疗效:试验组有效率为80.00%(24/30),对照组为46.67%(14/30),两组比较,差异有统计学意义(P<0.05)。中医证候疗效:试验组有效率为86.67%(26/30),对照组为46.67%(14/30),两组比较,差异有统计学意义(P<0.05)。治疗后,试验组、对照组W[83.00(76.50,89.25)kg vs 89.00(78.75,95.13)kg]、BMI[28.47(27.71,31.24)kg·m^(-2) vs 30.82(28.37,32.83)kg·m^(-2)]、FINS[15.30(13.33,16.00)mU·L^(-1) vs 17.00(15.45,20.48)mU·L^(-1)]、HOMA-IR[3.56(3.04,4.01)vs 4.22(3.54,5.18)]比较,差异均有统计学意义(P<0.05)。治疗后,试验组、对照组腰围[(96.33±4.88)cm vs(98.90±4.74)cm]比较,差异有统计学意义(P<0.05)。治疗后,试验组、对照组TG[1.80(1.54,2.00)mmol·L^(-1) vs 2.00(1.50,2.40)mmol·L^(-1)]、LDL-C[2.80(2.40,2.90)mmol·L^(-1) vs 3.00(2.90,3.10)mmol·L^(-1)]比较,差异均有统计学意义(P<0.05)。治疗后,试验组、对照组中医证候积分[10.00(8.00,12.25)分vs 14.00(12.00,15.25)分]比较,差异有统计学意义(P<0.05)。结论:化浊解毒方治疗肥胖胰岛素抵抗浊毒内蕴证临床疗效显著,可显著降低患者体质量、体质量指数,改善血糖、血脂代谢,且未见明显不良反应。Objective:To observe the clinical curative effect of Huazhuo Jiedu Recipe in the treatment of obese patients with insulin resistance and turbid toxicity syndrome.Methods:Selected 60 obese patients with insulin resistance and turbid toxicity,and divided them into the control group and the experimental group with 30 cases in each group according to the random number table method.The control group was given routine lifestyle intervention,and the experimental group was given Huazhuo Jiedu Recipe on this basis.After 12 weeks of treatment,the body weight(W),body mass index(BMI),waist circumference,waist-to-hip ratio(WHR),and fasting insulin(fasting insulin)were compared between the two groups.(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(total cholesterol,TC),low-density lipoprotein cholesterol(low-density lipoprotein cholesterol,LDL-C)and TCM syndrome scores.Results:Obesity curative effect:The effective rate was 80.00%(24/30)in the experimental group and 46.67%(14/30)in the control group,and the difference was statistically significant(P<0.05).Efficacy of TCM syndromes:the effective rate was 86.67%(26/30)in the experimental group and 46.67%(14/30)in the control group,the difference was statistically significant(P<0.05).After treatment,the experimental group and the control group was compared in W[83.00(76.50,89.25)kg vs 89.00(78.75,95.13)kg],BMI[28.47(27.71,31.24)kg·m^(-2) vs 30.82(28.37,32.83)kg·m^(-2)],FINS[15.30(13.33,16.00)mU·L^(-1) vs 17.00(15.45,20.48)mU·L^(-1)]and HOMA-IR[3.56(3.04,4.01)vs 4.22(3.54,5.18)],and the differences were statistically significant(P<0.05).After treatment,the waist circumference of the experimental group and the control group was compared[(96.33±4.88)cm vs(98.90±4.74)cm],and the difference was statistically significant(P<0.05).After treatment,TG[1.80(1.54,2.00)mmol·L^(-1) vs 2.00(1.50,2.40)mmol·L^(-1)],LDL-C[2.80(2.40,2.90)mmol·L^(-1) vs 3.00(2.90,3.10)mmol·L^(-1)

关 键 词：肥胖 胰岛素抵抗 浊毒内蕴证 化浊解毒方 血脂 血糖 

分 类 号：R259.87[医药卫生—中西医结合]