益气化聚方治疗脾虚痰湿型腹型肥胖  

Treatment of Abdominal Obesity with Spleen Deficiency and Phlegm Dampness with Yiqi Huaju Prescription

作　　者：张曾[1] 万雪影 周凤珠 张端淳 傅晓东[3] 冯晓桃[4] 何燕铭[1] ZHANG Zeng;WAN Xueying;ZHOU Fengzhu;ZHANG Duanchun;FU Xiaodong;FENG Xiaotao;HE Yanming(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai China 200437;Shihudang Community Health Service Center of Songjiang District of Shanghai,Shanghai China 201604;Huashan Hospital,Fudan University,Shanghai China 200400;Guangxi University of Chinese Medicine/Guangxi Key Laboratory of Basic Research of Traditional Chinese Medicine,Nanning Guangxi China 530200)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市松江区石湖荡镇社区卫生服务中心,上海201604 [3]复旦大学附属华山医院,上海200400 [4]广西中医药大学/广西中医基础研究重点实验室,广西南宁530200

出　　处：《中医学报》2023年第2期397-402,共6页Acta Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(82004263);国家自然科学基金面上项目(81973818);上海市卫健委中医专科培育项目;广西中医基础研究重点实验室开放课题项目(20-065-53-09);上海申康医院发展中心临床创新三年行动计划项目(SHDC12019124)。

摘　　要：目的:观察益气化聚方治疗脾虚痰湿型腹型肥胖患者的临床疗效。方法:采用随机双盲安慰剂对照法,将60例脾虚痰湿型腹型肥胖患者随机分为治疗组与对照组,各30例。治疗组在饮食及运动等基础治疗上给予益气化聚方,对照组在基础治疗上给予安慰剂。两组临床观察周期均为12周。比较两组患者治疗前后的形体学指标[体质量、腰围、腰围身高比、体质量指数(body mass index,BMI)]、糖脂代谢指标[总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、空腹血糖(fasting plasma glucose,FPG)]及中医临床证候。结果:治疗后,两组患者体质量、腰围、腰围身高比、BMI均显著降低(P<0.05),治疗组以上指标低于同期对照组(P<0.05);治疗组TG、TC、LDL-C、FINS和HOMA-IR均显著降低(P<0.05),治疗组与对照组TG[(1.42±0.53) mmol·L^(-1)vs(2.62±0.97) mmol·L^(-1)]、FINS[(22.35,18.1) mU·L^(-1)vs(35.23,19.85 mU·L^(-1))]和HOMA-IR[(5.45±2.25)vs(8.56±2.81)P<0.001]比较,差异均有统计学意义(P<0.001);治疗组与对照组中医证候积分[(7.03±3.60)分vs(14.63±3.19)分]比较,差异有统计学意义(P<0.001);治疗组有效率为90.0%,对照组有效率为36.7%,两组比较,差异有统计学意义(P<0.001)。结论:益气化聚方能有效降低脾虚痰湿型腹型肥胖患者体质量、腰围、腰围身高比、BMI,调节脂代谢异常,改善胰岛素抵抗及中医临床证候。Objective:To observe the clinical efficacy of Yiqi Huaju Prescription in treating abdominal obesity patients with Spleen deficiency and phlegm-dampness type.Methods:Using randomized double-blind placebo-controlled method,60 abdominal obesity patients with Spleen deficiency and phlegm-dampness type were randomly divided into a treatment group and a control group,30 cases in each group.The treatment group was given Yiqi Huaju Prescription on top of diet and exercise,and the control group was given placebo on top of basic treatment.The clinical observation period of both groups was 12 weeks.The physical indicators [body mass,waist circumference,waist-to-height ratio,body mass index(BMI)],glucose and lipid metabolism indicators [total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),fasting Insulin( FINS),fasting plasma glucose(FPG) ] and TCM clinical syndromes.Results:After treatment,the body weight,waist circumference,waist-to-height ratio,and BMI of the two groups were significantly reduced(P<0.05),and the above indicators in the treatment group were lower than those in the control group during the same period(P<0.05).TG,TC,LDL-C,FINS,and HOMA-IR in the treatment group were significantly decreased(P<0.05),and comparing TG [(1.42±0.53) mmol·L^(-1) vs(2.62±0.97) mmol·L^(-1)],FINS [(22.35,18.1) mU L^(-1) vs(35.23,19.85 mU·L^(-1))] and HOMA-IR [(5.45±2.25) vs(8.56±2.81) P<0.001] between the treatment group and the control group,the differences were statistically significant(P<0.001).And there was a statistically significant difference between the treatment group and the control group in TCM syndrome scores [(7.03±3.60) points vs(14.63±3.19) points](P<0.001).The effective rate of the treatment group was 90.0%,and that of the control group was 36.7%.There was a statistically significant difference between the two groups(P<0.001).Conclusion:Yiqi Huaju Prescription can effectively reduce body weight,waist circumf

关 键 词：腹型肥胖 益气化聚方 脾虚痰湿证 胰岛素抵抗 中医证候 

分 类 号：R212[医药卫生—中医学]