隔药饼灸修复血管内皮功能调节血脂治疗高脂血症的临床机制研究  

Clinical mechanism of moxibustion on herbal cake in treating hyperlipidemia by repairing vascular endothelial function to regulate blood lipid

作　　者：彭涵 李芊 刘红华[2] 邹逸凡 李丹 葛君芸[1] 常小荣[1] 刘迈兰[1] PENG Han;LI Qian;LIU Honghua;ZOU Yifan;LI Dan;GE Junyun;CHANG Xiaorong;LIU Mailan(College of Acupuncture&Tuina and Rehabilitation,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;School of Nursing,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Shenzhen Nanshan Medical Group Headquarters,Shenzhen,Guangdong 518000,China;Changsha Hospital of Chinese Medicine,Changsha,Hunan 410004,China)

机构地区：[1]湖南中医药大学针灸推拿与康复学院,湖南长沙410208 [2]湖南中医药大学护理学院,湖南长沙410208 [3]深圳市南山区医疗集团总部,广东深圳518000 [4]长沙市中医院,湖南长沙410004

出　　处：《湖南中医药大学学报》2023年第8期1478-1485,共8页Journal of Hunan University of Chinese Medicine

基　　金：国家自然科学基金项目(82074559,81704182);湖南省科技计划项目(2022RC1222);湖南省教育厅优秀青年基金项目(19B435,19B428);长沙市杰出创新青年培养计划项目(kq1905036);湖南中医药大学研究生创新课题(2022CX111)。

摘　　要：目的探究隔药饼灸修复血管内皮功能调节血脂治疗高脂血症患者的临床作用机制。方法选取湖南中医药大学第一附属医院及周边社区卫生服务机构招募符合纳入标准的60例高脂血症(低密度脂蛋白胆固醇增高)患者随机分为隔药饼灸组与辛伐他汀组,每组30例。隔药饼灸组给予隔药饼灸法,采用两组穴位(Ⅰ组:巨阙、天枢、丰隆;Ⅱ组:心俞、肝俞、脾俞)交替施灸;辛伐他汀组给予口服辛伐他汀。两组均治疗12周,随访4周、12周。采集治疗前后、随访期间两组患者的临床疗效、临床症状积分、临床症状积分疗效、血液流变学、同型半胱氨酸(homocysteine,Hcy)及胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)各指标进行比较分析。结果治疗后两组临床疗效比较,隔药饼灸组有效率86.67%,辛伐他汀组有效率93.33%,差异无统计学意义(P>0.05)。临床症状积分比较,隔药饼灸组治疗前后差值明显优于辛伐他汀组,差异有统计学意义(P<0.05)。临床症状积分疗效比较,隔药饼灸组有效率76.67%,辛伐他汀组有效率40.00%,差异有统计学意义(P<0.05)。治疗后两组均能有效上调患者IGF-1水平,差异有统计学意义(P<0.05),但两组间的IGF-1值变化差异无统计学意义(P>0.05)。治疗前后,两组对血液流变学及Hcy指标均有显著调控作用(P<0.05);随访4周,隔药饼灸组对血液流变学、Hcy指标改善均与辛伐他汀组差异显著(P<0.05);随访12周,两组血液流变学、Hcy指标变化与治疗前比较,差异均无统计学意义(P>0.05)。结论隔药饼灸可能通过调节IGF-1与Hcy的水平,调控血液流变学各指标,缓解内皮功能障碍,维持内皮功能稳定,从而调节血脂治疗高脂血症。且隔药饼灸近期调控作用优于辛伐他汀,具有疗效稳定的特点。Objective To investigate the mechanism of action of moxibustion on herbal cake(MHC)in repairing vascular endothelial function to regulate blood lipid in patients with hyperlipidemia.Methods Sixty patients with hyperlipidemia(increased low-density lipoprotein cholesterol)who met the inclusion criteria were recruited from the First Hospital of Hunan University of Chinese Medicine and surrounding community health service centers.Then they were randomly divided into MHC group(n=30)and simvastatin group(n=30).The patients in MHC group were treated with moxibustion on herbal cake alternately at two groups of acupoints:group I including Juque(RN14),Tianshu(ST25),and Fenglong(ST40)and group II including Xinshu(BL15),Ganshu(BL18),and Pishu(BL20),while the patients in simvastatin group were given oral simvastatin.Both groups were treated for 12 weeks,and followed up for 4 and 12 weeks.The clinical efficacy,clinical symptom score,clinical symptom score efficacy,indexes of hemorheology,levels of homocysteine(Hcy),and insulin-like growth factor 1(IGF-1)before and after treatment as well as during the follow-ups were compared and analyzed between the two groups.Results After treatment,the clinical efficacy of the two groups was compared.The effective rate of MHC group was 86.67%and that of simvastatin group was 93.33%,and the difference was not statistically significant(P>0.05).The difference value between clinical symptom scores before and after treatment in MHC group was significantly greater than that in simvastatin group,meanwhile,for the clinical symptom score efficacy,the effective rate was 76.67%in MHC group and 40.00%in simvastatin group,with the difference being statistically significant(P<0.05).After treatment,both groups could effectively up-regulate the IGF-1 level of patients with a statistically significant difference(P<0.05),but the difference in the changes of IGF-1 value between the two groups was not statistically significant(P>0.05).After treatment,the hemorheological and Hcy indexes were significantly regul

关 键 词：隔药饼灸 辛伐他汀 高脂血症 内皮功能 胰岛素样生长因子1 同型半胱氨酸 血液流变学 

分 类 号：R245[医药卫生—针灸推拿学]