基于“痰瘀同治”理论治疗超重/肥胖糖耐量异常  

Clinical study on the treatment of impaired glucose tolerance in overweight/obesity individuals based on the theory of synchronically treating phlegm and blood stasis

作　　者：包扬[1] 赵亮 韩笑[1] 吴巍[1] 张蒙蒙 高艺玲 邓永志[5] BAO Yang;ZHAO Liang;HAN Xiao;WU Wei;ZHANG Mengmeng;GAO Yiling;DENG Yongzhi(Department of Endocrine Metabolic Diseases,the Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China;Department of Geriatrics,Jilin Hospital of Traditional Chinese Medicine,Jilin 132011,China;School of Traditional Chinese Medicine,Changchun University of Chinese Medicine,Changchun 130117,China;School of Health Management,Changchun University of Chinese Medicine,Changchun 130117,China;College of Integrated Traditional Chinese and Western Medicine,Changchun University of Chinese Medicine,Changchun 130022,China)

机构地区：[1]长春中医药大学附属医院内分泌代谢病科,长春130021 [2]吉林市中医院老年病科,吉林吉林132011 [3]长春中医药大学中医学院,长春130117 [4]长春中医药大学健康管理学院,长春130117 [5]长春中医药大学中西医结合学院,长春130022

出　　处：《长春中医药大学学报》2024年第8期869-873,共5页Journal of Changchun University of Chinese Medicine

基　　金：吉林省中医药科技项目(2022032)。

摘　　要：目的基于“痰瘀同治”理论,运用痰瘀同调方治疗超重/肥胖糖耐量异常人群,评价痰瘀同调方治疗超重/肥胖糖耐量异常人群的临床有效性及安全性。方法选择超重/肥胖糖耐量异常痰湿瘀滞证患者72例,随机分为对照组与治疗组,各36例,对照组予基础治疗,治疗组在对照组基础上联合痰瘀同调方治疗。治疗3个月后观察2组体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、空腹血清胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、血脂以及中医痰湿瘀滞症状积分等指标变化,客观评价痰瘀同调方的临床疗效。结果治疗组治疗后BMI、WC、WHR、FPG、2 h PG、HbAlc、FINS、HOMA-IR、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),均较治疗前有明显改善,且改善程度均优于对照组(P<0.05);治疗组治疗后改善患者形体肥胖、腹部增大、脘腹胀满、倦怠乏力、胸闷、便溏、口淡无味或黏腻等中医症状方面均优于对照组(P<0.05);治疗组中医证候综合疗效总有效率明显高于对照组(P<0.05)。2组研究过程中均未出现不良事件。结论痰瘀同调方干预治疗超重/肥胖糖耐量异常效果明显,安全性良好。Objective To evaluate the clinical efficacy and safety of synchronically regulating phlegm and blood stasis prescription in the treatment of impaired glucose tolerance in overweight/obesity individuals based on the theory of"synchronically treating phlegm and blood stasis".Methods 72 overweight/obesity patients with impaired glucose tolerance and syndrome of stagnation and congelation of phlegm-damp were selected and randomly divided into the control group and the treatment group,with 36 cases in each group.The control group received basic treatment,and the treatment group received combined treatment with synchronically regulating phlegm and blood stasis prescription on the basis of the treatment of the control group.After 3 months of treatment,the changes of body mass index(BMI),waist circumference(WC),waist-hip ratio(WHR),the levels of fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc),fasting insulin(FINS)and blood lipids,and homeostasis model assessment-insulin resistance(HOMA-IR),and traditonal Chinese medicine(TCM)stagnation and congelation of phlegm-damp symptom score in two groups were observed.The clinical efficacy of synchronically regulating phlegm and blood stasis prescription was evaluated objectively.Results After treatment,compared with before treatment,BMI,WC,WHR,the levels of FPG,2hPG,HbAlc and FINS,HOMA-IR,and the levels of triglyceride(TG)and high density lipoprotein cholesterol(HDL-C)in the treatment group were significantly improved,and the improvement degree in the treatment group was better than that in the control group(P<0.05).After treatment,compared with the control group,the treatment group showed better improvement in TCM symptoms such as physical obesity,abdominal enlargement,amassment disease of epigastrium and abdomen,fatigue,chest tightness,loose stool,and tastelessness in mouth or sticky and greasy in mouth(P<0.05).After treatment,the total effective rate of TCM syndromes in the treatment group was significantly higher than that in

关 键 词：痰瘀同治 超重/肥胖 糖耐量异常 

分 类 号：R259[医药卫生—中西医结合]