防己黄芪汤对肥胖患者减重后体质量反弹及外周血Th1、Th2细胞水平变化的影响  

Effects of Stephania Root and Astragalus Decoction on Weight Regain and Peripheral Blood Th1/Th2 Cell Levels in Obese Patients After Weight Loss

作　　者：姜健 殷苏勤 刘曼曼 陈见纺[1] 严军[1] JIANG Jian;YIN Suqin;LIU Manman;CHEN Jianfang;YAN Jun(Shanghai Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China)

机构地区：[1]上海市嘉定区中医医院,上海201800

出　　处：《中医药学报》2025年第3期61-66,共6页Acta Chinese Medicine and Pharmacology

基　　金：上海市“十四五”中医特色专科项目(中医内分泌科)(ZYTSZK1-10);上海市嘉定区卫生健康委科研基金(2021-QN-ZYY-02);嘉定区“疁城杏林”人才培养项目(JDLCXLQNXZ-25)。

摘　　要：目的:观察防己黄芪汤对肥胖患者减重后体质量反弹和外周血Th1、Th2细胞水平变化的影响。方法:本研究纳入90例减重成功的肥胖患者,运用简单排序随机化方法,随机分成对照组45例,治疗组45例。治疗过程中,治疗组脱落3例,对照组脱落5例。治疗组予以防己黄芪颗粒剂联合生活方式干预,对照组给予生活方式干预,疗程3个月,观察体质量(包括体质量反弹率)、腰围、BMI、胰岛素抵抗指数、HbA1c和血脂、外周血Th1、Th2细胞比例及Th1/Th2比值等疗效指标,以及肝肾功能等安全性指标。结果:治疗后,治疗组体质量反弹率为19.05%(8/42),低于对照组的50.00%(20/40)(P<0.01),治疗组体质量、BMI、腰围较治疗前下降,且差异有统计学意义(P<0.01);对照组体质量、BMI、腰围较治疗前上升,且差异有统计学意义(P<0.05)。治疗组体质量、BMI、腰围的变化明显优于对照组(P<0.01)。治疗组HOMA-IR、HbA1c、总胆固醇较治疗前下降(P<0.05),而甘油三酯、高密度脂蛋白、低密度脂蛋白较治疗前无明显变化(P>0.05);对照组HOMA-IR、甘油三酯较治疗前上升(P<0.05),而HbA1c、总胆固醇、高密度脂蛋白、低密度脂蛋白较治疗前无明显变化(P>0.05)。治疗组HOMA-IR、总胆固醇、甘油三酯变化明显优于对照组(P<0.05,P<0.01)。治疗组外周血Th1细胞比例较治疗前下降(P<0.01),而外周血Th2细胞比例较治疗前上升(P<0.05),Th1/Th2比值有下降趋势,但差异无统计学意义(P>0.05);对照组外周血Th1细胞比例较治疗前上升(P<0.05),而Th2细胞比例及Th1/Th2比值较治疗前无明显变化(P>0.05);治疗组患者外周血Th1变化优于对照组(P<0.05),而两组患者外周血Th2、Th1/Th2比值变化幅度不明显(P>0.05)。治疗后,治疗组患者中医证候疗效的总有效率为85.71%(36/42),优于对照组的总有效率47.50%(21/40),且差异具有统计学意义(P<0.01)。两组患者肝肾功能未见明显异常。结论:防己黄芪�Objective:To observe the effects of Stephania Root and Astragalus Decoction on weight regain and changes in peripheral blood Th1/Th2 cell levels in obese patients after weight loss.Methods:This study included 90 obese patients who successfully lost weight.They were randomly assigned to a control group(45 cases)and a treatment group(45 cases)using simple randomization.During the treatment,3 cases dropped out from the treatment group and 5 cases from the control group.The treatment group was given Stephania Root and Astragalus granules combined with lifestyle intervention,while the control group received only lifestyle intervention.The treatment duration was 3 months.Efficacy indicators such as body weight(including weight regain rate),waist circumference,BMI,insulin resistance index,HbA1c,blood lipids,and peripheral blood Th1/Th2 cell proportions and Th1/Th2 ratio were observed,as well as safety indicators such as liver and kidney function.Results:After treatment,the weight regain rate in the treatment group was 19.05%,which was significantly lower than 50.00%in the control group(P<0.01).The treatment group showed a statistically significant decrease in body weight,BMI,and waist circumference compared to before treatment(P<0.01).In contrast,the control group experienced a statistically significant increase in body weight,BMI,and waist circumference(P<0.05).The changes in body weight,BMI,and waist circumference were more pronounced in both groups(P<0.01).The treatment group showed a decrease in HOMA-IR,HbA1c,and total cholesterol compared to before treatment(P<0.05),while triglycerides,high-density lipoprotein,and low-density lipoprotein showed no significant changes(P>0.05).The control group showed an increase in HOMA-IR and triglycerides compared to before treatment(P<0.05),with no significant changes in HbA1c,total cholesterol,high-density lipoprotein,and low-density lipoprotein(P>0.05).The changes in HOMA-IR,total cholesterol,and triglycerides were significant in both groups(P<0.05,P<0.01),while the changes in

关 键 词：防己黄芪汤 体质量反弹 肥胖记忆 随机对照研究 

分 类 号：R256.3[医药卫生—中医内科学]