治未病思想指导下加味黄连温胆汤治疗代谢综合征患者心血管危险因素的临床疗效  

Clinical Observation of Modified Huanglian Wendantang in Treatment of Cardiovascular Risk Factors in Patients with Metabolic Syndrome Under Guidance of Treating Disease before Its Onset

作　　者：韩艺 韩宇博[2] 邹国良[2] 王瑞楠 姚春丽 董新禹 刘莉[2] HAN Yi;HAN Yubo;ZOU Guoliang;WANG Ruinan;YAO Chunli;DONG Xinyu;LIU Li(Heilongjiang University of Chinese Medicine,Harbin 150040,China;First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第一医院,哈尔滨150040

出　　处：《中国实验方剂学杂志》2025年第9期142-149,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82074346);国家自然科学基金面上项目(82274473);国家自然科学基金青年基金项目(82205060);黑龙江省博士后经费项目(LBH-Z18253)。

摘　　要：目的:观察治未病思想指导下加味黄连温胆汤治疗代谢综合征患者心血管危险因素的临床效果。方法:选取黑龙江中医药大学附属第一医院2023年7月至2024年7月收治的82例代谢综合征患者,采用随机数字表法分为观察组(41例)和对照组(41例),其中对照组给予常规治疗,观察组在对照组常规治疗基础上联合加味黄连温胆汤治疗,2组治疗时间均为8周。评估2组治疗后中医证候疗效,观察2组患者治疗前后肥胖程度指标、血压指标、糖脂代谢指标、炎症因子、血管内皮功能指标水平及治疗安全性。结果:治疗后,观察组中医证候疗效总有效率为97.56%(40/41),对照组总有效率为87.80%(36/41),观察组明显优于对照组(χ^(2)=5.205,P<0.05);与本组治疗前比较,治疗后2组患者收缩压(SBD)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、负荷后后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质量、腹围(WC)、腰臀比(WHR)及瘦素(LEP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)、诱导型一氧化氮合酶(iNOS)均明显降低(P<0.05),与对照组治疗后比较,观察组患者以上指标降低更明显(P<0.05,P<0.01),观察组优于对照组。与本组治疗前比较,2组患者高密度脂蛋白胆固醇(HDL-C)、脂联素(ADP)、一氧化氮(NO)、内皮型一氧化氮合酶(eNOS)水平均明显升高(P<0.05),与对照组治疗后比较,观察组患者以上指标升高更显著(P<0.01)。结论:本文在治未病思想的指导下选用加味黄连温胆汤治疗代谢综合征患者,提高临床疗效,改善IR提高胰岛素敏感性,改善炎症状态,保护血管内皮功能,从而控制心血管危险因素,并且未见不良反应,值得临床应用和推广。Objective:To observe the clinical effect of modified Huanglian Wendantang on cardiovascular risk factors in patients with metabolic syndrome under the guidance of treating disease before its onset.Methods:A total of 82 patients with metabolic syndrome treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from July 2023 to July 2024 were selected and allocated into an observation group(41 cases)and a control group(41 cases)by the random number table method.The control group received routine treatment,and the observation group was treated with modified Huanglian Wendantang on the basis of routine treatment.Both groups were treated for 8 weeks.The therapeutic effects on TCM symptoms after treatment in the two groups were evaluated.The levels of obesity degree indicators,blood pressure indicators,glucose and lipid metabolism indicators,inflammatory factors,and vascular endothelial function indicators before and after treatment in the two groups were measured,and the treatment safety was evaluated.Results:After treatment,the total response rate of TCM symptoms in the observation group was 97.56%(40/41),which was higher than that(87.80%,36/41)in the control group(χ^(2)=5.205,P<0.05).After treatment,both groups showed declines(P<0.05)in systolic blood pressure(SBD),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),fasting blood glucose,2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),Homeostatic Model Assessment for Insulin Resistance(HOMA-IR),body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),leptin(LEP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),endothelin-1(ET-1),and inducible nitric oxide synthase(iNOS).Moreover,the declines in the observation group were more obvious than those in the control group(P<0.05,P<0.01).After treatment,both groups showed elevated levels of high density lipoprotein cholesterol(HDL-C),adiponectin(ADP),nitric oxide(NO),and e

关 键 词：治未病 代谢综合征 黄连温胆汤 心血管危险因素 临床观察 

分 类 号：R259[医药卫生—中西医结合] R541.8[医药卫生—中医内科学] R256.2[医药卫生—中医学]