健脾益肾化浊方联合生活方式干预对肥胖型多囊卵巢综合征患者胰岛素抵抗及糖脂代谢的影响  

Effects of Jianpi Yishen Huazhuo prescription combined with lifestyle on insulin resistance and glucose and lipid metabolism in obese polycystic ovary syndrome

作　　者：张晓静 季德江 冯亚宏 杜翠忠 马梅香 李玲义 ZHANG Xiaojing;JI Dejiang;FENG Yahong;DU Cuizhong;MA Meixiang;LI Lingyi(Ningxia Hui Autonomous Region Oriental Medicine Hospital and Institute of Oriental Medicine,Yinchuan 750021,China;Gansu University of Chinese Medicine,Lanzhou 730030,China)

机构地区：[1]宁夏回族自治区中医医院暨中医研究院,宁夏银川750021 [2]甘肃中医药大学,甘肃兰州730030

出　　处：《陕西中医》2025年第5期624-629,共6页Shaanxi Journal of Traditional Chinese Medicine

基　　金：宁夏自治区重点研发计划项目(2022BEG03137);第七批自治区青年科技人才托举工程项目[宁科协发组字(2023)6号];国家中医药管理局青年岐黄学者培养项目[国中医药人教函(2022)256号];中央财政转移支付地方项目(国家中医药管理局科技司)-中医药循证能力提升项目(妇科);青年拔尖人才培养项目[宁人社函(2017)787号]。

摘　　要：目的:探讨健脾益肾化浊方联合生活方式对肥胖型多囊卵巢综合征(PCOS)胰岛素抵抗及糖脂代谢的影响。方法:选取88例肥胖型PCOS患者,对照组及试验组各44例。两组均由专业的营养师给予生活方式干预指导,对照组给予二甲双胍肠溶片,试验组给予健脾益肾化浊方,共治疗3个月经周期。观察两组患者治疗前后体重指数(BMI)变化情况;生化分析仪测定空腹葡萄糖(FPG)、胰岛素(INS)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平;ELISA法测定白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)、胰高血糖素(GC)、抵抗素(Resistin)、性激素水平[促卵泡生成素(FSH)、促黄体生成素(LH)、垂体泌乳素(PRL)、雌二醇(E2)、孕酮(P)、睾酮(T)、硫酸脱氢表雄酮(DHES)];Western blot检测脂联素(ADPN)、瘦素(Leptin)、脂肪酸结合蛋白(FABP1)、脂肪酸转运蛋白(FATP2)、脂肪酸氧化酶(FAO)指标情况。结果:治疗后,两组患者BMI均显著下降,试验组在LDL-C和HDL-C水平的改善显著优于对照组(P<0.01),而两组在FPG、INS、TC和TG方面比较差异无统计学意义(P>0.05);对照组的T和E2的水平显著降低,试验组的T和DHES显著下降;试验组IL-6、TNF-α和Resistin有轻微的下降趋势(均P<0.05);健脾益肾化浊方治疗后的PCOS患者体内的Leptin和FATP2的蛋白表达极显著下调(P<0.001),ADPN、FAO表达极显著上调(P<0.001,P<0.01)。结论:健脾益肾化浊方联合生活方式干预能够升高ADPN及FAO蛋白表达,下调Leptin和FATP2的蛋白表达,调节激素水平、改善糖脂代谢,提高胰岛素敏感性,从而发挥治疗作用。Objective:To explore the effects of Jianpi Yishen Huazhuo prescription combined with lifestyle on insulin resistance and glucose and lipid metabolism in obese polycystic ovary syndrome(PCOS).Methods:A total of 88 obese PCOS patients,44 in control group and 44 in test group,were selected.Both groups were given lifestyle intervention guidance by professional dietitians,the control group was given metformin enteric-coated tablets,and the test group was given Jianpi Yishen Huazhuo prescription,a total of 3 menstrual cycles.The changes of body mass index(BMI)before and after treatment were observed.The levels of fasting glucose(FPG),insulin(INS),cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were measured by biochemical analyzer.Serum levels of interleukin-6(IL-6),tumor necrosis factor(TNF-α),glucagon(GC),Resistin(Resistin),sex hormones follicle-stimulating hormone(FSH),luteinizing hormone(LH),pituitary prolactin(PRL),estradiol(E2),progesterone(P),testosterone(T),sulfur were measured by ELISA Acid dehydroepiandrosterone(DHES);Western blot detection of adiponectin(ADPN),leptin(leptin),fatty acid binding protein(FABP1),fatty acid transporter protein(FATP2),fatty acid oxidase(FAO)indexes.Results:After treatment,BMI was significantly decreased in both groups,and the improvement of LDL and HDL levels in test group was significantly better than that in control group(P<0.01),but there were no significant differences in fasting blood glucose,fasting insulin,triglyceride and total cholesterol between two groups(P>0.05).The levels of T and E2 in the control group were significantly decreased,and the levels of T and DHES in the experimental group were significantly decreased.In the test group,IL-6,TNF-αand Resistin showed a slight tendency to decline(all P<0.05).The protein expressions of Leptin and FATP2 in PCOS patients treated with Jianpi Yishen Huazhuo prescription were significantly down-regulated(P<0.001),and the expressions of ADPN and FAO were s

关 键 词：多囊卵巢综合征 肥胖 胰岛素抵抗 健脾益肾化浊方 生活方式 糖脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]