加味半夏白术天麻汤对痰湿壅盛型代谢综合征的影响

Effects of Modified Banxia Baizhu Tianma Decoction on Metabolic Syndrome of Exuberance of Phlegm-dampness Type

目的:通过比较二甲双胍与加味半夏白术天麻汤对痰证症状的改变、以及血压、降糖、减肥、调节脂代谢、胰岛素敏感性指数等指标变化,提供代谢综合征相关中医的解释和分型以及治疗思路。方法:随机分为加味半夏白术天麻汤组和二甲双胍组,两组疗程均为6周,记录两组治疗前后空腹血糖、两组餐后2h血糖、血脂、血压,体重指数、腹围、空腹血胰岛素、及临床疗效观察表。结果:加味半夏白术天麻汤组在治疗后收缩压和舒张压都有降低;加味半夏白术天麻汤组病人经治疗后空腹血糖和餐后2h血糖均有降低;加味半夏白术天麻汤可改善胰岛素抵抗的指标;加味半夏白术天麻汤组治疗后低密度脂蛋白有明显降低,而高密度脂蛋白均有明显升高,并可降低胆固醇、甘油三酯、ApoB水平;加味半夏白术天麻汤组中药组在治疗后体重指数有下降;临床治疗疗效结果和治疗前后的病人证候积分显示加味半夏白术天麻汤组治疗有明显改善临床症状的作用。结论:加味半夏白术天麻汤不仅可降低血压、降糖、减肥、调节脂代谢、对胰岛素抵抗具有改善作用,还能改善痰湿壅盛型代谢综合征的临床症状。加味半夏白术天麻汤与二甲双胍对痰湿壅盛型代谢综合征治疗各有所长。

Objective： To explore the relationship between the phlegm syndrome and metabolic syndrome by comparing the effects of Modified Banxia Baizhu Tianma Decoction and Metformine on the changes of symptoms, OGTr, lipid, blood pressure, abdominal circumference, BMI, and ISI in patients with metabolic syndrome of exuberance of phlegm - dampness type. Methods： Confirmed metabolic syndrome of exuberance of phlegm - dampness type patients were random- ly divided into Modified Banxia Baizhu Tianma Decoction group and Mefformine group. The changes of symptoms, OGTT, lipid, blood pressure, abdominal circumference, BMI, and fasting insulin level were observed before and after the course of treatment. Results ： Both SBP and DBP in treatment group were lowered after treatment; Both FBG and OGTT in treatment group were reduced after treatment. There was elevation of ISI in treatment group after treatment;There was reduction of LDL, cholesterol, triglyceride and ApoB, and remarkable elevation of HDL in treatment group after treatment; BMI in treatment group decreased after treatment;There was significant improvement in symptoms in treatment group after treatment;Each of Modified Banxia Baizhu Tianma Decoction and Mefformine had its own strong points in the treatment of metabolic syndrome of exuberance of phlegm - dampness type.