健脾清化方改善代谢综合征患者内皮功能的临床研究

Clinical Research on Changes of Endothelial Function in Patients with Metabolic Syndrome Treated by"Jianpi Qinghua Decoction"

目的评价健脾清化方对代谢综合征患者血管内皮功能的作用及可能途径。方法采用随机双盲平行安慰剂对照的方法,治疗组和对照组各观察28例,通过8周临床治疗,比较治疗前后内皮依赖性血管舒张功能(高分辨血管外彩色多普勒测定肱动脉反应性充血后血管内径的最大变化率)、血管内皮相关因子(NO、ET-1)、胰岛素抵抗(HOMA2-IR)的变化。结果干预后治疗组的肱动脉内径最大变化率高于对照组(P<0.05),治疗组血清NO浓度高于对照组(P<0.05),治疗组血浆ET-1浓度下降(P<0.05),对照组治疗前后无明显变化(P>0.05),治疗组HOMA2-IR下降(P<0.05),对照组治疗前后无明显变化(P>0.05)。结论健脾清化方能改善代谢综合征患者血管内皮功能,其作用途径可能是降低血浆ET-1浓度、升高血清NO浓度和减轻胰岛素抵抗。

Objective To evaluate the endothelium function in patients with MS treated by ＂Jianpi Qinghua Decoction＂ and explore its mechanism. Methods A randomized double-blind placebo-controlled test was conducted, and through observations for 8 weeks, we measured changes of two groups in endothehum dependent dilation （ percentage of brachial artery diameter change of reactive hyperemia measured by high resolution ultrasonography ） and blood concentrations of endothelium-related factors（NO,ET-1） ,as well as insulin resistance（HOMA2-IR）was measured for comparison. Results Before treatment, there were no significant differ- ences of percentage of braehial artery diameter change, serum concentrations of NO and HOMA2-IR between groups （ P 〉 0.05 ） , but with significant differences after treatment （ P 〈 0.05 ）. In treatment group, both percentages of brachial artery diameter change and serum concentrations of NO increased, while HOMA2-IR decreased. There were significant differences of plasma concentrations of ET-1 between groups before treatment （ P 〈 0.05 ）. The treatment group recorded lower indexes in plasma ET-1, but the placebo group was on the other hand. Conclusion ＂Jianpi Qinghua Decoction＂ can improve endothelium function in patients with MS possibly by increasing NO, decreasing ET-1 and insulin resistance.