滋阴清心汤对代谢综合征患者脂联素、瘦素、肿瘤坏死因子-α的影响

Influence of Ziyin Qingxin Decoction on Adiponectin,Leptin,and TNF-α of Patients with Metabolic Syndrome

目的探讨滋阴清心汤对代谢综合征患者胰岛素抵抗(IR)、脂联素、瘦素、肿瘤坏死因子-α(TNF-α)的影响以及相关的作用机制。方法将患者随机分为两组,对照组在停用影响血糖及胰岛素功能的药物及在严格控制饮食的基础上服用罗格列酮4mg,每日1次;治疗组在此基础上服用滋阴清心汤。观察治疗前后血压(BP)、血脂、血糖IR指数、脂联素、瘦素及TNF-α的变化。结果两组治疗后疗效比较差异有统计学意义(P<0.05);治疗后两组代谢综合征患者血清IR指数、瘦素、TNF-α、脂联素与治疗前比较均有明显改善(P<0.05),治疗组治疗后与对照组比较差异有统计学意义(P<0.05);脂联素与腰围、IR指数、BP呈明显负相关(P<0.05),瘦素与WC、IR指数、甘油三酯(TG)呈明显正相关(P<0.05),TNF-α与BP、IR指数、瘦素呈明显正相关(P<0.05),与脂联素呈明显负相关(P<0.05)。结论滋阴清心汤和罗格列酮治疗代谢综合征疗效肯定,可能与改善脂肪组织所分泌脂联素、瘦素、TNF-α和胰岛素抵抗有关。

Objective To discuss the influence and mechanism of Ziyin Qingxin Decoction （Decoction for replenishing Yin and clearing heart） on insulin resistance （IR）, adiponectin, leptin, and TNF-α of patients with the metabolic syndrome. Methods The randomly divided two groups took rosiglitazone 4mg once a day based on stopping the drugs affecting blood glucose and insulin functions and on the strict diet. In addition, the treatment group took Ziyin Qingxin Decoction. Blood pressure （BP）, blood lipid, blood glucose, IR, adiponectin, leptin and TNF-α before were observed and after treatment. Results The therapeutic effect of two groups was significantly different （P〈0.05）. IR, leptin, TNF-α and adiponectin of the two groups were improved with a significant difference （P〈0. 05）. Compared with control group, the treatment group had a significant difference after treatment （P〈0.05）. Adiponectin was negatively correlated to waist circumference, IR, and BP （P〈0. 05）, while leptin positively correlated to waist circumference, IR, and TG （P〈0.05）. TNF-α was positively correlated to BP, IR index, and leptin （P〈0.05）, while negatively correlated to adiponectin （P〈0.05）. Conclusion The good effect of Ziyin Qingxin Decoction and rosiglitazone for metabolic syndrome may be related with the improvement of fat tissue in secreting adiponectin, leptin and TNF-α and the insulin resistance as well.