益气健脾化浊法对代谢综合征患者胰岛素敏感性影响的研究

Effect of Therapy of Strengthening Spleen,Replenishing Qi and Resolving Turbidity on Insulin Sensitivity of Metabolic Syndrome Patients

目的:观察根据益气健脾化浊法拟定的消脂汤对代谢综合征(MS)患者胰岛素敏感性的影响。方法:将符合纳入标准的MS患者80例随机分为2组各40例。中药组在基础治疗上加用消脂汤治疗;西药组在基础治疗上加服二甲双胍治疗。2组疗程均为8周。观察2组治疗前后体重指数(BM)I、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2h血糖(2hPG)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、胰岛素敏感指数(IS)I、中医证候积分的变化。结果:中药组患者治疗后BMI、WHR、SBP、FPG、2hPG、TG、LDL-C、ISI均较治疗前下降,差异有显著性或非常显著性意义(P<0.05,P<0.01),2组治疗后WHR、SBP、TG、ISI比较,差异均有显著性意义(P<0.05);中医证候积分方面,中药组疗效优于西药组,差异有显著性意义(P<0.05)。消脂汤未见明显不良反应,二甲双胍出现胃肠道不适等副作用。结论:益气健脾化浊法组成的消脂汤对MS患者具有较好的降糖减重、降压调脂的功效,其增加胰岛素敏感性作用与二甲双胍相当,在改善全身症状方面疗效优于二甲双胍,且不良反应较小,是干预MS的有效方法。

Objective： To observe Xiaozhi decoction, a prescription with the action of strengthening spleen, replenishing qi and resolving turbidity on insulin sensitivity of metabolic syndrome （MS） patients. Methods： Eighty patients subjecting to the inclusion criteria were equally randomized into two groups. The Chinese medicine（CM）group received Xiaozhi decoction on the basis of the conventional treatment, and the western medicine（WM）group received metformin on the basis of the conventional treatment. The treatment course lasted eight weeks. Body mass index （BMI）, waist to hip ratio（WHR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting plasma glucose （FPG）, 2-h postprandial plasma glucose （2hPG）, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, insulin sensitive index （ISI） and the scores of Chinese medical syndrome were observed before and after treatment. Results： After treatment, BMI, WHR, SBP, FPG, 2hPG, TG, LDL-C of the CM group were decreased （P 〈 0.05 compared with those before treatment）, ISI was lowered obviously （P 〈 0.01compared with that before treatment）. The improvement of SBP, WHR, TG level and the scores of Chinese medical syndrome in the CM group was superior to that in the WM group. No obvious side effect was present in CM group, while gastrointestinal side effect was found in WM group. Conclusion. Xiaozhi decoction has certain effect on reducing glucose, losing weight and adjusting blood lipid. Its effect on increasing the insulin sensitivity is similar to metformin. Xiaozhi decoction has better effect on relieving symptoms and has fewer side effects, which is effective for the intervention of MS.