辨证施灸治疗高脂血症49例临床观察

Clinical Observation on Moxibustion Based on Symptoms Differentiation for 49 Cases of Hyperlipemia

目的观察辨证施灸对高脂血症患者的临床疗效。方法 103例高脂血症患者随机分为艾灸组51例及西药组52例。艾灸组采用艾条温和灸的方法,在主穴神阙、足三里、三阴交的基础上,气虚痰阻型加丰隆,阴虚阳亢型加太溪,脾肾阳虚型加关元。每穴艾灸10 min,每周3次,共灸8周。西药组口服非诺贝特片,每日300 mg,分3次服,共8周。治疗前后比较两组患者血脂相关指标及临床疗效,并观察两组患者肝功能、肾功能、心电图、血常规、尿常规以评价治疗的安全性。结果艾灸组临床疗效总有效率为71.4%,西药组为66.7%,两组比较差异无统计学意义(P>0.05)。两组患者治疗后总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均较治疗前有不同程度下降,但差异均无统计学意义(P>0.05),两组间比较差异亦无统计学意义(P>0.05)。艾灸组治疗后丙氨酸氨基转移酶显著下降,且显著低于西药组(P<0.05)。门冬氨酸氨基转移酶、碱性磷酸酶、尿素氮、肌酐治疗前后两组间比较,差异均无统计学意义(P>0.05)。两组治疗后心电图的正常例数均较本组治疗前有所增加,但两组间比较差异无统计学意义(P>0.05)。结论辨证施灸治疗高脂血症与非诺贝特片疗效相当,且对患者丙氨酸氨基转移酶亦有改善。

Objective To observe the clinical curative effects of moxibustion based on symptoms differentiation in the treatment of patients with hyperlipemia. Methods Totally 103 cases of patients with hyperlipemia were ran- domly divided into the moxibustion group with 51 cases and the western medicine group with 52 cases. The moxibus- tion group was treated using moxa stick for mild moxibustion method. In addition to the basic acupoints Shenque （CVS）, Zusanli （ST36）, and Sanyinjiao （SP6）, Fenglong （ST40） was added for patients with Qi deficiency- caused phlegm stagnation syndrome, Taixi （KI3） was added for those with yin deficiency and yang hyperactivity syn- drome, and Guanyuan （CV4） was added for those with yang deficiency of spleen and kidney syndrome. Moxibustion was given on each point for 10 min, twice every week for 8 weeks in total. The western medicine group was given Fenofibrate pills 300 mg every day for 8 weeks in total. The related blood lipid index and clinical curative effects of two groups were compared before and after treatment. Liver-kidney function, electrocardiogram, blood routine tests, urine routine tests of two groups were observed to evaluate safety of the treatment. Results The total clinical cura- tive effective rate of the moxibustion group was 71.4% , while that of the western medicine group was 66. 7% , with no statistically significant difference between the two groups （P 〉 0. 05 ）. Levels of total cholesterol, triaeylglycerol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol of two groups all decreased to different degree after treatment, but with no statistically significant difference between before and after treatment （ P 〉 0. 05 ）. Also the there was no signi-ficant difference in the decreses between the two groups （ P 〉 0. 05 ）. Level of alanine aminotrans- ferase of the moxibustion group remarkably decreased after treatment, and it was significant lower than that of the western medicine group （P 〈 0. 05 ）. There were no statistically significant differences in levels of aspartate aminotransferase, alkaline phosphatase, urea nitrogen and creatinine in two groups both before and after treatment （P 〉0.05 ）. Cases with normal electrocardiogram increased in both two groups after treatment, but also with no statistically significant difference between the two groups （P 〉 0. 05 ）. Conclusion In treating hyperlipemia, moxi- bustion based on symptoms differentiation shows an equal therapeutic effect with Fenofibrate pills, and it also improves the level of alanine aminotransferase .