健脾利湿化浊汤联合常规西药治疗代谢综合征疗效观察及对脂联素和性激素结合球蛋白的影响

Clinical effect observation of Jianpi Lishi Huazhuo decoction combined with conventional western medications in treating metabolic syndrome and its impact on adiponectin and sex hormone binding globulin

目的观察健脾利湿化浊汤联合常规西药治疗代谢综合征(MS)的临床疗效,及对脂联素(APN)和性激素结合球蛋白(SHBG)的影响。方法将80例MS患者按照随机数字表法分为2组,治疗组40例予健脾利湿化浊汤联合常规西药治疗,对照组40例予常规西药治疗,2组均治疗4周。比较2组疗效;观察2组治疗前后血压、体质量指数(BMI)及主要肝功能、血脂、血糖指标变化;比较2组治疗前后APN、SHBG水平变化。结果治疗组总有效率85.00%(34/40),对照组总有效率70.00%(28/40),治疗组疗效优于对照组(P<0.05)。治疗组治疗后收缩压、舒张压、BMI均较本组治疗前降低(P<0.05),对照组治疗后BMI较本组治疗前降低(P<0.05);治疗后治疗组收缩压、舒张压、BMI均低于对照组(P<0.05)。2组治疗后AST、ALT水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后TG、TC、LDL-C水平均较本组治疗前降低(P<0.05),HDL-C较本组治疗前升高(P<0.05),且治疗后治疗组TG、TC、LDL-C水平均低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。2组治疗后FPG、2 hPG及HbA 1c水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后APN、SHBG水平均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。结论健脾利湿化浊汤联合常规西药治疗MS疗效确切,能有效控制患者血压、血脂、血糖,升高血清APN、SHBG水平。

Objective To observe the clinical efficacy of Jianpi Lishi Huazhuo decoction combined with conventional western medications in treating metabolic syndrome(MS).And to explore its impact on adiponectin(APN)and sex hormone binding globulin(SHBG).Methods 80 MS patients were divided into the treatment group(n=40)and the control group(n=40)according to the random number table.Patients in the treatment were treated with Jianpi Lishi Huazhuo decoction combined with conventional western medications while the control group with conventional western medications.The treatment period for both groups was four weeks.The therapeutic effects on the two groups were compared.And changes in the main liver functions,blood lipid,blood pressure,blood sugar,and body mass index(BMI)of the two groups were observed before and after treatment.Besides,the levels of APN and SHBG of the two groups were compared before and after treatment.Results The total effective rate(85.00%,34/40)in the treatment group was higher than that of the control group(70.00%,28/40).After treatment,the results of systolic pressure,diastolic pressure,and BMI in the treatment group were lower than those results before treatment(P<0.05).And the result of BMI in the control group was lower than that before treatment(P<0.05).However,the treatment group was lower than the control group in terms of systolic pressure,diastolic pressure,and BMI(P<0.05).Besides,the levels of aspartate transaminase(AST)and alanine transaminase(ALT)after treatment of the two groups were lower than their results before treatment(P<0.05).And those results in the treatment group were more obviously lower(P<0.05).For triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C),their results in the two groups were lower than results before treatment(P<0.05).However,the level of high-density lipoprotein cholesterol(HDL-C)was increased(P<0.05).By comparison to the control group,the levels of TG,TC,and LDL-C in the treatment group were lower(P<0.05)but the level of HDL-C was higher(P<0.05).After treatment,the levels of fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),and hemoglobin A1C(HbA1c)in the two groups were lower than levels before treatment(P<0.05).And the treatment group had an obvious reduction(P<0.05).After treatment,the levels of APN and SHBG in the two groups were higher than levels before treatment(P<0.05).And their levels in the treatment group were higher significantly(P<0.05).Conclusion MS patients can receive the definite effect with Jianpi Lishi Huazhuo decoction combined with conventional western medications which can control the blood pressure,blood lipid,and blood sugar effectively and increase APN and SHBG serum levels.