加味黄连温胆汤治疗痰瘀互结型代谢综合征疗效及对尿酸的影响

Effect of modified Huanglian Wendan Decoction on metabolic syndrome of type of phlegm stasis binding and its influence on uric acid

目的观察加味黄连温胆汤治疗痰瘀互结型代谢综合征(MS)患者的临床效果及对血清尿酸的影响。方法选取2021年4—12月就诊于黑龙江中医药大学附属第一医院门诊的68例痰瘀互结型MS患者,按照随机数字表法分为2组,对照组34例施以健康教育及常规西药治疗,治疗组34例在对照组治疗基础上加服加味黄连温胆汤,2组治疗周期均为8周。比较2组患者治疗前后主要中医症状总积分、血压[收缩压(SBP)、舒张压(DBP)]、体质指数(BMI)、血糖及胰岛功能指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血尿酸水平,评估2组中医疗效。结果治疗8周后,2组中医症状总积分、SBP、DBP、BMI、FPG、FINS、HOMA-IR及TC、TG、LDL-C、血尿酸水平均明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05);2组2hPG水平均明显低于治疗前(P均<0.05),但2组治疗后比较差异无统计学意义(P>0.05);2组HDL-C水平均明显高于治疗前(P均<0.05),且治疗组明显高于对照组(P<0.05)。治疗组中医症状总有效率为94.1%(32/34),对照组为76.5%(26/34),治疗组中医症状总有效率明显高于对照组(P<0.05)。结论在常规治疗同时加服加味黄连温胆汤,可以通过调控血压及调节糖脂代谢等改善痰瘀互结型MS患者中医证候,提高临床疗效,并可有效降低尿酸水平。

Objective It is to observe the clinical efficacy of modified Huanglian Wendan Decoction in patients with metabolic syndrome(MS)of type of phlegm stasis binding and its influence on uric acid.Methods Sixty-eight patients with MS of type of phlegm stasis binding treated in outpatient department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from April to December 2021 were selected and divided into 2 groups according to random number method,with 34 cases in each group.The control group was treated with health education and conventional western medicine,the treatment group was treated with modified Huanglian Wendan Decoction on the basis of the treatment in the control group.Both groups were treated for 8 weeks.The total score of main TCM symptoms,the levels of blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],body mass index(BMI),blood glucose and islet function indicators[fasting plasma glucose(FPG),2h postprandial plasma glucose(2hPG),fasting insulin(FINS),islet resistance index(HOMA-IR)],blood lipid indicators[total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]and blood uric acid before and after treatment were compared between the two groups,and the curative effects of the two groups were evaluated.Results After 8 weeks of treatment,the total score of TCM symptoms,the levels of SBP,DBP,BMI,FPG,2hPG,FINS,HOMA-IR,TC,TG,LDL-C and blood uric acid in the two groups were significantly lower than those before treatment(all P<0.05),while the levels of HDL-C were significantly higher than those before treatment(both P<0.05),and these indexes except for 2hPG in the treatment group were significantly higher than those in the control group(all P<0.05).The total effective rate of TCM symptoms was 94.1%(32/34)in the treatment group and 76.5%(26/34)in the control group,the rate in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion Modified Huanglian Wendan Decoction based on conventional treatment can improve traditional Chinese medicine syndrome,improve clinical curative effect and effectively reduce the level of uric acid in patients with MS of type of phlegm and blood stasis binding by regulating blood pressure and glucose and lipid metabolism.