苍术麻黄汤对血脂异常痰浊阻滞证患者血脂水平及中医证候改善的临床研究

Clinical study of Cangzhu Mahuang decoction on the improvement of blood lipid levels and traditional Chinese medicine symptoms in patients with phlegm block syndrome of dyslipidemia

目的探讨苍术麻黄汤(苍麻汤)对血脂异常的痰浊阻滞证患者中医证候的临床疗效及安全性。方法选取2019年1月至2022年5月首都医科大学附属北京中医医院及北京市和平里医院收治的符合高总胆固醇/高低密度脂蛋白胆固醇(LDL-C)及中医痰浊阻滞证诊断标准的患者60例,抽血进行相关指标检测并记录。比较患者口服苍麻汤治疗4周及8周时相关生化指标变化及不良反应记录,同时将治疗8周时中医证候量表评分进行记录后加以分析。结果60例患者治疗4周时与治疗前的总胆固醇、LDL-C、三酰甘油水平比较无明显变化,治疗8周时呈现血脂水平略有下降,但未达到预设的统计学差异显著性。治疗4、8周时血常规、肝功能、血尿素氮、肌酸激酶等安全性指标与治疗前比较差异均无统计学意义(P>0.05);治疗4周时的HDL-C与治疗前比较差异无统计学意义(P>0.05);治疗8周时患者HDL-C较治疗前有升高,差异有统计学意义(P<0.05)。治疗8周时患者体型、头重如裹、呕恶痰涎、肢麻沉重、倦怠乏力的中医证候评分均低于治疗前[(1.62±0.64)分比(1.87±0.72)分、(1.12±0.37)分比(1.78±0.61)分、(1.10±0.30)分比(1.32±0.60)分、(1.18±0.43)分比(1.67±0.71)分、(1.33±0.57)分比(1.72±0.80)分](均P<0.05),便溏的评分高于治疗前[(1.70±0.96)分比(1.25±0.60)分](P<0.05)。结论苍麻汤可升高血脂异常的痰浊阻滞证患者HDL-C水平,并且可以改善患者体型、头重如裹、呕恶痰涎、肢麻沉重、倦怠乏力、便溏等中医证候,且具有良好的安全性。

Objective To explore the clinical efficacy and safety of Cangzhu Mahuang decoction(Cangma decoction)on traditional Chinese medicine(TCM)symptoms of patients with phlegm block syndrome of dyslipidemia.Methods Totally 60 patients were selected who were consistent the diagnostic criteria of high total cholesterol(TC)/high low-density lipoprotein cholesterol(LDL-C)and TCM phlegm block syndrome admitted to Beijing Hospital of Traditional Chinese Medicine,Capital Medical University and Beijing Hepingli Hospital from January 2019 to May 2022.Blood samples of patients were tested and recorded.At 4 and 8 weeks after treatment with Cangma decoction,the changes of biochemical parameters and adverse reactions were compared.The score of TCM symptom scale at 8 weeks after treatment was recorded and analyzed.Results Compared with treatment prior,levels of TC,LDL-C,and triacylglycerols of 60 patients had no significant changes 4 weeks after treatment.The levels of blood lipid decreased slightly 8 weeks after treatment,but the differences were not statistically significant.There were no significant differences in safety indicators such as blood routine,liver function,blood urea nitrogen,and creatine kinase at 4 and 8 weeks after treatment compared with those before treatment(P>0.05);there was no significant difference in the level of high-density lipoprotein cholesterol(HDL-C)between 4 weeks after treatment and before treatment(P>0.05);8 weeks treatment,the level of HDL-C was higher than that before treatment,and the difference was statistically significant(P<0.05).After 8 weeks of treatment,the TCM syndrome scores of body size,heavy head like being wrapped,vomiting and sputum salivation,limb numbness and fatigue were lower than those before treatment[(1.62±0.64)vs(1.87±0.72),(1.12±0.37)vs(1.78±0.61),(1.10±0.30)vs(1.32±0.60),(1.18±0.43)vs(1.67±0.71),(1.33±0.57)vs(1.72±0.80)](all P<0.05),and the score of loose stool were higher than that before treatment[(1.70±0.96)vs(1.25±0.60)](P<0.05).Conclusions Cangma decoction can increase the level of HDL-C in patients with phlegm block syndrome of dyslipidemia,improve the symptoms of heavy head like being wrapped,vomiting and sputum salivation,limb numbness,fatigue and loose stools,and has certain safety.