苍附导痰汤加减对痰湿阻滞型单纯性肥胖儿童糖脂代谢的影响

Effect of Modified Cangfu Daotantang on Glucose and Lipid Metabolism in Simple Obese Children with Phlegm Dampness and Stagnation

目的:观察比较苍附导痰汤加减对痰湿阻滞型单纯性肥胖儿童糖脂代谢的干预效果。方法:将60例单纯性肥胖患儿按照随机数字表简单随机化法分为2组,奇数归入对照组,偶数归入基础观察组,每组30例。在全部签署知情同意告知书的基础上,观察组给予苍附导痰汤加减联合基础治疗,对照组仅给予基础治疗作为对照。经为期3个月的疗程治疗后,观察比较治疗前后不同组患儿的体质量指数(BMI)、糖脂代谢水平[血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、中医证候总积分及治疗有效率的改变情况。结果:与本组治疗前比较,观察组与对照组BMI均显著降低(P<0.01);治疗后与对照组比较,观察组BMI水平明显降低(P<0.05)。与本组治疗前比较,观察组与对照组TC、TG、LDL-C水平均显著降低(P<0.01);治疗后与对照组比较,观察组TC、TG、LDL-C水平明显降低(P<0.05),其中,观察组治疗后TC水平较对照组改善显著(P<0.01)。与本组治疗前比较,观察组与对照组FPG、FINS、HOMA-IR水平均明显降低(P<0.05);治疗后与对照组比较,观察组FPG、FINS、HOMA-IR水平明显降低(P<0.05),其中,观察组治疗后FPG水平较对照组改善显著(P<0.01)。与本组治疗前比较,两组患儿中医证候总积分均显著下降(P<0.01)。治疗后与对照组比较,观察组的中医证候总积分更低(P<0.01)。治疗后,观察组患儿治疗总有效率为86.67%(26/30),对照组患儿治疗总有效率为73.33%(22/30),经秩和检验比较,观察组总有效率优于对照组(Z=−2.100,P<0.05)。结论:苍附导痰汤加减联合基础治疗能够有效降低肥胖患儿的BMI指数,改善其糖脂代谢水平,临床疗效颇佳,具有较高的临床应用价值,值得进一步深入研究和推广。

Objective:To observe and compare the intervention effect of modified Cangfu Daotantang on glucose and lipid metabolism in simple obese children with phlegm dampness and stagnation.Method:A total of 60 children with simple obesity were randomly divided into two groups according to the simple randomization method of the random number table.The odd number was included in the test group,and the even number was included in the basic treatment group,with 30 cases in each group.On the basis of signing the informed consent notice,the treatment group was given modified Cangfu Daotantang combined with basic treatment,while the control group was only given basic treatment.After three months of treatment,the body mass index(BMI),glucose and lipid metabolism level[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),fasting insulin(FINS),and homeostasis model assessment-insulin resistance(HOMA-IR)],the change in the total score of traditional Chinese medicine(TCM)syndromes,and the effective rate of treatment were observed and compared.Result:After treatment,the BMI of the observation group and the control group decreased significantly(P<0.01).Compared with the control group,the BMI level in the observation group decreased significantly(P<0.05).After treatment,the levels of TC,TG,and LDL-C in the observation group and the control group decreased significantly(P<0.01).Compared with the control group,the levels of TC,TG,and LDL-C in the observation group decreased significantly(P<0.05).In addition,the level of TC in the observation group improved significantly compared with that in the control group(P<0.01).The levels of FPG,FINS,and HOMA-IR in the observation group and the control group were significantly lower than those before treatment(P<0.05).After treatment,compared with the control group,the levels of FPG,FINS,and HOMA-IR in the observation group were significantly reduced(P<0.05).The level of FPG in the observation group was significantly improved compared with that in the control group(P<0.01).After treatment,the total score of TCM syndromes in the two groups decreased significantly(P<0.01).Compared with the control group,the total score of TCM syndromes in the observation group was lower(P<0.01).After treatment,the total effective rate of treatment was 86.67%(26/30)in the observation group and 73.33%(22/30)in the control group.By rank sum test,the total effective rate of the observation group was better than that of the control group(Z=−2.100,P<0.05).Conclusion:Modified Cangfu Daotantang combined with basic treatment can effectively reduce the BMI of obese children and improve their glucose and lipid metabolism.It has good clinical effects and high clinical application value,which is worth further in-depth research and promotion.