分消走泄法对代谢综合征患者代谢、应激、炎症状态的影响

flEffects of the Fenxiao Zouxie method on the metabolism,stress and inflammatory state in patients with metabolic syndrome

目的探讨国医大师路志正“分消走泄法”治疗代谢综合征的临床疗效及对患者代谢、应激、炎症状态的影响。方法收集我院2018年3月-2020年4月湿热型代谢综合征患者200例,并随机分为对照组(盐酸吡格列酮)和试验组(祛湿降浊方),比较2组患者的疗效、治疗前后的中医症状评分、代谢相关指标[三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(glutamic oxaloacetic transaminase,AST)、空腹血糖(fasting blood glucose,FBG)、尿酸(uric acid,UA)]、应激和炎症相关指标[谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、总抗氧化能力(total antioxidant capacity,T-AOC)、髓过氧化物酶(myeloperoxidase,MPO)、丙二醛(malondialdehyde,MDA)、白介素-6(interleukin-6,IL-6)、人单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)、脂联素(adiponectin,ADP)、脂蛋白(lipoprotein,LP)]。结果与对照组比较,试验组的总有效率明显增高(P<0.05)。治疗前,2组的主症评分、次症评分、中医症状总分、代谢、应激、炎症相关指标差异无统计学意义(P>0.05);治疗后,与对照组比较,试验组主症评分、次症评分、中医症状总分、TG、TC、ALT、FBG、UA、MPO、MDA、IL-6、MCP-1、LP均降低(P<0.05),HDL-C、GSH-Px、T-AOC、ADP均增高(P<0.05)。结论路志正“分消走泄法”可用于治疗MS,可明显改善湿热型MS患者的症状、代谢、应激、炎症状态,值得临床推广。

Objective To explore the clinical efficacy of the"Fenxiao Zouxie method"in the treatment of metabolic syndrome(MS)by Lu Zhizheng,a Chinese medicine master,and its influence on the metabolism,stress and inflammatory status in patients with the syndrome of dampness-heat.Methods From March 2018 to April 2020,200 MS patients with the dampness-heat pattern in our hospital were randomly divided into the control group(treated with pioglitazone hydrochloride)and the experimental group(treated with Qushi Jiangzhuo Decoction).The therapeutic effects of the two groups were compared after treatment.The traditional Chinese medicine symptom scores,metabolism related indicators[triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine transaminase(ALT),glutamic transaminase(AST),fasting blood glucose(FBG),uric acid(UA)],stress and inflammation related indicators[glutathione peroxidase(GSH-Px),total antioxidant capacity(T-AOC),myeloperoxidase(MPO),malondialdehyde(MDA),interleukin-6(IL-6),human monocyte chemotactic protein-1(MCP-1),adiponectin(ADP)and lipoprotein(LP)]were collected and compared between the two groups before and after treatment.Results Compared with the control group,the total effective rate of the experimental group was significantly increased(P<0.05).Before treatment,there was no statistically significant difference in main symptom score,secondary symptom score,total score of traditional Chinese medicine symptoms,metabolism,stress and inflammation related indicators between the two groups(P>0.05).After treatment,compared with the control group,the main symptom score,secondary symptom score,total score of traditional Chinese medicine symptoms,levels of TG,TC,ALT,FBG,UA,MPO,MDA,IL-6,MCP-1,LP in the experimental group were significantly decreased(P<0.05),while the levels of HDL-C,GSH-Px,T-AOC,and ADP were increased(P<0.05).Conclusion Lu Zhizheng's"Fenxiao Zouxie method"can be used in the treatment of MS with the dampness-heat syndrome,which may help improve their symptoms,metabolism,stress and inflammatory state,and is worthy of clinical promotion.