健脾化湿方治疗代谢减重术后脾虚痰湿证的效果

Effect of Jianpi Huashi Decoction in treating spleen deficiency and phlegm dampness syndrome after metabolic weight loss surgery

目的探讨健脾化湿方治疗代谢减重术后脾虚痰湿证患者的效果。方法选取2023年9月至2024年1月在湖南中医药高等专科学校附属第一医院肝胆胰脾、代谢减重外科的80例行腹腔镜下袖状胃切除术后患者为研究对象,按照随机数字表法分为对照组(40例)与中药组(40例)。对照组采用腹腔镜下袖状胃切除术后患者常规方案治疗,中药组在对照组基础上加用健脾化湿方口服,两组治疗周期均为60 d,比较两组治疗前后中医证候积分、形态学指标[腰围、体重、体重指数(BMI)、多余体重减少值(%EWL)]、糖脂代谢水平[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血清胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及安全性。结果治疗后,中药组的中医证候积分低于对照组,差异有统计学意义(P<0.05)。中药组的总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后两组间的腰围、体重、BMI、%EWL比较,差异无统计学意义(P>0.05)。治疗后两组间的FPG、HbA1c、FINS、TC、TG、HDL-C水平比较,差异无统计学意义(P>0.05),中药组的LDL-C水平低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者生命体征平稳,均无肝肾功能损害等明显不良反应发生。结论健脾化湿方能够有效改善代谢减重术后脾虚痰湿证患者临床症状,在一定程度上调节糖脂代谢,降低LDL-C水平,促进患者术后恢复,提高生活质量。

Objective To explore the therapeutic effect of Jianpi Huashi Decoction on patients with spleen deficiency and phlegm-dampness syndrome after metabolic bariatric surgery.Methods A total of 80 patients who underwent laparoscopic sleeve gastrectomy in the Department of Metabolic Weight Loss,Hepatobiliary Pancreatic and Splenic Surgery,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from September 2023 to January 2024 were selected as the study objects,and they were divided into control group(40 cases)and traditional Chinese medicine group(40 cases)according to random number table method.The control group received routine treatment for patients after laparoscopic sleeve gastrectomy,while the traditional Chinese medicine group received oral administration of Jianpi Huashi Decoction in addition to the control group.The treatment period for both groups were 60 d.Traditional Chinese medicine syndrome score,morphological indexes(waist circumference,body weight,body mass index[BMI],percent of excess weight loss[%EWL]),glucose and lipid metabolism levels(fasting blood glucose[FPG],glycated hemoglobin[HbA1c],serum insulin[FINS],total cholesterol[TC],triglyceride[TG],low density lipoprotein cholesterol[LDL-C],high density lipid protein cholesterol[HDL-C])before and after treatment and its safety were compared between the two groups.Results After treatment,the traditional Chinese medicine syndrome score in the traditional Chinese medicine group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total effective rate of traditional Chinese medicine group was higher than that of control group,and the difference was statistically significant(P<0.05).There was no significant difference in waist circumference,body weight,BMI and%EWL between the two groups after treatment(P>0.05).After treatment,there was no significant difference in the levels of FPG,HbA1c,FINS,TC,TG and HDL-C between the two groups(P>0.05),while the LDL-C level in the troditional Chinese medicine group was lower than that in the control group,the difference was statistically significant(P<0.05).During the treatment period,the vital signs of patients in both groups were stable,and no obvious adverse reactions such as liver and kidney function damage occurred.Conclusion Jianpi Huashi Decoction can effectively improve the clinical symptoms of patients with spleen deficiency and phlegm-dampness syndrome,regulate the metabolism of glucose and lipid,reduce the level of LDL-C,promote the postoperative recovery and improve the quality of life.