蒼附導(dǎo)痰湯加減方聯(lián)合胰島素增敏劑治療代謝綜合征的臨床研究
發(fā)布時間：2018-10-18 08:13
【摘要】：[目的]觀察蒼附導(dǎo)痰湯加減方聯(lián)合胰島素增敏劑與單純胰島素增敏劑治療代謝綜合征的臨床療效并通過隨機對照的臨床研究進行比較,從患者三個月內(nèi)的臨床癥狀和生化指標(biāo)的改變以及有無毒副反應(yīng)等方面,真實、客觀地評估蒼附導(dǎo)痰湯加減方治療代謝綜合征的臨床療效,為其臨床應(yīng)用提供實踐依據(jù)。[方法]采用隨機對照的臨床試驗方法,將60例符合納入標(biāo)準(zhǔn)的研究病例隨機分為兩組：試驗組和對照組,每組各30人。對照組以健康生活方式為基礎(chǔ)初級干預(yù)措施并服用二甲雙胍和吡格列酮。試驗組在對照組基礎(chǔ)上加以服用蒼附導(dǎo)痰湯加減方。28天為1個治療周期,治療3個周期后,觀察及比較2組代謝綜合征患者用藥的療效。[結(jié)果]兩組患者治療后的一般指標(biāo)與治療前比較,體重、體重指數(shù)、收縮壓、舒張壓均顯著降低,差異有統(tǒng)計學(xué)意義(P0.05)；試驗組治療后腰圍與組內(nèi)治療前比較,差異有統(tǒng)計學(xué)意義(P0.05)；試驗組治療后腰圍及收縮壓與對照組治療后比較,差異有統(tǒng)計學(xué)意義(P0.05)。兩組患者治療后的血糖與治療前比較,FBG、PG2h、HbAlc的水平均顯著降低,差異有統(tǒng)計學(xué)意義(P0.05)；其中治療組降低FBG、PG2h、HbAlc的效果優(yōu)于對照組(P0.05)。改善胰島素分泌水平方面,兩組患者治療后的INS2h水平顯著降低,差異有統(tǒng)計學(xué)意義(P0.05),治療組降低INS2h的效果優(yōu)于對照組(P0.05)。兩組患者治療前后胰島素抵抗指數(shù)的比較與本組治療前比較水平下降,有統(tǒng)計學(xué)差異(P0.05)；試驗組治療后較對照組治療后胰島素抵抗指數(shù)下降比較明顯,有統(tǒng)計學(xué)差異(P0.05)。兩組患者治療前后血脂的比較與本組治療前比較,TC、LDL-C水平下降,有統(tǒng)計學(xué)差異(P0.05)；試驗組治療后較治療前TG水平下降,差異有統(tǒng)計學(xué)差異(P0.05)；試驗組治療后HDL-C上升(P0.05),對照組較治療前未見明顯改變(P=0.079);試驗組治療后較對照組治療后TC水平下降比較明顯,有統(tǒng)計學(xué)差異(P0.05)。治療相關(guān)不良反應(yīng)方面,試驗組的不良反應(yīng)較少,安全性較高。[結(jié)論]蒼附導(dǎo)痰湯治療代謝綜合征不僅可以減小腰圍、減輕體重,降低血壓和血糖,調(diào)節(jié)血脂紊亂,還能改善胰島素分泌并減輕胰島素抵抗。該方用藥安全,無明顯毒副反應(yīng),值得臨床進一步研究和推廣。
[Abstract]:[objective] to observe the clinical efficacy of Cangfu Daotan decoction combined with insulin sensitizer and insulin sensitizer in the treatment of metabolic syndrome, and to compare the efficacy of Cangfu Daotan decoction with insulin sensitizer in the treatment of metabolic syndrome. From the changes of clinical symptoms, biochemical indexes and toxic and side effects of the patients within three months, the clinical efficacy of Cangfu Dodao phlegm decoction in the treatment of metabolic syndrome was evaluated objectively and truthfully, which provided a practical basis for its clinical application. [methods] A randomized controlled clinical trial was conducted to divide 60 cases into two groups randomly: the experimental group and the control group with 30 persons in each group. The control group was treated with metformin and pioglitazone. The experimental group was treated with Cangfu Daophan decoction on the basis of control group, 28 days was a treatment cycle, after 3 cycles of treatment, the curative effect of two groups of patients with metabolic syndrome was observed and compared. [results] after treatment, the body mass index, systolic blood pressure and diastolic blood pressure in the two groups were significantly lower than those before treatment (P0.05), and the waist circumference after treatment in the trial group was higher than that in the pre-treatment group. The difference was statistically significant (P0.05); the experimental group after treatment waist circumference and systolic blood pressure compared with the control group after treatment, the difference was statistically significant (P0.05). The level of FBG,PG2h,HbAlc in the two groups was significantly lower than that before treatment (P0.05), and the effect of FBG,PG2h,HbAlc reduction in the treatment group was better than that in the control group (P0.05). Improve insulin secretion level, the two groups of patients after treatment significantly decreased the level of INS2h, the difference was statistically significant (P0.05), the treatment group was better than the control group in reducing INS2h (P0.05). Two groups of patients before and after treatment insulin resistance index compared with this group before and after treatment level decreased statistically (P0.05); the trial group after treatment compared with the control group after treatment insulin resistance index decreased significantly (P0.05). Two groups of patients before and after treatment compared with the treatment before and after treatment, the TC,LDL-C level decreased, there was statistical difference (P0.05), the experimental group after treatment compared with the pre-treatment TG level decreased, the difference was statistically significant (P0.05); After treatment, HDL-C increased in the trial group (P0.05), but no significant change was found in the control group (P0. 079). The level of TC in the experimental group decreased significantly after treatment than that in the control group (P0.05). In the side of treatment-related adverse reactions, there were less adverse reactions and higher safety in the trial group. [conclusion] Cangfu Doutan decoction can not only reduce waist circumference, weight, blood pressure and blood sugar, regulate blood lipid disorder, but also improve insulin secretion and reduce insulin resistance. The prescription is safe and has no obvious side effects, so it is worthy of further clinical study and popularization.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R589
本文編號：2278528
[Abstract]:[objective] to observe the clinical efficacy of Cangfu Daotan decoction combined with insulin sensitizer and insulin sensitizer in the treatment of metabolic syndrome, and to compare the efficacy of Cangfu Daotan decoction with insulin sensitizer in the treatment of metabolic syndrome. From the changes of clinical symptoms, biochemical indexes and toxic and side effects of the patients within three months, the clinical efficacy of Cangfu Dodao phlegm decoction in the treatment of metabolic syndrome was evaluated objectively and truthfully, which provided a practical basis for its clinical application. [methods] A randomized controlled clinical trial was conducted to divide 60 cases into two groups randomly: the experimental group and the control group with 30 persons in each group. The control group was treated with metformin and pioglitazone. The experimental group was treated with Cangfu Daophan decoction on the basis of control group, 28 days was a treatment cycle, after 3 cycles of treatment, the curative effect of two groups of patients with metabolic syndrome was observed and compared. [results] after treatment, the body mass index, systolic blood pressure and diastolic blood pressure in the two groups were significantly lower than those before treatment (P0.05), and the waist circumference after treatment in the trial group was higher than that in the pre-treatment group. The difference was statistically significant (P0.05); the experimental group after treatment waist circumference and systolic blood pressure compared with the control group after treatment, the difference was statistically significant (P0.05). The level of FBG,PG2h,HbAlc in the two groups was significantly lower than that before treatment (P0.05), and the effect of FBG,PG2h,HbAlc reduction in the treatment group was better than that in the control group (P0.05). Improve insulin secretion level, the two groups of patients after treatment significantly decreased the level of INS2h, the difference was statistically significant (P0.05), the treatment group was better than the control group in reducing INS2h (P0.05). Two groups of patients before and after treatment insulin resistance index compared with this group before and after treatment level decreased statistically (P0.05); the trial group after treatment compared with the control group after treatment insulin resistance index decreased significantly (P0.05). Two groups of patients before and after treatment compared with the treatment before and after treatment, the TC,LDL-C level decreased, there was statistical difference (P0.05), the experimental group after treatment compared with the pre-treatment TG level decreased, the difference was statistically significant (P0.05); After treatment, HDL-C increased in the trial group (P0.05), but no significant change was found in the control group (P0. 079). The level of TC in the experimental group decreased significantly after treatment than that in the control group (P0.05). In the side of treatment-related adverse reactions, there were less adverse reactions and higher safety in the trial group. [conclusion] Cangfu Doutan decoction can not only reduce waist circumference, weight, blood pressure and blood sugar, regulate blood lipid disorder, but also improve insulin secretion and reduce insulin resistance. The prescription is safe and has no obvious side effects, so it is worthy of further clinical study and popularization.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R589
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