【摘要】：目的：探討針灸溫陽通絡法治療高脂血癥的臨床療效,為臨床提供治療該病的新思路和客觀依據(jù)。方法：采用隨機數(shù)字表法,將符合納入標準的90例高脂血癥(hyperlipidemia, HLP)患者分為3組,空白組30例、對照組30例、治療組30例�？瞻捉M：予單純改變生活方式；對照組：予每日口服10mg阿托伐他汀鈣片;治療組：予針刺脾俞(雙)、腎俞(雙)命門、中脘、三陰交雙、足三里雙,臨癥加減,結(jié)合麥粒灸脾俞、腎俞、命門治療,針刺及麥粒灸均每日1次,每周6次,周日休息。均以2周為1個療程,4個療程后進行前后對照研究。療程結(jié)束后,評定三組患者的臨床療效,觀察中醫(yī)癥狀量化積分和血脂4項、丙氨酸轉(zhuǎn)氨酶(alanine aminotransferase, ALT)、谷草轉(zhuǎn)氨酶(aspartate transaminase, AST)、肌酸激酶(creatine kinase, CK)和體重指數(shù)(body mass index, BMI)等指標,采用SPSS19.0統(tǒng)計軟件對收集數(shù)據(jù)進行統(tǒng)計學分析。結(jié)果：本研究總共完成87例治療,空白組脫失0例,對照組脫失1例,治療組脫失2例。1、治療前三組患者的性別、年齡、病程、各抽血檢測成分、中醫(yī)癥狀量化積分、中醫(yī)證型及基本情況差異無統(tǒng)計學意義,具可比性。2、4個療程后臨床療效評定,空白組臨床痊愈0例,顯效0例,有效8例,無效22例,總有效率為26.67%；對照組臨床痊愈2例,顯效11例,有效14例,無效2例,總有效率為93.10%：治療組臨床痊愈1例,顯效8例,有效16例,無效3例,總有效率為89.29%,經(jīng)檢驗,對照組與治療組療效均明顯優(yōu)于空白組,對照組與治療組具有同等療效。3、4個療程后中醫(yī)臨床療效評定,空白組臨床痊愈1例,顯效1例,有效18例,無效10例,總有效率為66.67%；對照組臨床痊愈0例,顯效1例,有效15例,無效13例,總有效率為55.17%;治療組臨床痊愈1例,顯效9例,有效18例,無效0例,總有效率為100%,經(jīng)檢驗,治療組明顯優(yōu)于空白組與對照組,空白組與對照組具有同等療效。4、對比三組血脂檢測指標,治療后空白組總膽固醇(total cholesterol, TC)、甘油三酯(triglyeeride, TG)均有降低,高密度脂蛋白膽固醇(high-density lipoproteincholesterol, HDL-c)、低密度脂蛋白膽固醇(low-density lipoprotein cholesterol,LDL-C)療效不明顯；治療后對照組及治療組各血脂檢測指標均有降低,說明三種療法高脂血癥均有療效；經(jīng)統(tǒng)計學分析,針灸溫陽通絡法及阿托伐他汀鈣片治療高脂血癥明顯優(yōu)于單純改變生活方式,針灸溫陽通絡法與阿托伐他汀鈣片治療兩者具有同等的療效。5、對比三組BMI,三組治療前后BMI均有顯著下降�？瞻捉M與對照組在降BMI方面無明顯差異,治療組則明顯優(yōu)于空白組與對照組。6、對比三組ALT、AST、CK,治療后對照組ALT、AST、CK歸顯升高,空白組及治療組治療前后無明顯差異,說明針灸溫陽通絡法在治療高脂血癥上具有更好的安全性。7、對比三組中醫(yī)癥狀量化積分,治療組在中醫(yī)癥狀量化積分總分上較空白組與對照組降低更明顯,差異有統(tǒng)計學意義,說明針灸溫陽通絡法在治療各型高脂血癥上具有更好地改善癥狀的優(yōu)勢。結(jié)論：根據(jù)本研究得出,針灸溫陽通絡法及口服阿托伐他汀鈣片治療高脂血癥具有同等療效,且明顯優(yōu)于單純改變生活方式。在對ALT、AST、CK的影響方面,阿托伐他汀鈣片組對其升高程度明顯高于針灸溫陽通絡法組及單純改變生活方式組。在降低體重指數(shù)、改善中醫(yī)證候方面,針灸溫陽通絡法較單純改變生活方式及口服阿托伐他汀鈣片治療更有效。運用針灸溫陽通絡法治療高脂血癥具有安全、有效、無毒副作用等優(yōu)點,值得進一步研究推廣。
[Abstract]:Objective: To explore the clinical effect of acupuncture and moxibustion warming yang and dredging collaterals in the treatment of hyperlipidemia, and to provide a new idea and objective basis for clinical treatment of the disease.Methods: 90 patients with hyperlipidemia (HLP) were divided into three groups according to the inclusion criteria by random number table method, 30 cases in blank group, 30 cases in control group and 30 cases in treatment group. The control group was given 10 mg of atorvastatin calcium tablets orally daily; the treatment group was given acupuncture at Spleen Shu (Shuang), Shenshu (Shuang) Mingmen, Zhongwan, Sanyinjiaoshuang, Zusanli Shuang, plus or minus the symptoms, combined with wheat grain moxibustion at Spleen Shu, Shenshu, Mingmen, acupuncture and wheat grain moxibustion once a day, six times a week, and rest on Sunday. After four courses of treatment, the clinical efficacy of the three groups was evaluated, and the symptoms of TCM, blood lipids, ALT, AST, creatine kinase (CK) and body mass index (BMI) were observed. Results: 87 cases were treated with SPSS19.0 statistical software. There were 0 cases of loss in blank group, 1 case in control group and 2.1 cases in treatment group. Before treatment, the sex, age, course of disease, component of blood test, quantitative integral of TCM symptoms, TCM syndrome types and basic conditions of the three groups were poor. There was no significant difference in clinical efficacy. 2,4 courses after clinical evaluation, blank group clinical recovery 0 cases, markedly effective 0 cases, effective 8 cases, ineffective 22 cases, the total effective rate was 26.67%; control group clinical recovery 2 cases, markedly effective 11 cases, effective 14 cases, ineffective 2 cases, the total effective rate was 93.10%: treatment group clinical recovery 1 case, markedly effective 8 cases, effective 16 cases, ineffective 3 cases, the total effective rate was 93.10%. The total effective rate was 89.29%. The control group and the treatment group were significantly better than the blank group. The control group and the treatment group had the same curative effect. 3,4 courses later, the blank group was cured in 1 case, markedly effective in 1 case, effective in 18 cases, ineffective in 10 cases, the total effective rate was 66.67%; the control group was cured in 0 cases, markedly effective in 1 case, effective in 15 cases. 13 cases were ineffective, the total effective rate was 55.17%; 1 case was cured in the treatment group, 9 cases were markedly effective, 18 cases were effective, 0 cases were ineffective, the total effective rate was 100%. The treatment group was obviously better than the blank group and the control group, the blank group and the control group had the same effect. Triglyeeride (TG) was decreased, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-C) was not significantly effective; after treatment, the control group and the treatment group, all the blood lipid detection indicators were reduced, indicating that the three treatment of hyperlipidemia are all. Statistical analysis shows that acupuncture and moxibustion Wenyang Tongluo method and atorvastatin calcium tablets in the treatment of hyperlipidemia is significantly better than simply changing lifestyle, acupuncture and moxibustion Wenyang Tongluo method and atorvastatin calcium tablets treatment both have the same effect. 5, compared with three groups of BMI, three groups of BMI before and after treatment were significantly reduced. There was no significant difference in ALT, AST, CK between the treatment group and the control group. Compared with the three groups, ALT, AST, CK in the control group increased significantly after treatment. There was no significant difference between the blank group and the treatment group before and after treatment. It showed that acupuncture and moxibustion warming Yang and dredging collaterals method had better safety in the treatment of hyperlipidemia. The total score of symptoms quantification in the treatment group was lower than that in the blank group and the control group, and the difference was statistically significant, indicating that the acupuncture-moxibustion-warming-yang-dredging-collaterals method has a better advantage in improving symptoms in the treatment of various types of hyperlipidemia. Conclusion: According to this study, the acupuncture-moxibustion-warming-yang-dredging-collaterals method and oral atorvastatin calcium tablets The effect of atorvastatin calcium tablets on ALT, AST and CK was higher than that of acupuncture and moxibustion with Warming Yang and dredging collaterals and simple change of life style. Acupuncture and moxibustion warming Yang and dredging collaterals are safe, effective and non-toxic in the treatment of hyperlipidemia.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.1

【參考文獻】

相關(guān)期刊論文 前10條

1 朱雪瓊;林希;朱建龍;林祥;張薔蓉;;疏肝調(diào)脂湯結(jié)合立普妥治療高脂血癥的臨床觀察[J];中國中醫(yī)藥科技;2014年05期

2 石秋軼;蔡運昌;;停用他汀類藥物的不良后果及可能機制[J];貴州醫(yī)藥;2014年06期

3 黃惠明;;2008 2013年他汀類藥物致橫紋肌溶解癥文獻分析[J];中國藥物應用與監(jiān)測;2014年02期

4 朱翠玲;朱明軍;劉新燦;孫彥琴;裴英豪;;從肝腎論治血脂異常新思路[J];中醫(yī)學報;2014年04期

5 胡金蘭;張潔;;穴位注射銀杏葉維生素B_(12)注射液聯(lián)合辛伐他汀膠囊治療高脂血癥療效觀察[J];陜西中醫(yī);2014年02期

6 唐小平;萬沁;陳楓;陳麗麗;劉佳興;馮世明;代雨岑;陳莊;;IL-10基因啟動子-592(C/A)多態(tài)性與血脂異常的關(guān)系[J];免疫學雜志;2014年01期

7 何玲;鄭現(xiàn)紅;;自體血穴位注射對痰瘀阻滯型高脂血癥的影響[J];陜西中醫(yī);2013年07期

8 陳清杰;楊毅寧;;他汀類藥物不良反應的研究進展[J];心血管病學進展;2013年02期

9 歐陽思艷;;阿托伐他汀與辛伐他汀治療原發(fā)性高脂血癥的臨床藥理療效比較[J];當代醫(yī)學;2012年21期

10 楊永革;王占慶;姜楠;許雪廷;杜洪;;他汀類藥物的不良反應[J];醫(yī)藥導報;2011年06期

，

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