【摘要】：目的:觀察芪仙調(diào)脂湯配合生活方式干預(yù)對脾腎陽虛型絕經(jīng)后早期脂代謝異常患者的臨床療效,及其對血脂、性激素水平的影響,初步探索本治療方法可能的療效機(jī)制。方法:將符合入選標(biāo)準(zhǔn)的65例絕經(jīng)后早期脂質(zhì)代謝異常者,按就診順序隨機(jī)分成兩組,其中試驗組33例、對照組32例。試驗組采用芪仙調(diào)脂湯聯(lián)合更年期一日門診的方式,予飲食、運動等生活干預(yù);對照組則單純予中藥口服。治療3個月后觀察兩組中醫(yī)臨床癥狀、血脂及性激素水平的變化,停藥3個月后隨訪記錄中醫(yī)證候變化。結(jié)果:1.總體療效:總有效率比較,試驗組為86.7%,高于對照組的63.3%,差異有統(tǒng)計學(xué)意義(P0.05)。2.中醫(yī)證候改善:在中醫(yī)證候方面,試驗組有效率為86.7%,對照組為60%,P0.01,說明試驗組明顯優(yōu)于對照組;在單一癥狀及中醫(yī)癥狀量表評分方面,兩組治療后、隨訪時均較治療前有改善,且試驗組優(yōu)于對照組,P0.05,有統(tǒng)計學(xué)差異。3.血脂水平變化:在血脂改善方面,試驗組的總有效率為86.7%,較對照組的60%高,P0.01,有統(tǒng)計學(xué)意義;治療后兩組血脂水平較前明顯改善,其中試驗組對于TC、LDL-C的降低,HDL-C的升高明顯優(yōu)于對照組(P0.01)。4.激素水平變化:兩組激素水平在治療前無明顯差異,P0.05;治療后兩組E2輕微升高,但無統(tǒng)計學(xué)意義,T、SHBG較前改善,P0.05;組間對比,實驗組在升高SHBG方面明顯優(yōu)于對照組,P=0.01,具有統(tǒng)計學(xué)意義。5.研究過程中有5例患者因依從性差、失訪脫落,其中試驗組3例,對照組2例,均無不良事件發(fā)生。結(jié)論:芪仙調(diào)脂湯能夠緩解脾腎陽虛型絕經(jīng)后早期患者脂質(zhì)代謝異常癥狀,調(diào)節(jié)血脂水平,改善生活質(zhì)量,配合飲食、運動等生活方式干預(yù)效果更佳。
[Abstract]:Objective: to observe the clinical effect of Qixian Tiaozhi decoction combined with lifestyle intervention on the abnormal lipid metabolism in the early postmenopausal patients with deficiency of spleen and kidney yang, and to explore the possible therapeutic mechanism of this treatment. Methods: 65 patients with abnormal lipid metabolism in the early postmenopausal period were randomly divided into two groups: the experimental group (n = 33) and the control group (n = 32). The experimental group was treated with Qixian Tiaozhi decoction combined with climacteric one day outpatient service, and the control group was given only oral Chinese medicine. After 3 months of treatment, the changes of TCM clinical symptoms, serum lipids and sex hormones in the two groups were observed, and the changes of TCM syndromes were recorded after 3 months of withdrawal. The result is 1: 1. Overall efficacy: the total effective rate was 86.7 in the trial group, higher than 63.3 in the control group, the difference was statistically significant (P0.05). The improvement of TCM syndromes: the effective rate of the experimental group was 86.7%, and that of the control group was 60% (P0.01), which indicated that the experimental group was obviously superior to the control group, and the single symptoms and TCM symptom scale scores were improved after the treatment in both groups. And the test group is better than the control group, P 0.05, there is statistical difference. The total effective rate of the experimental group was 86.7%, which was higher than that of the control group (60%, P 0.01). The increase of HDL-C and the decrease of TC,LDL-C in the experimental group were significantly better than those in the control group (P0.01). The changes of hormone level: there was no significant difference between the two groups before treatment, P0.05; after treatment, E2 increased slightly, but there was no statistical significance, TG-SHBG was improved before treatment, P0.05. Compared with the control group, the experimental group was significantly better than the control group in increasing SHBG, P0.01, with statistical significance. In the course of the study, there were 5 patients with poor compliance and no adverse events occurred in the trial group (3 cases) and the control group (2 cases). Conclusion: Qixian Tiaozhi decoction can relieve the abnormal symptoms of lipid metabolism, regulate the level of blood lipid, improve the quality of life, cooperate with diet, exercise and other lifestyle intervention in early postmenopausal patients with deficiency of spleen and kidney yang.
【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】：2017
【分類號】：R259

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