【摘要】：目的:觀察中藥內(nèi)服(健脾調(diào)肝飲)配合隔姜灸干預(yù)肥胖癥合并糖調(diào)節(jié)受損(IGR)的臨床療效。方法:采用隨機(jī)、對(duì)照的臨床試驗(yàn)研究方法,將符合研究要求的受試者分為中醫(yī)治療組(30例)和西藥對(duì)照組(30),兩組均進(jìn)行包括控制飲食和規(guī)律運(yùn)動(dòng)的基礎(chǔ)治療。在此基礎(chǔ)上,治療組給予中藥健脾調(diào)肝飲配合隔姜灸,對(duì)照組給予西藥二甲雙胍治療,觀察周期為12周。并用SPSS17軟件對(duì)試驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,觀察兩組患者中醫(yī)證候積分、肥胖相關(guān)指標(biāo)(體重、BMI、腰圍、WHR)以及脂代謝指標(biāo)(TC、TG、HDL-C、LDL-C)糖代謝指標(biāo)(FPG、2h-PG、FINS、HOMA-IR、Hb A1c)的變化。結(jié)果:治療前后比較,兩組患者的肥胖相關(guān)指標(biāo)(體重、BMI、腰圍、WHR)均有所下降,但治療組體重、BMI、腰圍下降更明顯,兩組治療后體重、BMI、腰圍差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01),兩組WHR的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組中醫(yī)臨床證候積分均明顯降低(P0.01),治療組下降幅度明顯大于對(duì)照組;在改善脂代謝方面,治療組TC、TG、LDL-C的降低均具有顯著統(tǒng)計(jì)學(xué)意義(P0.01),HDL-C的升高有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組TC、TG、LDL-C的下降有統(tǒng)計(jì)學(xué)意義(P0.05),HDL-C的改變無統(tǒng)計(jì)學(xué)意義(P0.05);在改善糖代謝方面,治療后兩組2h-PG、FINS、Hb A1差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01),HOMA-IR差異有統(tǒng)計(jì)學(xué)意義(P0.05),治療組在2h-PG、FINS、HOMA-IR、Hb A1降低幅度更大,在調(diào)節(jié)FPG上與口服二甲雙胍療效相當(dāng)。結(jié)論:健脾調(diào)肝飲配合隔姜灸可有效降低肥胖癥合并IGR患者體重、BMI、腰圍、WHR等肥胖相關(guān)指標(biāo),減輕肥胖,降低TC、TG,調(diào)節(jié)其糖脂代謝,改善胰島素抵抗;在中醫(yī)證候方面,此療法可有效改善肥胖癥合并IGR患者臨床癥狀,且治療組總有效率明顯高于對(duì)照組。
[Abstract]:Objective: to observe the clinical effect of traditional Chinese medicine (Jianpi Tiaogan decoction) combined with ginger-separated moxibustion on obesity with impaired glucose regulation (IGR). Methods: a randomized, controlled clinical trial was conducted. The subjects who met the requirements of the study were divided into Chinese medicine treatment group (30 cases) and western medicine control group (30 cases). Both groups were treated with basic treatment including diet control and regular exercise. On this basis, the treatment group was treated with traditional Chinese medicine Jianpi Tiaogan decoction and ginger separated moxibustion, while the control group was treated with metformin, the observation period was 12 weeks. The test data were statistically analyzed by SPSS17 software. The scores of TCM syndromes, obesity related indexes (body weight, BMI, waist circumference, WHR) and lipid metabolism index (TC,TG,HDL-C,LDL-C), glucose metabolism index (FPG,) were observed in the two groups. HbA1c). Results: compared with before and after treatment, the obesity related indexes (body weight, BMI, waist circumference, WHR) were decreased in both groups, but the weight and BMI, waist circumference in the treatment group decreased more obviously. After treatment, the weight of the two groups, BMI,. Waist circumference difference was statistically significant (P0.01), the two groups of WHR difference was statistically significant (P0.05). The scores of TCM syndromes in the two groups were significantly decreased (P0.01), and the decrease in the treatment group was significantly greater than that in the control group. In improving lipid metabolism, the decrease of TC,TG,LDL-C in the treatment group was statistically significant (P0.01), and the increase of HDL-C was statistically significant (P0.05). The decrease of TC,TG,LDL-C in the control group was statistically significant (P0.05), but the change of HDL-C was not significant (P0.05). In the aspect of improving glucose metabolism, the difference of 2h-PGN FINSb HbA1 and HOMA-IR was statistically significant (P0.01), and the difference of 2h-PGFINSHOMA-IRR in treatment group was significant (P0.01), the difference of HOMA-IR was statistically significant (P0.05). The decrease of Hb A1 was greater than that of oral metformin in regulating FPG. Conclusion: Jianpi Tiaogan decoction combined with ginger separated moxibustion can effectively reduce obesity related indexes such as body weight, BMI, waist circumference and WHR in obese patients with IGR, reduce obesity, reduce TC,TG, regulation of glucose and lipid metabolism and improve insulin resistance. In TCM syndromes, this treatment can effectively improve the clinical symptoms of obese patients with IGR, and the total effective rate of the treatment group is significantly higher than that of the control group.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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