苍附导痰汤加减方联合胰岛素增敏剂治疗代谢综合征的临床研究
发布时间：2018-10-18 08:13
【摘要】：[目的]观察苍附导痰汤加减方联合胰岛素增敏剂与单纯胰岛素增敏剂治疗代谢综合征的临床疗效并通过随机对照的临床研究进行比较,从患者三个月内的临床症状和生化指标的改变以及有无毒副反应等方面,真实、客观地评估苍附导痰汤加减方治疗代谢综合征的临床疗效,为其临床应用提供实践依据。[方法]采用随机对照的临床试验方法,将60例符合纳入标准的研究病例随机分为两组：试验组和对照组,每组各30人。对照组以健康生活方式为基础初级干预措施并服用二甲双胍和吡格列酮。试验组在对照组基础上加以服用苍附导痰汤加减方。28天为1个治疗周期,治疗3个周期后,观察及比较2组代谢综合征患者用药的疗效。[结果]两组患者治疗后的一般指标与治疗前比较,体重、体重指数、收缩压、舒张压均显著降低,差异有统计学意义(P0.05)；试验组治疗后腰围与组内治疗前比较,差异有统计学意义(P0.05)；试验组治疗后腰围及收缩压与对照组治疗后比较,差异有统计学意义(P0.05)。两组患者治疗后的血糖与治疗前比较,FBG、PG2h、HbAlc的水平均显著降低,差异有统计学意义(P0.05)；其中治疗组降低FBG、PG2h、HbAlc的效果优于对照组(P0.05)。改善胰岛素分泌水平方面,两组患者治疗后的INS2h水平显著降低,差异有统计学意义(P0.05),治疗组降低INS2h的效果优于对照组(P0.05)。两组患者治疗前后胰岛素抵抗指数的比较与本组治疗前比较水平下降,有统计学差异(P0.05)；试验组治疗后较对照组治疗后胰岛素抵抗指数下降比较明显,有统计学差异(P0.05)。两组患者治疗前后血脂的比较与本组治疗前比较,TC、LDL-C水平下降,有统计学差异(P0.05)；试验组治疗后较治疗前TG水平下降,差异有统计学差异(P0.05)；试验组治疗后HDL-C上升(P0.05),对照组较治疗前未见明显改变(P=0.079);试验组治疗后较对照组治疗后TC水平下降比较明显,有统计学差异(P0.05)。治疗相关不良反应方面,试验组的不良反应较少,安全性较高。[结论]苍附导痰汤治疗代谢综合征不仅可以减小腰围、减轻体重,降低血压和血糖,调节血脂紊乱,还能改善胰岛素分泌并减轻胰岛素抵抗。该方用药安全,无明显毒副反应,值得临床进一步研究和推广。
[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.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R589
本文编号：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.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R589
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