芪仙调脂汤联合生活方式干预对妇女绝经后脂代谢异常的临床观察

发布时间：2018-10-19 14:30

【摘要】：目的:观察芪仙调脂汤配合生活方式干预对脾肾阳虚型绝经后早期脂代谢异常患者的临床疗效,及其对血脂、性激素水平的影响,初步探索本治疗方法可能的疗效机制。方法:将符合入选标准的65例绝经后早期脂质代谢异常者,按就诊顺序随机分成两组,其中试验组33例、对照组32例。试验组采用芪仙调脂汤联合更年期一日门诊的方式,予饮食、运动等生活干预;对照组则单纯予中药口服。治疗3个月后观察两组中医临床症状、血脂及性激素水平的变化,停药3个月后随访记录中医证候变化。结果:1.总体疗效:总有效率比较,试验组为86.7%,高于对照组的63.3%,差异有统计学意义(P0.05)。2.中医证候改善:在中医证候方面,试验组有效率为86.7%,对照组为60%,P0.01,说明试验组明显优于对照组;在单一症状及中医症状量表评分方面,两组治疗后、随访时均较治疗前有改善,且试验组优于对照组,P0.05,有统计学差异。3.血脂水平变化:在血脂改善方面,试验组的总有效率为86.7%,较对照组的60%高,P0.01,有统计学意义;治疗后两组血脂水平较前明显改善,其中试验组对于TC、LDL-C的降低,HDL-C的升高明显优于对照组(P0.01)。4.激素水平变化:两组激素水平在治疗前无明显差异,P0.05;治疗后两组E2轻微升高,但无统计学意义,T、SHBG较前改善,P0.05;组间对比,实验组在升高SHBG方面明显优于对照组,P=0.01,具有统计学意义。5.研究过程中有5例患者因依从性差、失访脱落,其中试验组3例,对照组2例,均无不良事件发生。结论:芪仙调脂汤能够缓解脾肾阳虚型绝经后早期患者脂质代谢异常症状,调节血脂水平,改善生活质量,配合饮食、运动等生活方式干预效果更佳。
[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.
【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】：2017
【分类号】：R259

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