中药内服配合隔姜灸干预肥胖症合并IGR的临床研究

发布时间：2018-11-07 16:00

【摘要】：目的:观察中药内服(健脾调肝饮)配合隔姜灸干预肥胖症合并糖调节受损(IGR)的临床疗效。方法:采用随机、对照的临床试验研究方法,将符合研究要求的受试者分为中医治疗组(30例)和西药对照组(30),两组均进行包括控制饮食和规律运动的基础治疗。在此基础上,治疗组给予中药健脾调肝饮配合隔姜灸,对照组给予西药二甲双胍治疗,观察周期为12周。并用SPSS17软件对试验数据进行统计分析,观察两组患者中医证候积分、肥胖相关指标(体重、BMI、腰围、WHR)以及脂代谢指标(TC、TG、HDL-C、LDL-C)糖代谢指标(FPG、2h-PG、FINS、HOMA-IR、Hb A1c)的变化。结果:治疗前后比较,两组患者的肥胖相关指标(体重、BMI、腰围、WHR)均有所下降,但治疗组体重、BMI、腰围下降更明显,两组治疗后体重、BMI、腰围差异有显著统计学意义(P0.01),两组WHR的差异有统计学意义(P0.05)。两组中医临床证候积分均明显降低(P0.01),治疗组下降幅度明显大于对照组;在改善脂代谢方面,治疗组TC、TG、LDL-C的降低均具有显著统计学意义(P0.01),HDL-C的升高有统计学意义(P0.05);对照组TC、TG、LDL-C的下降有统计学意义(P0.05),HDL-C的改变无统计学意义(P0.05);在改善糖代谢方面,治疗后两组2h-PG、FINS、Hb A1差异有显著统计学意义(P0.01),HOMA-IR差异有统计学意义(P0.05),治疗组在2h-PG、FINS、HOMA-IR、Hb A1降低幅度更大,在调节FPG上与口服二甲双胍疗效相当。结论:健脾调肝饮配合隔姜灸可有效降低肥胖症合并IGR患者体重、BMI、腰围、WHR等肥胖相关指标,减轻肥胖,降低TC、TG,调节其糖脂代谢,改善胰岛素抵抗;在中医证候方面,此疗法可有效改善肥胖症合并IGR患者临床症状,且治疗组总有效率明显高于对照组。
[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.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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