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目的 :观察疏肝化浊汤联合西医常规疗法治疗代谢综合征的疗效。方法 :将120例代谢综合征痰浊郁阻证患者随机分为西医组和中西医结合组各60例。西医组除生活方式干预外,根据患者的具体情况采用马来酸依那普利片、胰岛素、阿托伐他汀钙片来治疗,中西医结合组在西医组治疗基础上加用疏肝化浊汤治疗,2组疗程均为4月。检测2组患者治疗前后的空腹血糖(FBG)、餐后2 h血糖(P2h BG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)水平,计算胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR);测量体质量、腰围和臀围,计算腰臀比(WHR)和体质量指数(BMI);检测甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平;并进行痰浊郁阻证评分。结果:治疗后,2组FBG、P2h BG、Hb A1c、FINS、HOMA-IR均较治疗前下降(P<0.01),ISI均较治疗前上升(P<0.01);中西医结合组Hb A1c、FINS、HOMA-IR水平均低于西医组(P<0.01),ISI高于西医组(P<0.01),2组间FBG和P2h BG比较,差异均无统计学意义(P>0.05)。2组体质量、腰围、WHR和BMI均较治疗前下降(P<0.01);中西医结合组体质量、腰围、WHR和BMI均低于西医组(P<0.05)。2组TC、TG、LDL-C水平均较治疗前下降(P<0.01),HDL-C水平均较治疗前升高(P<0.01);中西医结合组TG、TC、LDL-C水平均低于西医组(P<0.01),HDL-C水平高于西医组(P<0.01)。2组痰浊郁阻证评分均较治疗前下降(P<0.01),中西医结合组痰浊郁阻证评分低于西医组(P<0.01)。结论 :在西医降糖、调脂、降压等干预的基础上加用疏肝化浊汤治疗,能进一步调节代谢综合征患者的糖脂代谢,提高机体的胰岛素敏感性,改善胰岛素抵抗,改善中医证候,有助于防治心血管疾病和延缓糖尿病的发生、发展。
Objective: To observe the curative effect of Shugan Huazhuo Decoction combined with Western conventional therapy on metabolic syndrome. Methods: 120 patients with metabolic syndrome phlegm stagnation syndrome were randomly divided into Western medicine group and Integrative Medicine group 60 cases. Western medicine group in addition to lifestyle intervention, according to the specific circumstances of patients with enalapril maleate tablets, insulin, atorvastatin calcium tablets to treat, Integrative Medicine Group on the basis of Western medicine group with Shugan Huazhuo Soup treatment, two groups of treatment are April. The fasting blood glucose (FBG), postprandial 2h blood glucose (HbA), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index -IR). Body mass, waist circumference and hip circumference were measured. WHR and BMI were calculated. TG, TC, HDL- C) and low-density lipoprotein cholesterol (LDL-C) levels; Results: After treatment, the FBG, P2h BG, Hb A1c, FINS and HOMA-IR of two groups were significantly lower than those before treatment (P <0.01) The levels of FINS and HOMA-IR in the two groups were lower than those in western medicine group (P <0.01), ISI was higher than western medicine group (P <0.01). There was no significant difference between FBG and P2h BG in the two groups (P> 0.05). The body weight, waist circumference, WHR and BMI of two groups were significantly lower than those before treatment (P <0.01). The body mass, waist circumference, WHR and BMI of the TCM-WM group were lower than those of the WM group (P <0.05). The levels of TC, TG and LDL-C in the two groups were significantly lower than those before treatment (P <0.01), while the levels of HDL-C in the two groups were significantly higher than those before treatment (P <0.01) Lower than Western medicine group (P <0.01), HDL-C level higher than Western medicine group (P <0.01). The phlegm and blood stasis syndrome score decreased in both groups (P <0.01), while the score of phlegm-turbidity depression syndrome in combination group was lower than that in Western medicine group (P <0.01). Conclusion: Western medicine hypoglycemic, lipid-lowering, blood pressure and other interventions based on the addition of Shuganhuazhuo decoction can further regulate glucose and lipid metabolism in patients with metabolic syndrome, improve the body’s insulin sensitivity, improve insulin resistance, improve TCM syndromes, help prevent and cure cardiovascular diseases and delay the occurrence and development of diabetes.