泄热化浊方治疗胃热滞脾证肥胖患者的临床研究
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摘要
目的:探讨泄热化浊方对胃热滞脾证肥胖患者的减肥作用。方法:通过12周随机平行阳性对照的临床试验,观察泄热化浊方对患者体重、体脂量、体脂分布及脂肪因子的影响。结果:81名受试者完成试验[中药组,男21例/女20例,体重指数(32.3±4.0)kg/m~2,奥利司他组;男15例/女25例,体重指数(33.0±4.5)kg/m~2]。①体质量:试验组体重(91.4±14.7→88.8±14.6,P<0.05)和体重指数下降(32.4±0.6→31.5±0.6,P<0.05),对照组体重和体重指数也下降,干预前后差值两组间比较无差异(P>0.05)。②体脂量:试验组体脂肪量下降(52.3±2.3→48.9±2.6,P<0.05),与对照组相比,两组下降幅度无明显差异。③体脂分布:试验组腰围缩小(103.4±9.3→100.5±9.4,P<0.05),与对照组相比,试验组的腰围缩小幅度优于对照组;试验组躯干脂肪量下降(20.5±4.7→20.0±4.8,P<0.05),对照组躯干体脂肪量未见明显变化。④脂肪因子及炎症因子:试验组血清瘦素水平降低(22.4±21.0→17.0±18.2,P<0.05),与对照组比较无显著差异;试验组肿瘤坏死因子α水平降低(12.1±15.3→8.3±3.6,P<0.05),对照组治疗前后无显著变化;两组脂联素、白介素-6治疗前后均无显著性变化。⑤两组血糖、血脂治疗前后均无显著性变化。结论:泄热化浊方可以一定程度降低胃热滞脾证肥胖患者体质量、体脂量、腰围及血清瘦素水平,改善肥胖的炎症状态,具有减肥作用。
Objective:To investigate the clinical effect of Xiere Huazhuo Decoction in treatment of obesity(stagnation of heat in spleen and stomach).Methods:A 12-week randomized positive controlled trial was designed to observe the effect of Xiere Huazhuo Decoction on weight,body fat,body fat distribution and adipose factor of obesity patients.Results:Eighty-one subjects completed the test[Chinese medicine group,21 male/20 female,body mass index(32.3±4.0)kg/m~2,the orlistat group,15 male/25 female,body mass index(33.0±4.5)kg/m~2].①Weight:The weight of the test group(91.4±14.7→88.8±14.6,P<0.05) and body mass index(32.4±0.6→31.5±0.6,P<0.05) decreased,while the weight and body mass index of the control group also decreased.There was no difference between the two groups before and after intervention(P>0.05).②Body fat:The body fat in the test group decreased(52.3±2.3→48.9±2.6,P<0.05),and there was no significant difference between the test group and control group.③The distribution of body fat:The waist of the test group reduced(103.4±9.3→100.5±9.4,P<0.05) and the amplitude of waist decreasing of the test group wass better than that of the control group.Moreover,the abdominal fat decreased in the test group(20.5±4.7→20.0±4.8,P<0.05).There was no significant change in body fat of the control group.④Adipokines and inflammatory factors:The serum leptin level of the test group decreased(22.4±21.0→17.0±18.2,P<0.05).There was no significant difference compared with the control group.The tumor necrosis factor-α level of the test group decreased(12.1±15.3→8.3±3.6,P<0.05).There was no significant change in the control group before and after treatment.Adiponectin and IL-6 of two groups did not change significantly.⑤There was no significant change in blood glucose or blood lipid of the two groups.Conclusion:Xiere Huazhuo Decoction can reduce the weight,body fat,waist and leptin of obesity patients and improve the inflammatory state of obesity to a certain extent.
Objective:To investigate the clinical effect of Xiere Huazhuo Decoction in treatment of obesity(stagnation of heat in spleen and stomach).Methods:A 12-week randomized positive controlled trial was designed to observe the effect of Xiere Huazhuo Decoction on weight,body fat,body fat distribution and adipose factor of obesity patients.Results:Eighty-one subjects completed the test[Chinese medicine group,21 male/20 female,body mass index(32.3±4.0)kg/m~2,the orlistat group,15 male/25 female,body mass index(33.0±4.5)kg/m~2].①Weight:The weight of the test group(91.4±14.7→88.8±14.6,P<0.05) and body mass index(32.4±0.6→31.5±0.6,P<0.05) decreased,while the weight and body mass index of the control group also decreased.There was no difference between the two groups before and after intervention(P>0.05).②Body fat:The body fat in the test group decreased(52.3±2.3→48.9±2.6,P<0.05),and there was no significant difference between the test group and control group.③The distribution of body fat:The waist of the test group reduced(103.4±9.3→100.5±9.4,P<0.05) and the amplitude of waist decreasing of the test group wass better than that of the control group.Moreover,the abdominal fat decreased in the test group(20.5±4.7→20.0±4.8,P<0.05).There was no significant change in body fat of the control group.④Adipokines and inflammatory factors:The serum leptin level of the test group decreased(22.4±21.0→17.0±18.2,P<0.05).There was no significant difference compared with the control group.The tumor necrosis factor-α level of the test group decreased(12.1±15.3→8.3±3.6,P<0.05).There was no significant change in the control group before and after treatment.Adiponectin and IL-6 of two groups did not change significantly.⑤There was no significant change in blood glucose or blood lipid of the two groups.Conclusion:Xiere Huazhuo Decoction can reduce the weight,body fat,waist and leptin of obesity patients and improve the inflammatory state of obesity to a certain extent.
引文
[1] 侯瑞芳,陶枫,陆灏,等,肥胖的中医治疗进展[J].中华中医药学刊,2015,33(8):1959-1962.
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[10] 陆施婷,陈清光,徐佩英,等.基于中医传承辅助平台探讨丁学屏诊治糖尿病的临证经验及用药规律[J].中国实验方剂学杂志,2017,23(7):198-205.
[11] 陈清光,戴正乾,陶枫,等.丁学屏从脾论治肥胖病临床经验[J].上海中医药杂志,2016,50(6):17-19.
[12] 周仲瑛.中医内科学[M].北京:中国中医药出版社,2008.
[13] Tao F,Lu H,Oppert J M,et al.ZHENG May Contribute to Obesity Phenotypes Based on Body Composition:A Pilot Study on the Traditional Chinese Medicine Approach[J].Evidence-Based Complementray and Alternative Medicine,2014,2014(3):580803.
[14] NCD Risk Factor Collaboration (NCD-RisC).Trends in adult body-mass index in 200 countries from 1975 to 2014:a pooled analysis of 1698 population-based mea- surement studies with 19.2 million participants [J].Lancet,2016,387(10026):1377-1396.
[15] 程棣,林琳,彭魁,等.中国社区人群肥胖与心血管疾病风险的相关性研究[J].中华内分泌代谢杂志,2017,33(6):465-472.
[16] 汪泓,秦黎虹,马文明.浅议中医诊治肥胖[J].中国中医药现代远程教育,2011,9(8):111-112.
[17]吴志远.“肥人多痰湿”探讨[J].浙江中西医结合杂志,2004,14(10):620.
[18]刘晓倩,陶枫,金昕,等.基于文本挖掘方法探索中医治疗肥胖病的用药规律[J].世界科学技术:中医药现代化,2017,19(2):212-217.
[19]史晓娜,陶枫,陆灏,等.肥胖证候和证素分布特征的文献研究[J].上海中医药大学学报,2014,28(4):53-57.
[20]金昕,陈思,徐杰,等.单纯性肥胖就诊患者的中医证素特征分析[J].中华中医药杂志,2016,7(31):2774-2778.
[21] Zhang W L,Zhu L,Jiang J G. Active ingredients from natural botanicals in the treatment of obesity[J]. Obesity Reviews An Official Journal of the International Association for the Study of Obesity,2014,15(12):957-967.
[22]侯瑞芳,徐杰,陈思,等.清化颗粒对高脂饲料诱导肥胖模型大鼠的减重效应及血清瘦素的影响[J].中华中医药杂志,2016,31(3):1005-1008.
[23]闫美玲,夏丽莎,胡长平.代谢炎症与肥胖相关研究进展[J].中国动脉硬化杂志,2015,23(6):634-638.
[4] Korsic'M,Fister K,Ivankovic'D,et al. Visceralobesity[J]. Lijec Vjes,2011,133(7-8):284-287.
[2] Ng M,Fleming T,Robinson M,et al.Global,regional,and national prevalence of overweight and obesity in children and adults during 1980–2013:a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet,2014,384(9945):766-781.
[3] 王兴纯,曲伸.腹型肥胖及其危害[J].糖尿病临床,2015,9(3):,et al.Visceralobesity[J].LijecVjes,2011,133(7-8):284-287.
[5] 姜勇,张梅,李镒冲,等.2010年我国中心型肥胖流行状况及腰围分布特征分析[J].中国慢性病预防与控制,2013,21(3):288-291.
[6] 金昕,侯瑞芳,陶枫,等.防风通圣散调节体重和体脂的研究进展[J].世界中西医结合杂志,2017,12(10):1472-1476.
[7] Qiang Zhou,Bai Chang,Xin-Yan Chen,et al.Chinese herbal medicine for obesity:a randomized,double-blinded,multicenter,prospective trial[J].American Journal of Chinese Medicine,2014,42(6):1-12.
[8] Sui Y,Zhao HL,Wong VCW,et al.A systematic review on use of Chinese medicine and acupuncture for treatment of obesity[J].Obes Rev,2012,13(5):409-430.
[9] 陈清光,戴正乾,陶枫,等.丁学屏从脾论治肥胖病临床经验[J].上海中医药杂志,2016,50(6):17-19.
[10] 陆施婷,陈清光,徐佩英,等.基于中医传承辅助平台探讨丁学屏诊治糖尿病的临证经验及用药规律[J].中国实验方剂学杂志,2017,23(7):198-205.
[11] 陈清光,戴正乾,陶枫,等.丁学屏从脾论治肥胖病临床经验[J].上海中医药杂志,2016,50(6):17-19.
[12] 周仲瑛.中医内科学[M].北京:中国中医药出版社,2008.
[13] Tao F,Lu H,Oppert J M,et al.ZHENG May Contribute to Obesity Phenotypes Based on Body Composition:A Pilot Study on the Traditional Chinese Medicine Approach[J].Evidence-Based Complementray and Alternative Medicine,2014,2014(3):580803.
[14] NCD Risk Factor Collaboration (NCD-RisC).Trends in adult body-mass index in 200 countries from 1975 to 2014:a pooled analysis of 1698 population-based mea- surement studies with 19.2 million participants [J].Lancet,2016,387(10026):1377-1396.
[15] 程棣,林琳,彭魁,等.中国社区人群肥胖与心血管疾病风险的相关性研究[J].中华内分泌代谢杂志,2017,33(6):465-472.
[16] 汪泓,秦黎虹,马文明.浅议中医诊治肥胖[J].中国中医药现代远程教育,2011,9(8):111-112.
[17]吴志远.“肥人多痰湿”探讨[J].浙江中西医结合杂志,2004,14(10):620.
[18]刘晓倩,陶枫,金昕,等.基于文本挖掘方法探索中医治疗肥胖病的用药规律[J].世界科学技术:中医药现代化,2017,19(2):212-217.
[19]史晓娜,陶枫,陆灏,等.肥胖证候和证素分布特征的文献研究[J].上海中医药大学学报,2014,28(4):53-57.
[20]金昕,陈思,徐杰,等.单纯性肥胖就诊患者的中医证素特征分析[J].中华中医药杂志,2016,7(31):2774-2778.
[21] Zhang W L,Zhu L,Jiang J G. Active ingredients from natural botanicals in the treatment of obesity[J]. Obesity Reviews An Official Journal of the International Association for the Study of Obesity,2014,15(12):957-967.
[22]侯瑞芳,徐杰,陈思,等.清化颗粒对高脂饲料诱导肥胖模型大鼠的减重效应及血清瘦素的影响[J].中华中医药杂志,2016,31(3):1005-1008.
[23]闫美玲,夏丽莎,胡长平.代谢炎症与肥胖相关研究进展[J].中国动脉硬化杂志,2015,23(6):634-638.
[4] Korsic'M,Fister K,Ivankovic'D,et al. Visceralobesity[J]. Lijec Vjes,2011,133(7-8):284-287.
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