益肾活血胶囊治疗糖耐量异常的临床研究

目的观察益肾活血胶囊治疗糖耐量异常的临床疗效和安全性。方法采用随机平行对照的临床试验。选取60例既符合糖耐量异常,又符合中医气虚血瘀证辨证标准的患者随机分为两组：治疗组30例和阳性对照组30例。治疗组：在饮食运动干预的基础上口服益肾活血胶囊0.5g/粒,一次4粒,一日3次;对照组：在饮食运动干预的基础上口服盐酸二甲双胍肠溶片0.25g/片,一次1片,一日3次;两组均以6周为一个疗程。治疗前后分别检测：糖耐量试验（Oral Glucose Tolerance Test,OGTT）,总胆固醇（Total Cholesterol,TC）、甘油三酯（Triglyceride,TG）、高密度脂蛋白胆固醇（High Density Lipoprotein Cholesterol,HDL-C）、低密度脂蛋白胆固醇（Low Density Lipoprotein Cholesterol,LDL-C）、体重指数（Body Mass Index,BMI）。结果治疗组服用益肾活血胶囊后能明显改善患者的临床症状与体征,与对照组相比差异性显著（P〈0.05）,同时患者OGTT中空腹血糖（FPG）、餐后2h血糖（2hPG）、TC、TG、LDL-C、BMI较治疗前明显下降,与治疗前相比差异有显著性（P〈0.05）。结论益肾活血胶囊可以用于干预糖耐量异常,并且降低糖尿病患病率;新型的中药制剂在治疗慢性病患者时,提高了患者的依从性。     

艾灸对高脂血症患者血脂、血糖的影响

目的观察艾灸对高脂血症患者血脂、血糖代谢的影响。方法以高脂血症患者为研究对象,温和灸神阙、双侧足三里穴。观察患者治疗前和治疗后空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)变化,疗程为12星期。结果治疗后FBG、TC、LDL-C下降(P<0.01);TG下降(P<0.05);HDL-C治疗前后无统计学差异(P>0.05)。结论艾灸治疗高脂血症患者,不仅能改善血脂代谢,同时还改善调节糖代谢。     

中药降脂汤配合阿托伐他汀对高血脂症患者的影响研究

目的:研究临床上利用中药降脂汤联合阿托伐他汀治疗高血脂症患者的临床效果。方法:选我院接受治疗的高脂血症66例,33例单纯采用阿托伐他汀治疗,为对照组;33例采用阿托伐他汀联合中药降脂汤治疗,为观察组。对比临床治疗效果、不良反应的发生情况,最后进行统计。结果:两组患者的血脂情况[总胆固醇(Total Cholesterol,TC)、低密度脂蛋白胆固醇(Low Density Lipoprotein Cholesterol, LDL-C)、高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)以及甘油三酯(Triglyceride,TG)]治疗前并没有明显差别,P 0.05,但观察组明显优于对照组,P 0.05;此外,观察组患者临床治疗有效率显著优于对照组患者,P 0.05;而且,观察组患者的不良反应发生情况也明显优于对照组患者,P 0.05,差异具有统计学意义。结论:由此可知,对高脂血症患者利用中药降脂汤配合阿托伐他汀进行治疗可以明显的改善患者的血脂情况,从而更明显的提高患者的临床治疗效果,安全可靠。     

阿托伐他汀钙治疗高脂血症合并高尿酸血症38例

目的观察阿托伐他汀钙治疗高脂血症合并高尿酸血症的临床疗效。方法将76例高脂血症合并高尿酸血症患者随机分为两组：阿托伐他汀钙组38例,口服阿托伐他汀钙20mg;辛伐他汀组38例,口服辛伐他汀20mg;均每晚睡前顿服1次,疗程8周,对比两组治疗前后总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和血尿酸（BUA）的变化。结果两组治疗后TC、LDL-C、TG均有降低,HDL-C升高（P〈0.05）;但治疗后阿托伐他汀钙组血尿酸水平明显下降（P〈0.05）,而辛伐他汀组下降不明显（P〉0.05）;两组比较差异有统计学意义（P〈0.05）。结论阿托伐他汀钙除了能较好的降脂外,还有降低血尿酸作用。因此高脂血症合并高尿酸血症患者应首选阿托伐他汀钙。     

益气活血法对冠心病患者血脂的影响

目的：评价益气活血法对冠心病患者合并高脂血症的疗效。方法：采用随机、单盲、对照试验方法,疗程4周,治疗组和对照组各50例,两组均常规抗冠心病药物治疗。治疗组在常规治疗基础上,加服益气活血法之调脂宁心汤,每日1剂,水煎分2次温服,4周为1疗程。治疗前后抽取两组患者空腹静脉血,按常规方法检查血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。结果：治疗后两组TC、LDL-C均明显降低（P〈0.05）;治疗组TG亦明显下降、而HDL-C明显升高（P〈0.05）,而对照组TG则无明显下降、HDL-C亦无明显升高（P〉0.05）。且治疗组在降低TC和LDL-C方面明显优于对照组（P〈0.05）。结论：益气活血法对冠心病患者的高脂血症具有良好的疗效,且使用安全。     

调脂活络方对高脂血症的影响

目的观察调脂活络方对高脂血症的影响。方法将72例高脂血症患者随机分为2组,对照组37例予烟酸肌醇酯片治疗,治疗组35例予调脂活络方治疗。2组均治疗4周。检测2组治疗前后总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）变化情况,统计临床疗效。结果治疗组总有效率91.43%,对照组总有效率81.08%,2组总有效率比较差异有统计学意义（P〈0.01）,治疗组疗效优于对照组。2组治疗后TC、TG与本组治疗前比较均下降（P〈0.05）,HDL-C升高（P〈0.05）,且治疗组TG低于对照组（P〈0.01）;治疗组治疗后LDL-C与本组治疗前比较明显下降（P〈0.05）。结论调脂活络方对高脂血症患者有较好的调脂作用,疗效确切。     

PGLA穴位埋植治疗高脂血症的临床研究

目的:探讨PGLA穴位埋植治疗高脂血症的临床效果。方法:随机选取2017年8月-2018年3月我院住院部高脂血症患者38例,按照1∶1的比例随机分为实验组与对照组,每组19例。实验组采取PGLA穴位埋植治疗,对照组采用口服阿托伐他汀钙片治疗8周。比较两组患者治疗后用血清总胆固醇(Total Cholesterol,TC)、总甘油三脂(Triglyceride,TG)、血高密度脂蛋白胆固醇(High-Dinsify Liporprotein Cholesterol,HDL-C)、血低密度脂蛋白胆固醇(Low-Density Lipoprotein Cholesterol,LDL-C)水平以及治疗有效率。结果:实验组与观察组治疗后TC、TG、HDL-C、LDL-C差异无统计学意义(P 0.05)。实验组经PGLA穴位埋植不良反应发率为5.26%,显著低于对照组的10.53%,差异显著具有统计学意义(P 0.05)。实验组有效率为89.47%,显著高于对照组的68.42%(P 0.05)。结论:PGLA穴位埋植治疗法能够降低高脂血症患者的血脂水平,对治疗高脂血症有显著效果,可以在临床上进行推广使用。     

中医护理联合常规医护措施干预2 型糖尿病合并高脂血症临床研究

目的：观察中医护理联合常规医护措施干预2 型糖尿病（T2DM） 合并高脂血症的临床疗效。方法：将116 例患者随机分为对照组和观察组各58 例。2 组均予药物控制血糖、调脂，通过慢病管理平台对患者进行管理，给予健康教育及减轻体质量、调整膳食结构、运动方式的指导。观察组给予中医饮食指导和心理调摄指导。2 组疗程均为12 周，患者每周至少接受3 次护理指导。治疗前后检测甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）、餐后2 h 血糖（P2hBG） 和糖化血红蛋白（HbA1c） 水平，治疗后计算LDL-C 达标率，评价护理满意度和弗明汉危险评分（FRS）。结果：治疗后，观察组LDL-C 达标率高于对照组（P＜0.05）。2 组TC、TG、LDL-C 水平均治疗前下降（P＜0.01），HDL-C 水平均较治疗前升高（P＜0.01）。观察组TC、TG、LDL-C 水平均低于对照组（P＜0.05），HDL-C 水平高于对照组（P＜0.05）。2 组FBG、P2hBG、HbA1c 水平均较治疗前下降（P＜0.01），观察组P2hBG、HbA1c 水平均低于对照组（P＜0.05）。观察组心血管危险程度轻于对照组（P＜0.05），护理满意度高于对照组（P＜0.05）。结论：在常规药物治疗和护理的基础上加用中医饮食指导和心理调摄指导干预T2DM 合并高脂血症患者，可进一步调节血脂水平，提高LDL-C 达标率，并能调节糖代谢，减轻心血管危险程度，同时提高患者对护理工作的满意度。     

依折麦布辛伐他汀片与辛伐他汀治疗高脂血症的疗效观察

目的研究依折麦布辛伐他汀片与不同剂量辛伐他汀片治疗高脂血症的临床疗效。方法将125例高脂血症患者随机分为A组（40例）、B组（43例）、C组（42例）3组,分别给予A组依折麦布辛伐他汀片（10mg/20mg）、B组辛伐他汀40mg、C组辛伐他汀20mg,均每晚顿服,共治疗12周,观察其调脂疗效及安全性。结果治疗12周后,3组患者总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、LDL-C/HDL-C均呈下降趋势（P〈0.05）,高密度脂蛋白胆固醇（HDL-C）呈上升趋势（P〈0.05）。组间比较：A组TC、LDL-C降低水平较B组明显（P〈0.05）;B组TC、LDL-C降低较C组明显（P〈0.05）;A组TC、LDL-C、TG降低水平较C组明显（P〈0.05）;观察期间3组均无不良反应及心血管事件发生。结论依折麦布辛伐他汀片较辛伐他汀的调脂效果明显,且安全性好。     

自拟调脂方治疗高脂血症疗效观察

目的：观察中医药自拟方治疗高脂血症临床疗效。方法：将78例确诊的高脂血症患者随机分为治疗组40例,对照组38例,治疗组予中医药自拟方加减治疗,对照组口服血脂康,每次0.6g,每天2次,疗程均为2个月。结果：治疗组有效率为90%,对照组为71%,治疗组疗效优于对照组（P〈0.05）。2组治疗后血清胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）均显著降低（P〈0.05）,高密度脂蛋白胆固醇（HDL-C）显著升高（P〈0.05）;治疗组降低TG和升高HDL-C的差值均优于对照组（P均〈0.05）。结论：中医药自拟方对高脂血症有良好的临床疗效。     

Effect of preventive acupuncture and moxibustion on hypothalamus and ovarian leptin and blood lipid levels in menopausal rats

Objective:To observe the changes of hypothalamus, ovarian leptin levels and blood lipid in 12-month-old rats with natural menopause, and the effect of preventive acupuncture and moxibustion at Guanyuan (CV 4). To explore the impact of preventive acupuncture and moxibustion on the internal environment of early menopause disorder. Methods:Menopausal female rats were screened by vaginal smear. Rat model of menopause was obtained by natural aging method. Preventive acupuncture and moxibustion at Guanyuan (CV 4) was used as intervention methods. Hypothalamus and ovarian leptin levels were detected by radioimmunoassay. Plasma total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) levels were determined by biochemical methods. Results:Compared with the young control group, leptin levels in the hypothalamus and ovarian increased (P<0.01), plasma TC increased (P<0.05), LDL increased (P<0.01), and HDL reduced in 12-month-old rats. Hypothalamus and ovary leptin levels in 12-month-old rats with preventive acupuncture and moxibustion were significantly decreased (P<0.01); plasma TC and LDL levels decreased and HDL levels were increased in rats with preventive acupuncture (P<0.05). Conclusion:Preventive acupuncture and moxibustion can improve leptin resistance state and restore the abnormal lipid levels in menopausal body, and therefore can slow down the disorder of inner environment in early menopause.     

Effects of modified Lingguizhugan decoction combined with weekend fasting on metabolic syndrome

Objective

To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome (MetS).

Methods

Twenty-one patients with MetS were recruited from the First Affiliated Hospital of Sun Yat-Sen University. Fasting plasma glucose (FPG), 30-min and 2-h post-prandial blood glucose (PG), fasting serum insulin (FINS), blood pressure (BP), body mass index (BMI), waist circumference (WC), homeostasis model assessment for insulin resistance index (HOMA-IR), and levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were tested. Patients were allowed to drink only water and a Chinese herbal decoction during weekends. All samples were tested again after 12 weeks of treatment.

Results

FPG, 30-min PG, 2-h PG, FINS, LDL-C, systolic BP, diastolic BP, BMI, WC, and HOMA-IR decreased significantly (P<0.05) compared with before treatment. Levels of TG, TC, and HDL-C did not change significantly.

Conclusion

Weekend fasting improved glucose metabolism, lowered BP, reduced LDL-C levels, BMI, and WC. These data suggest that weekend fasting may be an effective therapy for MetS by protection against coronary atherosclerosis.     

Effect of tuina exercise on simple obesity in college students

Objective

To observe the effect of tuina exercise on simple obesity in college students.

Methods

Fifty-seven college students with simple obesity were divided into two groups according to the stratified randomization method. Twenty-eight in the tuina exercise group were trained in tuina exercise; while 29 in the auricular acupoint sticking group were treated with acuricular acupoint sticking. The tuina exercise group was trained once every other day, and 10 times made one course. The auricular acupoint sticking was replaced once every 4 d, and 5 times made one course. After 2-course treatment, the total therapeutic effect, weight, body mass index (BMI), waist and hip circumferences, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed.

Results

The total therapeutic effect was 86.2% in the auricular acupoint sticking group and 85.7% in the tuina exercise group. There was no significant difference between the two groups (P>0.05). After treatment, the weight, BMI, waist and hip circumferences were decreased and the differences were statistically significant (all P<0.05). The waist and hip circumferences in the tuina exercise group were lower than those in the auricular acupoint sticking group, showing statistically significant differences (all P<0.05). After treatment, there were no significant intra-group differences in TC, TG, HDL-C and LDL-C in the two groups (all P>0.05), and the between-group differences were not significant (all P>0.05).

Conclusion

Tuina exercise has reliable effect in treating obesity. It can produce more significant improvements in waist and hip circumferences than auricular acupoint sticking. But no obvious effect is shown in blood lipid indicators.

     

Lipid-lowering effects of Danhong injection on hyperlipidemia rats

Ethnopharmacological relevance

Danhong injection (DHI), a Chinese medical product extracted from Radix et Rhizoma Salviae Miltiorrhizae (Salvia miltiorrhiza Bge., Labiatae, Danshen in Chinese) and Flos Carthami (Carthamus tinctorius L., Compositae, Honghua in Chinese), has been reported to have anti-inflammatory, anti-oxidative and anti-fibrinolytic properties and is used extensively for the clinical treatment of cardiovascular disease in clinic. This study aimed to investigate the preventive and therapeutic effects of DHI on hyperlipidemia.

Materials and methods

Forty-eight adult male Sprague-Dawley rats were randomly divided into four groups: normal control (NC), model control (MC) and DHI-treated at doses of 1.0 mL/kg and 2.0 mL/kg. The effects of DHI on serum triglyceride (TG), total cholesterol (TC), glucose, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were evaluated and insulin was determined by enzyme-linked immunosorbent assay (ELISA). Moreover, the expression of acetyl-CoA carboxylase 1 (ACC1), fatty acid synthase (FAS), carnitine palmitoyl transferase 1 (CPT1), hydroxymethylglutaryl-CoA reductase (HMGR) and peroxisome proliferator-activated receptor alpha (PPAR-α) in liver were determined by real-time PCR.

Results

Compared with the MC group, rats treated with DHI had significantly reduced TG, TC, LDL-C and arteriosclerosis index (AI). Expression of FAS and HMGR mRNA was significantly reduced, whereas the CPT1 and PPAR-α were significantly increased.

Conclusion

DHI treatment was accompanied by significantly increased lipolysis in the liver and decreased fatty acid synthesis. The insights gained from this study will improve both understanding of the mechanisms involved in the effect of DHI on hyperlipidemia and the pharmacological rationale for the use of DHI in diseases caused by lipid metabolic disorders.     

健身气功八段锦对糖耐量低减的干预效果研究

[目的]探讨健身气功八段锦对糖耐量低减(IGT)患者生化指标的影响。[方法]从广东省中医院体检中心选取89例IGT患者,随机分成A、B、C组,依次采用健康教育、健康教育+步行、健康教育+八段锦干预1 a,比较干预前后空腹血糖(FBG)、餐后2小时血糖(2 hBG)、糖化血红蛋白(HbA1C)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDLC)、胆固醇(TC)、甘油三酯(TG)的变化情况。[结果]干预后,A组的FBG、2 h BG、LDL-C和B组的FBG、2 h BG、HbA1C、LDL-C、TG及C组的FBG、2 h BG、HbA1C、LDL-C、TC、TG均明显减少(P0.05或P0.01)。B组的2 h BG值明显低于A组(P0.05),C组的FBG、TC值明显低于A组(P0.05或P0.01),其他指标组间比较均无统计学意义(P0.05)。[结论]健康教育特别是健康教育+八段锦等运动干预能明显降低IGT患者的血糖、糖化血红蛋白和血脂。     

针刺配合雷火灸治疗颈型颈椎病临床研究

目的：观察针刺配合雷火灸治疗颈型颈椎病的临床疗效。方法：将符合纳入标准的60例颈型颈椎病患者随机分为治疗组和对照组,每组30例。治疗组采用针刺配合雷火灸治疗;对照组采用单纯针刺治疗。观察治疗前后症状、体征积分及视觉模拟量表（Visual Analogue Scale,VAS）评分的变化。结果：治疗组在提高临床疗效、降低VAS评分,改善临床症状、体征积分方面均优于对照组（P〈0.01 或P〈0.05）。差异均有统计学意义。结论：针刺配合雷火灸能明显减轻颈型颈椎病患者的疼痛症状,改善颈椎功能。     

Effect of warm needling plus oral medication on blood lipids in cerebral infarction patients

Objective

To observe the effect of warm needling plus oral administration of rosuvastatin calcium tablets on blood lipids in cerebral infarction patients.

Methods

A total of 125 eligible cases were randomly allocated into group A (n=42), group B (n=40) and group C (n=43). Cases in group A received warm needling plus oral administration of rosuvastatin calcium tablets, cases in group B received warm needling, whereas cases in group C received oral administration of rosuvastatin calcium tablets.

Results

After treatment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) all dropped obviously in the three groups, with significant differences (all P<0.05), modified Barthel index (BI) scores all significantly rise (all P<0.05), and high-density lipoprotein cholesterol (HDL-C) remained unchanged (all P>0.05). After treatment, the changes of TC, TG and LDL-C in group A were significantly different from those in group B and group C (all P<0.05), while the changes showed no statistical significance between group B and group C (P>0.05). There were no between-group differences in HDL-C among the three groups (all P>0.05); the modified BI scores in group A and group B were significantly higher than that in group C (both P<0.05), while there was no significant difference between group A and group B (P>0.05). After treatment, the total effective rate was significantly higher in group A than that in group B and group C (both P<0.05), there was no significant difference between group B and group C (P>0.05).

Conclusion

Warm needling and oral administration of rosuvastatin calcium tablets both can adjust blood lipids effectively in cerebral infarction patients with a similar therapeutic efficacy, while the effect gets better based upon combining both methods; acupuncture-moxibustion plays an important role in the recovery of nerve functions in cerebral infarction patients.

     

2型糖尿病眼肌麻痹患者胰岛素抵抗、脂代谢紊乱与神经病变的关系

目的探讨2型糖尿病眼肌麻痹患者胰岛素抵抗、脂代谢紊乱与神经病变的关系。方法对56例2型糖尿病眼肌麻痹患者(T2DM+OMP)、56例2型单纯糖尿病患者(T2DM)及56例健康对照者(HC)进行隔夜空腹12 h血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)检测并进行分析,用稳态模型方法评估各组人群空腹胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)及胰岛β细胞功能(HOMA-β)。结果 T2DM+OMP组FBG、FINS、HOMA-IR、HbA1c、TC、TG、LDL-C浓度均显著高于T2DM组及HC组(P均<0.01),ISI、HOMA-β、HDL-C血清浓度显著低于T2DM组及HC组(P均<0.01)。T2DM组FBG、FINS、HOMA-IR、HbA1c、TC、TG浓度高于HC组(P均<0.05),T2DM组ISI、HOMA-β、HDL-C浓度低于HC组(P均<0.01)。结论胰岛素抵抗、脂代谢紊乱极大地促进了糖尿病微血管及神经病变的发生和发展,控制血糖、改善脂代谢异常、减少胰岛素抵抗、保护胰岛β细胞功能对预防和治疗2型糖尿病神经病变有指导意义。     

Treatment of primary dysmenorrhea with herb-partitioned moxibustion plus ultra-short wave

Objective： To observe the clinical effect of herb-partitioned moxibustion plus ultra-short wave for primary dysmenorrhea （PD）. Methods： One hundred and thirty patients with PD were randomly divided into a treatment group and a control group, 65 cases in each group. Patients in the treatment group were treated with herb-partitioned moxibustion plus ultra-short wave, while patients in the control group were treated with oral administration of Ibuprofen sustained-release capsules. After completing three courses of treatments, the clinical effects were evaluated by professional researchers. Results： The recovery rate of the treatment group was 58.5%, and the total effective rater was 98.5%; versus 24.6% and 81.5% in the control group. The between-group differences were statistically significant （P〈0.05）. Conclusion： Herb-partitioned moxibustion plus ultra-short wave is an easy-to-operate and effective therapy for PD.