健脾化湿法联合西药治疗脾虚痰湿型高脂血症的临床观察

目的观察健脾化湿法联合西药治疗脾虚痰湿型高脂血症的疗效。方法将2016年11月—2018年11月期间收治的106例原发性高脂血症病例随机分为治疗组与对照组,各53例。对照组采用西药辛伐他汀片治疗,治疗组在对照组基础上联合健脾化湿法,疗程均为3个月。比较两组临床疗效总有效率、治疗前后的中医证候总积分、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)及治疗期间不良反应总发生率。结果治疗后治疗组总有效率90.57%,显著高于对照组75.47%,差异有统计学意义(P<0.05)。治疗后两组中医证候总积分均较治疗前显著降低(P<0.05);且治疗组中医证候总积分为(2.30±0.49)分,显著低于同期对照组(2.90±0.53)分,差异有统计学意义(P<0.05)。治疗后两组血清TC、TG、LDL-C均较治疗前显著降低,HDL-C均较治疗前显著升高(P<0.05);且治疗组血清TC、TG、LDL-C分别为(5.02±0.68)mmol/L、(1.36±0.33)mmol/L、(2.16±0.35)mmol/L,显著低于对照组(5.45±0.57)mmol/L、(1.58±0.39)mmol/L、(2.53±0.38)mmol/L,HDL-C为(1.52±0.30)mmol/L,显著高于对照组(1.33±0.25)mmol/L,两组比较差异有统计学意义(P<0.05)。治疗后两组患者均无严重不良反应,治疗组与对照组不良反应总发生率分别为13.21%与9.43%,差异无统计学意义(P>0.05)。结论健脾化湿法联合西药治疗脾虚痰湿型高脂血症可进一步强化降血脂作用,并缓解患者症候,疗效满意,安全性高。

Effect of Jianpi Huashi Therapy combined with western medicine in the treatment of hyperlipidemia in spleen deficiency with phlegm-dampness pattern

Objective To observe the effect of Jianpi Huashi Therapy combined with western medicine in treating hyperlipidemia in spleen deficiency with phlegm-dampness pattern.Methods A total of 106 patients with primary hyperlipidemia admitted from November,2016 to November,2018 were randomly divided into an observation group and a control group using random number table method,with 53 patients in each group.The control group was given western medicine of simvastatin tablets,while the observation group was given Jianpi Huashi Therapy(spleen-invigorating and dampness-resolving)on the basis of the control group.The course of treatment was 3 months.The total effective rate,total TCM syndrome score,TC,TG,LDL-C,HDL-C before and after treatment and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the observation group(90.57%)was significantly higher than that of the control group(75.47%)(P<0.05).After treatment,the total TCM syndrome score in both groups were significantly lower than those before treatment(P<0.05),and the observation group(2.30±0.49)was significantly lower than the control group(2.90±0.53)at the same time point,with statistical significance(P<0.05).After treatment,the serum levels of TC,TG and LDL-C in both groups significantly decreased and the level of HDL-C significantly increased,compared with those before treatment(P<0.05);the serum levels of TC,TG and LDL-C in the observation group[(5.02±0.68)mmol/L,(1.36±0.33)mmol/L,(2.16±0.35)mmol/L]were significantly lower than those in the control group[(5.45±0.57)mmol/L,(1.58±0.39)mmol/L,(2.53±0.38)mmol/L];the level of HDL-C in the observation group(1.52±0.30)mmol/L was significantly higher than that of the control group(1.33±0.25)mmol/L,with statistical significance(P<0.05).The total incidence of adverse reactions in the observation group and the control groupwas 13.21%and 9.43%respectively,without statistical significance(P>0.05),and no severe adverse reaction was found in either group after treatment.Conclusion For hyperlipidemia in spleen deficiency with phlegm-dampness pattern,Jianpi Huashi therapy combined with western medicine can reduce lipid level,relieve TCM symptoms with a satisfactory effect and high safety.