健脾益气方对脾气虚型更年期综合征糖脂影响的临床研究

 目的 观察健脾益气方改善脾气虚型更年期综合征(climactericsyndrome, CS)症状及调节内分泌代谢的临床疗效。方法 取脾气虚型的更年期综合征患者30例作为病例组，另取年龄匹配的无明显更年期综合征症状的更年期女性20例作为对照组。检测两组血清瘦素（leptin）、胰岛素(insulin, INS)、睾酮(testosterone,T)、胆固醇(total cholesterol, TC)、甘油三脂(triglycerides, TG)、低密度脂蛋白(low density lipoprotein, LDL)、高密度脂蛋白(high density lipoprotein, HDL)、空腹血糖(Blood glucose, BG)、餐后两小时血糖(2hBG)、胰岛素敏感指数(Insulin sensitivity index, ISI)、卵泡刺激素(follicle stimulating hormone, FSH)、黄体生成素(luteinizing hormone, LH)和雌二醇(estradiol, E2)，测量两组腰围(waist circle, WC)、体重指数(Body mass index,BMI)和腰臀比(waist hip ratio, WHR)，以及对病例组进行Kupperman评分、中医脾气虚证候评分，比较病例组与对照组检测指标的组间差异；病例组中24例作为中药组，采用健脾益气方治疗4周，比较治疗前后Kupperman评分、中医脾气虚证候评分及WC、BMI、WHR、Leptin、 INS、T、ISI、BG、2hBG、TC、TG、HDL、LDL、E2、LH、FSH。结果 病例组和对照组E2、T、FSH、LH水平无显著性差异(P >0.05)；病例组和对照组WC、BMI、WHR及BG、 INS、 ISI、 Leptin比较病例组高于对照组，差异有统计学显著意义(P<0.05)；病例组和对照组TC、TG、HDL、LDL比较虽无显著性差异(P>0.05)，但病例组血脂水平均高于对照组；中药组治疗前后T、E2、FSH、LH无显著性差异(P >0.05)；治疗后BG、血脂有下降趋势；血INS, Leptin下降而ISI增高有统计学差异(P<0.05)；治疗后kupperman评分和脾气虚评分均显著下降有统计学差异（P<0.01）；结论 更年期综合征存在能量物质的代谢障碍；雌激素水平低下可能并不是引起脾气虚型更年期综合征症状以及糖脂代谢异常的唯一因素；INS、Leptin分泌异常可能是脾气虚型更年期综合征发病以及导致糖脂代谢异常的不可忽略的因素；健脾益气方能有效改善脾气虚型更年期综合征症状及调节INS、Leptin的异常。

Clinical study of the invigorating spleen and replenishing Qi formula on the patients with climacteric syndrome of Pi Qi deficiency

Objective To observe whether “the invigorating spleen and replenishing qi formula” improves the symptom of climacteric syndrome and accommodates the endocrine function and metabolism. Methods 30 climactericsyndrome (CS) patients were observed as the patient group, 20 agematched females were in the control group. Testing the serum level of leptin, insulin, testosterone, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fast blood glucose, insulin intensity index, follicle stimulating hormone, luteinizing hormone and estradiol of both groups were detected; The body mass index(BMI), waist and hip ratio were measured.in both groups; Scoring the patient group with kupperman index and pi index. 24 patients with CS in the patient group were treated with the invigorating spleen and replenishing qi formula for 4 weeks; The indexes before and after the treatment were compared. Results After treatment kupperman index is significantly declined.（P<0.01）; INS，ISI, Leptin, waist, BMI have significant declined after the treatment. There is no significant variance of E2, T, FSH, LH in both groups and before and after the treating. Conclusions There is abnormal metabolic disorder in energy and material in CS with Pi qi deficiency type; low estradiol may be not the only reason in CS with Pi qi deficiency type; abnormal Leptin and INS may be the unneglected factors in CS; invigorating spleen and replenishing qi formula could improve the symptoms and accommodate the Leptin and INS level.