平肝益肾涤痰饮治疗高血压肥胖31例临床观察

目的观察平肝益肾涤痰饮对高血压肥胖患者的临床疗效,并探讨其可能的作用机制。方法共60例患者,随机分为对照组和中药组(在对照组方法上加用中药),治疗8周。观察血压、体重、腰围(WC)、腰臀比(WHR)、代谢参数及胰岛素(FINS)、瘦素的变化,进行治疗前后和组间比较。结果中药组治疗后收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、WC、WHR、血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、FINS、瘦素、胰岛素敏感指数(ISI)与治疗前比较差异有显著性意义(P<0.05或P<0.01),SBP、DBP、FPG、TC、HDL-C、LDL-C、ISI和对照组比较差异也有显著性意义(P<0.05)。结论临床上治疗高血压肥胖患者时,在适度运动、合理膳食及口服降压药的基础上加用中药疗法,可以更有效地改善血压、体重和BMI等,对代谢参数也有调整作用,其机理可能与增加胰岛素敏感性和降低瘦素有关。

Pinggan Yishen Ditan Decoction for Hypertensive Obesity: A Clinical Observation of 31 Cases

Objective To observe the therapeutic effect of Pinggan Yishen Ditan Decoction (Liver-Calming Kidney-Boosting Phlegm-Flushing Decoction) for hypertensive obesity and its possible mechanism.Methods Sixty cases of hypertensive obesity were randomly divided into Chinese medicine group (Chinese medicine was added on the basis of treatment in control group) and control group.The treatment course lasted for 8 weeks.Blood pressure (BP),body weight,waist circum-ference(WC),waist-to-hip ratio(WHR),metabolism parameters,fasting insulin(FINS) and Leptin were observed and compared before and after treatment.Results There was significant difference in SBP,DBP,BMI,WC,WHR,FPG,TC,TG,HDL-C,LDL-C,FINS,Leptin and ISI after treatment in Chinese medicine group (P<0.05 or P<0.01),and there was significant difference in SBP,DBP FPG TC,HDL-C,LDL-C and ISI between the two groups (P<0.05).Conclusion Chinese medicine treatment can improve BP,body weight and BMI and regulate metabolism parameters for hypertensive obesity on the basis of moderate exercises,rational diet and enalapril meleate,which maybe relvant to its increasing insulin sensitivity and decreasing Leptin.