六君子汤加味联合奥利司他治疗脾虚湿阻证单纯性肥胖症临床研究

目的:观察六君子汤加味联合奥利司他治疗脾虚湿阻证单纯性肥胖症的临床疗效及对血清瘦素(leptin)和脂联素(ADPN)水平的调节作用。方法:将80例患者随机分为对照组40例和观察组40例,对照组口服奥利司他治疗,观察组在对照组的基础上加用六君子汤加味治疗,2组均连续治疗12周;观察比较2组脾虚湿阻证证候评分、肥胖指征、临床疗效及血清leptin、ADPN水平。结果:总有效率观察组为95.00%,对照组为75.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组患者浮肿、疲乏无力、肢体困重、纳差、腹满等脾虚湿阻证证候评分较治疗前明显下降(P<0.05),且观察组上述各项评分均低于对照组(P<0.05)。治疗后,2组患者体质量、体质量指数(BMI)、体脂含量(FAT)值均较治疗前明显下降(P<0.05),且观察组上述各指标改善较对照组更显著(P<0.05)。治疗后,2组血清leptin水平均较治疗前降低(P<0.05),ADPN水平升高(P<0.05);且观察组两项指标改善较对照组更显著(P<0.05)。结论:六君子汤加味联合联合奥利司他治疗脾虚湿阻证单纯性肥胖症疗效显著,调节leptin、ADPN水平可能是其作用机制之一。

Clinical Study on Modified Liujunzi Tang Combined with Orlistat for Simple Obesity with Syndrome of Spleen Deficiency with Dampness Obstruction

Objective: To observe the clinical effect of modified Liujunzi tang combined with Orlistat for simple obesity with syndrome of spleen deficiency with dampness obstruction and its regulation of levels of leptin and adiponcetin(ADPN).Methods:A total of 80 cases of patients were randomly divided into the control group and the observation group,40 cases in each group. The control group was given oral administration of orlistat, and the observation group was additionally treated with Liujunzi tang based on the treatment of the control group. Both groups were treated for 12 weeks. The syndrome scores of syndrome of spleen deficiency with dampness obstruction, the indexes of obesity, the clinical effect and the levels of leptin and ADPN in serum in the two groups were observed and compared. Results:The total effective rate was 95.00% in the observation group and 75.00% in the control group, the difference being significant(P < 0.05). After treatment, the syndrome scores of syndrome of spleen deficiency with dampness obstruction including edema,fatigue and asthenia,heavy sensation in limbs,poor appetite and abdominal fullness in the two groups were significantly decreased when compared with those before treatment(P < 0.05),and the above scores in the observation group were lower than those in the control group(P < 0.05). After treatment,the values of body weight,BMI and FAT in the two groups were significantly decreased when compared with those before treatment(P < 0.05),and the improvement of the above indexes in the observation group was more significant than that in the control group(P < 0.05). After treatment,the levels of leptin in serum in the two groups were decreased when compared with those before treatment(P < 0.05),and the levels of ADPN were increased(P < 0.05);the improvement of the above two indexes in the observation group was more significant than that in the control group(P < 0.05).Conclusion: The therapy of modified Liujunzi tang combined with Orlistat for simple obesity with syndrome of spleen deficiency with dampness obstruction has significant curative effect. One of its mechanism may be regulating levels of leptin and ADPN.