补肾调脾方对女性更年期综合征糖脂代谢的影响

目的： 探讨补肾调脾方对女性更年期综合征（CS）糖脂代谢及内分泌水平的影响。方法： 将80例CS患者随机按数字法分为观察组和对照组各40例。两组均适当心理辅导治疗，进行膳食和运动指导。对照组采用替勃龙片，2.5 mg/次，口服，1次/d。观察组采用补肾调脾方，1剂/d，常规水煎分2次服用。疗程为12周。记录治疗前、治疗后4、8、12周KI评分；检测治疗前后血清雌二醇（E₂）、促卵泡刺激素（FSH）、促黄体生成素（LH）、血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）及低密度脂蛋白（LDL-C）水平；测量身高、体重、腰围和臀围，计算体质指数（BMI）和腰/臀围比值（WHR）；检测治疗前后空腹血糖（FBG）、空腹胰岛素（FINS），并计算稳态胰岛素评价指数（HOMA-IR）；测定治疗前后血清瘦素（LP）及脂联素（APN）水平。结果： 观察组总有效率92.5%，对照组87.5%，2组比较差异无统计学意义；治疗后两组KI评分均明显下降，两组不同时点KI评分治疗前后差值组间比较差异无统计学意义；治疗后两组E₂水平明显升高，组间差异无统计学意义；治疗后两组FSH，LH水平明显降低，组间差异无统计学意义；治疗后观察组BMI和WHR较治疗前明显降低并低于对照组（P<0.05）；治疗后观察组TG，TC，LDL-C均较治疗前下降，并低于对照组（P<0.05或P<0.01），HDL-C明显上升，并高于对照组（P<0.01）；治疗后观察组FBG，FINS，HOMA-IR均较治疗前降低，并低于对照组（P<0.05或P<0.01）；治疗后观察组血清LP水平低于对照组，APN水平高于对照组（P<0.01）。结论： 补肾调脾方能改善CS临床症状及内分泌水平，其疗效与替勃龙片相当；补肾调脾方还能调节CS患者糖脂代谢，其作用机制可能与升高血清APN、降低LP水平有关。

The Influence of Bushen Tiaopi Fang on Female Climacteric Syndrome Glucolipid Metabolism

Objective: The study the influence of Bushen Tiaopi fang on female climacteric syndrome (CS) glucolipid metabolism And endocrine level. Method: Eighty cases of CS patients were randomly divided into control group (40 cases) and observation group (40 cases) according to digital method. The patients in both groups took appropriate psychological counseling treatment and guidance on diet and exercise. Patients in control group took Tibolone Tablets, 2.5 mg/time, 1 time/day, orally. Patients in observation group took Bushen Tiaopi fang, 1 dose/day, 2 times/day, conventional water frying, treatment course 12 weeks. The KI scores of before and after the treatment of 4, 8 and 12 weeks were recorded. Levels of serum estradiol (E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH), serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were detected before and after the treatment. The height, weight, waist circumference and hip circumference were measured, calculating body mass index (BMI) and waist-hip ratio (WHR). Fasting blood glucose (FBG) and fasting insulin (FINS) were detected, calculating the homeostasis insulin rate (HOMA-IR). Levels of serum Leptin (LP) and Adiponectin (APN) were measured. Result: The total effects of the observation group and control group were 92.5% and 87.5% respectively, which means no statistical significance from the differences between two groups. After the treatment, KI scores of two groups were significantly decreased, which also means no statistical significance from the differences between two groups at different points. E₂ levels of two groups increased dramatically, which shows no statistical significance from differences between groups. Levels of FSH and LH significantly decreased after treatment, which shows no statistical significance from differences between groups. BMI and WHR of observation group were significantly decreased after the treatment and were lower than the control group (P<0.05). TG, TC and LDL-C of observation group were decreased after the treatment and were lower than the control group (P<0.05 or P<0.01). HDL-C of observation group increased apparently and was higher than the control group (P<0.01). After treatment, FBG, FINS and HOMA-IR of observation group all reduced, which were lower than the control group (P<0.05 or P<0.01). Serum LP level of observation group was lower than the control group, while APN level was higher than the control group (P<0.01). Conclusion: Bushen Tiaopi fang can improve the clinical symptoms and CS endocrine levels of CS patients, which has the similar effect as Tibolone Tablets. Bushen Tiaopi fang can also regulate glycolipid metabolism of CS patients.Its mechanism may be associated with increasing serum APN and decreasing LP level.