摘要
目的:观察防己黄芪汤对肥胖患者减重后体质量反弹和外周血Th1、Th2细胞水平变化的影响。方法:本研究纳入90例减重成功的肥胖患者,运用简单排序随机化方法,随机分成对照组45例,治疗组45例。治疗过程中,治疗组脱落3例,对照组脱落5例。治疗组予以防己黄芪颗粒剂联合生活方式干预,对照组给予生活方式干预,疗程3个月,观察体质量(包括体质量反弹率)、腰围、BMI、胰岛素抵抗指数、HbA1c和血脂、外周血Th1、Th2细胞比例及Th1/Th2比值等疗效指标,以及肝肾功能等安全性指标。结果:治疗后,治疗组体质量反弹率为19.05%(8/42),低于对照组的50.00%(20/40)(P<0.01),治疗组体质量、BMI、腰围较治疗前下降,且差异有统计学意义(P<0.01);对照组体质量、BMI、腰围较治疗前上升,且差异有统计学意义(P<0.05)。治疗组体质量、BMI、腰围的变化明显优于对照组(P<0.01)。治疗组HOMA-IR、HbA1c、总胆固醇较治疗前下降(P<0.05),而甘油三酯、高密度脂蛋白、低密度脂蛋白较治疗前无明显变化(P>0.05);对照组HOMA-IR、甘油三酯较治疗前上升(P<0.05),而HbA1c、总胆固醇、高密度脂蛋白、低密度脂蛋白较治疗前无明显变化(P>0.05)。治疗组HOMA-IR、总胆固醇、甘油三酯变化明显优于对照组(P<0.05,P<0.01)。治疗组外周血Th1细胞比例较治疗前下降(P<0.01),而外周血Th2细胞比例较治疗前上升(P<0.05),Th1/Th2比值有下降趋势,但差异无统计学意义(P>0.05);对照组外周血Th1细胞比例较治疗前上升(P<0.05),而Th2细胞比例及Th1/Th2比值较治疗前无明显变化(P>0.05);治疗组患者外周血Th1变化优于对照组(P<0.05),而两组患者外周血Th2、Th1/Th2比值变化幅度不明显(P>0.05)。治疗后,治疗组患者中医证候疗效的总有效率为85.71%(36/42),优于对照组的总有效率47.50%(21/40),且差异具有统计学意义(P<0.01)。两组患者肝肾功能未见明显异常。结论:防己黄芪汤可降低肥胖患者减重后的体质量反弹率,可进一步降低体质量、腰围、BMI,改善胰岛素抵抗、血糖、血脂,降低外周血Th1细胞比例、升高Th2细胞比例,同时可以改善患者症状,具有较好的安全性。
Objective:To observe the effects of Stephania Root and Astragalus Decoction on weight regain and changes in peripheral blood Th1/Th2 cell levels in obese patients after weight loss.Methods:This study included 90 obese patients who successfully lost weight.They were randomly assigned to a control group(45 cases)and a treatment group(45 cases)using simple randomization.During the treatment,3 cases dropped out from the treatment group and 5 cases from the control group.The treatment group was given Stephania Root and Astragalus granules combined with lifestyle intervention,while the control group received only lifestyle intervention.The treatment duration was 3 months.Efficacy indicators such as body weight(including weight regain rate),waist circumference,BMI,insulin resistance index,HbA1c,blood lipids,and peripheral blood Th1/Th2 cell proportions and Th1/Th2 ratio were observed,as well as safety indicators such as liver and kidney function.Results:After treatment,the weight regain rate in the treatment group was 19.05%,which was significantly lower than 50.00%in the control group(P<0.01).The treatment group showed a statistically significant decrease in body weight,BMI,and waist circumference compared to before treatment(P<0.01).In contrast,the control group experienced a statistically significant increase in body weight,BMI,and waist circumference(P<0.05).The changes in body weight,BMI,and waist circumference were more pronounced in both groups(P<0.01).The treatment group showed a decrease in HOMA-IR,HbA1c,and total cholesterol compared to before treatment(P<0.05),while triglycerides,high-density lipoprotein,and low-density lipoprotein showed no significant changes(P>0.05).The control group showed an increase in HOMA-IR and triglycerides compared to before treatment(P<0.05),with no significant changes in HbA1c,total cholesterol,high-density lipoprotein,and low-density lipoprotein(P>0.05).The changes in HOMA-IR,total cholesterol,and triglycerides were significant in both groups(P<0.05,P<0.01),while the changes in HbA1c,high-density lipoprotein,and low-density lipoprotein were not significant(P>0.05).The treatment group showed a decrease in the proportion of peripheral blood Th1 cells compared to before treatment(P<0.01),an increase in Th2 cells(P<0.05),and a trend towards a decrease in Th1/Th2 ratio,although the difference was not statistically significant(P>0.05).The control group showed an increase in the proportion of peripheral blood Th1 cells(P<0.05),with no significant changes in Th2 cells and Th1/Th2 ratio(P>0.05).The change in Th1 cells was more significant in the treatment group compared to the control group(P<0.05),while the changes in Th2 cells and Th1/Th2 ratio were not significant between the two groups(P>0.05).After treatment,the total effective rate of TCM syndrome improvement in the treatment group was 85.71%,which was significantly higher than the 47.50%in the control group(P<0.01).There were no significant abnormalities in liver and kidney functions in either group.Conclusion:Stephania Root and Astragalus Decoction can reduce weight regain in obese patients after weight loss,further decrease body weight,waist circumference,and BMI,improve insulin resistance,blood glucose,and blood lipids,and lower the proportion of peripheral blood Th1 cells while increasing Th2 cells.It also improves patient symptoms and has good safety.
作者
姜健
殷苏勤
刘曼曼
陈见纺
严军
JIANG Jian;YIN Suqin;LIU Manman;CHEN Jianfang;YAN Jun(Shanghai Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China)
出处
《中医药学报》
2025年第3期61-66,共6页
Acta Chinese Medicine and Pharmacology
基金
上海市“十四五”中医特色专科项目(中医内分泌科)(ZYTSZK1-10)
上海市嘉定区卫生健康委科研基金(2021-QN-ZYY-02)
嘉定区“疁城杏林”人才培养项目(JDLCXLQNXZ-25)。
关键词
防己黄芪汤
体质量反弹
肥胖记忆
随机对照研究
Stephania Root and Astragalus Decoction
Weight regain
Obesity memory
Randomized controlled study
