周雷 杨宁

摘要 目的：探討中西医结合治疗代谢综合征（MS）的临床疗效及对患者血脂、血糖的影响。方法：选取2014年2月至2016年9月江苏省中医院收治的MS患者108例，并据治疗方式不同分为观察组和对照组，每组54例，对照组采用二甲双胍片降糖、阿托伐他汀降脂治疗;观察组在对照组的基础上加用健脾利湿化浊汤治疗，1周为1个疗程，2组均连续治疗4个疗程。统计并比较2组患者临床疗效，检测并比较2组患者治疗前后血脂、血糖的变化，并计算平均体重指数（BMI）变化。结果：治疗后观察组总有效率明显高于对照组（P<0.05）;治疗后2组HDL-C较治疗前升高，BMI、TC、TG、LDL-C及FPG、2 hPG、HbAlc均较治疗前显著下降，且观察组HDL-C显高于对照组，BMI、TC、TG、LDL-C及FPG、2 hPG、HbAlc均显低于对照组（P<0.05或P<0.01）。结论：中西医结合治疗MS效果显著，能有效控制患者血糖、血脂水平，降低BMI。

关键词 代谢综合征;中西医结合;血脂;血糖;健脾利湿化浊汤

Effects of Combination of Traditional Chinese and Western Medicine on Blood Lipid

and Blood Glucose Level in Patients with Metabolic Syndrome

Zhou Lei1， Yang Ning2

（1 Department of Endocrinology， Jiangsu Traditional Chinese Medicine Hospital， Nanjing 210029， China;

2 Nanjing Brain Hospital Affiliated to Nanjing Medical University， Nanjing 210029， China）

Abstract Objective：To explore the clinical effects of combination of traditional Chinese and western medicine in the treatment of metabolic syndrome （MS） and its effects on blood lipid and blood glucose. Methods：A total of 108 patients with MS enrolled in our hospital from February 2014 to September 2016 were divided into control group （n=54） and observation group （n=54）. The control group was treated with metformin tablets and hypoglycemic and atorvastatin， while the observation group on the basis of the control group was treated with Jianpi Lishi Huazhuo Decoction. After 1 week for a course of treatment， the 2 groups were continuously treated for 4 courses. The clinical efficacy in the 2 groups before and after treatment was compared; the blood lipids， blood glucose changes of the 2 groups were detected and compared， and the mean body mass index （BMI） changes were detected. Results：The total effective rate in the observation group was higher than that in the control group （85.19%） and the difference was statistically significant （P<0.05）. The levels of HDL-C was significantly higher than before treatment， BMI while TC， TG， LDL-C and FPG， 2 hPG， HbAlc in the 2 groups were significantly lower than those before treatment. The levels of BMI， TC， TG， LDL-C and FPG， 2 hPG， HbAlc were significantly lower in the observation group than those in the control group. HDL-C was significantly higher than that in the control group （P<0.05 or P<0.01）. Conclusion：The combination of traditional Chinese and western medicine in the treatment of MS has significant effects， which can effectively control the blood glucose， blood lipid levels and reduce BMI.

Key Words Metabolic syndrome; Integrated traditional Chinese and western medicine; Blood lipids; Blood glucose; Jianpi Lishi Huazhuo decoction

中图分类号：R255.4文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.025

代谢综合征（Metabolic Syndrome，MS）属于多种疾病和多重危险因素共同作用于个体的聚集型代谢紊乱综合征，临床主要表现为腹型肥胖、糖脂代谢紊乱以及高血压、高血脂等，且随着病情的持续恶化，易引发动脉粥样硬化性心血管疾病[1-2]。近些年，随着人们生活水平的提高及体力活动减少，并在不良生活方式的影响下，MS的发病率逐年升高，西医常采用调脂、降压等常规治疗，但部分患者仍未达到理想疗效[3-4]。中医理论认为，MS的病机多由饮食不节、劳逸失当而致“脾胃内伤，痰湿淤热”所致。研究发现[5-6]，采用以祛湿清热、化瘀降浊为主的健脾利湿化浊汤可显著改善患者临床症状。本研究探讨在常规西医治疗手段的基础上加用健脾利湿化浊汤治疗MS的临床疗效及对患者血脂、血糖的影响。

1 资料与方法