【作者】 王斌胜；

【导师】 王新陆；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2009， 博士

【摘要】 目的:系统阐述血浊的理论体系,通过临床研究和实验研究探讨化浊行血兼以温阳法治疗代谢综合征的作用机制,为临床辨证施治提供新的思路和方法。方法:临床研究将65例代谢综合征患者随机分为化浊行血汤加淫羊藿治疗组(33例)和罗格列酮对照组(32例),疗程为8周,分别观察各组的临床症状疗效,中医症候疗效,腰围、腰臀比、体重及体重指数疗效,血脂、血糖、血压、空腹胰岛素及胰岛素抵抗指数疗效。实验研究将将32只雄性SD大鼠随机分为对照组、模型组、中药组及西药组,对照组给于基础饲料,其余三组给于高脂高盐饮食,连续喂养8周造模成功后中药组给于化浊行血汤加淫羊藿,西药组给于罗格列酮,对照组和模型组给于生理盐水各治疗4周,各组治疗期间饮食同前,分别观察各组体重、血脂、血糖及胰岛素抵抗指数、瘦素、血清TNF-α及内脏脂肪水平变化。结果:临床研究表明化浊行血汤加淫羊藿能明显改善代谢综合征患者临床症状,降低胆固醇和血压水平,减轻腰围、腰臀比、体重及体重指数,效果优于罗格列酮;而罗格列酮在降低甘油三酯方面则优于化浊行血汤加淫羊藿。实验研究表明化浊行血汤加淫羊藿与罗格列酮均能明显降低MS大鼠血脂、血糖、TNF-α及LP水平,改善胰岛素抵抗;化浊行血汤加淫羊藿可有效降低MS大鼠体重及内脏脂肪,且作用明显优于罗格列酮。结论:阳虚血浊是MS的基本病机,化浊行血汤加淫羊藿可明显改善MS患者胰岛素抵抗、腹型肥胖、糖脂代谢及血压异常;其作用机制可能是减轻体重、减少内脏脂肪、调节脂肪因子、控制炎症状态及改善胰岛素抵抗。更多还原

【Abstract】 Objective: Completely expounded the theoretical system of blood turbidity, Through the observation of clinical and experimental research, this study is primarily to discuss the mechanism of treating Metabolic syndrome by the method of eliminating the turbidity in blood and warming yang, provide a new way for treating MS. Methods: In clinical observation, 65 cases were divided into two groups, they are group of taking orally Huazhuoxingxue Tang and Epimedium (33 cases), group of taking orally Rosiglitazone (32 cases). The treatment course of each group is eight weeks. We observed the change of Clinical symptom , TCM syndrome, waist, waist-hip ratio, weight and body mass index, blood fats, blood sugar, blood pressure, fasting insulin and insulin resistance index of each group. In experimental research, 32 male Sprague Dawley rats were randomly divided into four groups: Chinese medicine-treated group, western medicine-treated group, model group and control group. The control group were feed basic diet, and the rest groups were established to be insulin resistance models with feeding high-fat-salt diet in 8 weeks. Then the Chinese medicine-treated group were treated with HuazhuoxingxueTang and Epimedium, the western medicine-treated group with Rosiglitazone, the model group and the control group with physiological saline. The treatment course of each group is four weeks. We observed the change of body weight, blood fats, blood sugar and insulin resistance index, leptin, TNF-αand internal fat level of each group. Results: The treatment of taking orally Huazhuoxingxue Tang and Epimedium can more effectively improve clinical symptom, reduce the blood pressure , the blood cholesterol, the waist, the waist-hip ratio, the weight and body mass index level than taking orally Rosiglitazone, and in the other hand taking orally Rosiglitazone more effectively than taking orally Huazhuoxingxue Tang and Epimedium in reducing triglyceride level. The experimental research tell us that both of Huazhuoxingxue Tang and Epimedium and Rosiglitazone can effectively improve insulin resistance, reduce blood fats, blood sugar, TNF-αand leptin level of MS model rats, taking orally Huazhuoxingxue Tang and Epimedium can more effectively reduce body weight and internal fats than Rosiglitazone. Conclusion: The syndrome of blood turbidity and deficiency of Yang is the basic TCM pathogenesis of MS, Huazhuoxingxue Tang and Epimedium has improving effect on glucose and lipid metabolism, insulin resistance , central obesity, and abnormalities of blood pressure; and its mechanisms may be: reducing body weight and internal fats, regulating above adipocytokines, controlling inflammational state in the body and improving insulin resistance.更多还原