【作者】 张默；

【导师】 郭宏敏；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的探讨养阴剔络方对老年代谢综合征患者炎症因子的影响,及对中医阴虚血瘀证疗效及安全性评价。方法本实验共纳入69例符合代谢综合征西医诊断标准及阴虚血瘀证中医诊断标准的老年病人,其中男55人、女14人,年龄在60-89岁,随机分为观察组35人,对照组34人,观察组予养阴剔络方+西药基础治疗,对照组仅予西药基础治疗,观察时间三周,分别测定患者炎症因子(CRP、TNF、IL-6)治疗前后水平,并评估中医症状积分疗效,统计分析两组治疗结果。结果观察组与对照组的年龄、性别、体重指数、肥胖、高血压、血脂异常、血糖异常分布、治疗前中医症状积分均无显著统计学差异(P值均>0.05),两组具有可比性。中医症状积分疗效结果提示,观察组治疗后积分低于对照组,疗效指数(51.12±13.07)高于对照组(39.23±13.67),观察组中显效2例、有效31例、无效2例,对照组中有效25例、无效9例,观察组疗效明显优于对照组。炎症因子结果提示,治疗后观察组CRP、TNF、IL-6水平降低,对照组水平未见明显改变,观察组疗效明显优于对照组。结论1、养阴剔络方以养阴药与和瘀通络药相配伍,切合老年人代谢综合征肝肾阴虚、久病入络、瘀毒互结的基本病机,临床上能有效地改善阴虚血瘀证症状体征；2.养阴剔络方可降低老年代谢综合征患者CRP、TNF、IL-6水平,减轻体内炎症状态;3.养阴剔络方治疗老年代谢综合征是安全有效的；4.养阴剔络方能减轻老年代谢综合征阴虚血瘀证患者体内的炎症状态,对防治代谢综合征及其相关的心脑血管疾病的发生发展有重要的意义。更多还原

【Abstract】 Objective To investigate the safety and effect of decreasing the inflammatory factors in elderly patients with metabolic syndrome typed in Yin deficiency blood stasis treating by the Nourishing-Yin-and-Dredging-Collateral formula.Methods The study includes 69 elderly patients in accordance with western medicine diagnosis standard of MS and TCM diagnosis standard of yin deficiency blood stasis, among which male 55, female 14, age between 60 and 89, randomly being divided,35 into the observation group and 34 into the control group. The observation group is treated by the nourishing-Yin-and-Dredging-Collateral Formula and common western medicine. The control group was treated only by common western medicine.We carry out test of the inflammation factors (CRP、TNF、IL-6) before and after treatment, and make appraisal of the effect of the total points of TCM symptoms, finally conduct the statistic analysis.Results There is no evident statistic difference(P>0.05) between the two groups about the distribution of age, gender, BMI, obesity, hypertension, blood lipid disorder, diabates, and the total points of the TCM symptoms. So they have comparability.The result of the total points of TCM symptoms told us, after treatment the total points of the observation group is lower than the control group, and the efficacy index is higher (51.12±13.07) than the control group (39.23±13.67).There is 2 cases of obvious effect,31 cases of common effect,2 cases of non-effect in the observation group. There is 25 cases of common effect,9 cases of non-effect in the control group. The effect of the observation group outperformed the control group. The result of the inflammation factors told us:the level of CRP、TNF、IL-6 is decreased after treatment in the observation group, and no significant change in the control group, the effect of observation group is better than control group.Conclusion 1. The formula is combinated by the Nourishing-Yin herbs and Dredging-Collateral herbs.This compatibility fit the basic pathogenic principle of Asthenia of Hepatonephric Yin and Chronic Diseases Transforming to Collaterals for elderly patients with MS. It can improve the clinic TCM symptoms; 2.The formula decrease the inflammation factors (CRP、TNF、IL-6),and reduce inflammation in vivo; 3.It’s safe and effective towards elderly MS by the Nourishing-Yin-and-Dredging-Collateral formula; 4. The formula can improve hemoendothelial malfunction in elderly MS patients typed in Yin deficiency blood stasis,it also has great significance of delaying senility of the vessels, and preventing from the onset and development of MS and its related cardio-cerebral vascular diseases.更多还原