复方通络中药改善肥胖患者血管内皮细胞功能障碍研究

1、复方通络中药改善肥胖患者血管内皮细胞功能障碍研究         11-05-02 15:49:00     编辑：studa20                作者：毕桂芝,段军,仝小林,董柳,陈良,甄仲,李爱国,张志远  【摘要】  目的 观察复方通络中药对单纯性肥胖患者血管内皮依赖性舒张功能障

2、碍的干预效应,探讨其作用机制。方法 应用高分辨血管超声检查选择血管内皮依赖性舒张功能障碍以血流介导的肱动脉扩张率(FMD)表示肥胖患者(65例),随机分为通络中药治疗组和对照组。治疗组32例,对照组33例。治疗组给予辛香疏络2号胶囊,3 g/次,每日3次；对照组给予淀粉胶囊,3 g/次,每日3次。共用药12周,分别测定用药前后FMD、肱动脉内径(D0),同时检测辛香疏络2号治疗前后患者血清总胆固醇(TC)、三酰甘油(TG)的变化。结果 治疗后治疗组FMD较对照组明显增加(P0.01),TC、TG较治疗前及对照组明显下降(P0.01)。结论 复方通络中药辛香疏络2号胶囊可明显改善肥胖患者血管内皮

3、障碍,调节血脂可能是其改善血管内皮功能机制之一。 【关键词】  肥胖；内皮功能障碍；血脂；复方通络中药；辛香疏络2号胶囊    Abstract：Objective To observe the effects of Chinese herbal meridian and vessel deoppilant compound on the dysfunction of endothelium-dependent dilation (EDD) of simple obesity patients, and explore its mechanism. Me

4、thods Sixty-five obese patients with dysfunction of EDD (denoted by FMD：flow mediated brachial artery vasodilatation rate) were found through the preliminary high-resolution vascular ultrasound check, and randomized into the therapy group (treated with Chinese herbal meridian and vessel deoppilant c

5、ompound) and the control group. The therapy group took Xinxiang Shuluo 2# capsules three times a day, 3 gram each time, and the control group was given the same doses of starch capsules. The experiment lasted 12 weeks. Before and after the experiment, FMD and inner diameter of brachial arteries (D0)

6、 of all the patients were measured, and the changes of total cholesterol (TC) and triglyceride (TG) in serum were compared. Results FMD of the therapy group was significantly higher than the control group (P0.01). TC and TG levels of the therapy group were significantly lower than before the treatme

7、nt and the control group (P0.01). Conclusion EDD has been significant improved after the treatment of Chinese herbal meridian and vessel deoppilant compound, which can markedly relieve the vascular endothelial malfunction of obese patients, and blood-lipid regulation may be the one of the functional

8、 mechanisms.    Key words：obesity；endothelial dysfunction；blood lipid；Chinese herbal meridian deoppilant compound；Xinxiang Shuluo 2# capsules    既往的研究已经显示了中医中药对内皮功能的保护作用和对糖尿病血管并发症的防治优势,本研究的目的是把二者与胰岛素抵抗(IR)的早期防治结合起来。肥胖为2型糖尿病重要危险因素,血管病变贯穿IR的始终。从早期的血管内皮功能障碍到最后的动脉粥样硬化,这些均归属

9、于中医的络气郁滞、络脉血瘀和络脉损伤证,辛香疏络、活血通络是IR和代谢综合征的一个重要治法。辛香疏络2号方由桃仁泥、三七粉等组成,具有辛香疏络作用。本研究旨在探讨辛香疏络2号在IR和代谢综合征早期的应用价值和可能机制。1  资料与方法1.1  一般资料    选择肥胖及超重者中内皮功能障碍者65例,随机分为2组。治疗组32例,男15例,女17例；年龄(43.38±6.76)岁,体重指数(BMI)为(29.00±2.97)kg/m2。对照组33例,男16例,女17例；年龄(44.21±7.02)岁,BMI为(28.8

10、7±2.88)kg/m2。2组患者一般情况比较差异无统计学意义(P0.05),具有可比性。1.2  入选标准根据2002年中国肥胖问题工作组数据汇总分析协作组建议的我国成人超重和肥胖界限。超重：BMI为24.027.9 kg/m2；肥胖：BMI28.0 kg/m2。符合上述诊断标准,并经检测血流介导血管扩张率(flow mediated dilation,FMD)10%,知情同意,并签署知情同意书者；年龄在1855岁,性别不限；无糖尿病、冠心病、高血压及脑血管病病史者。1.3  治疗方法    治疗组给予辛香疏络2号胶囊(卫生部中日友

11、好医院药学部提供),每次5粒(3 g),饭前服,每日3次。对照组给予淀粉胶囊(卫生部中日友好医院药学部提供),每次5粒(3 g),饭前服,每日3次。2组均治疗12周。1.4  观察指标与方法根据Celermajer等1报道的方法,利用高分辨率超声技术检测,受试者仰卧休息10 min,测量血压和心率。左臂肘关节上方210 cm处扫描肱动脉,取其纵切面。测舒张末期内径,分别测3个心动周期,取均值。在此过程中受试者仰卧,左上肢外展15°,掌心向上,超声探头位置与角度保持固定。测量基础状态下肱动脉内径(D0),然后用血压计袖带充气加压到37.24 kPa,维持4.5 min后放气,

12、放气后6090 s内测肱动脉充血后内径。并按下列公式计算：FMD(%)(充血后动脉内径基础内径)/基础内径×100%。治疗前后分别禁食12 h后采空腹静脉血,测总胆固醇(TC)、三酰甘油(TG)。1.5  统计学方法    全部数据采用SPSS10.0统计软件进行处理,数据均以x±s表示,计量资料各组变量均经正态性检验。正态分布资料,组内比较采用配对t检验,组间比较采用独立t检验；非正态分布资料,转换成正态分布后进行检验。P0.05认为有统计学意义。2  结果2.1  2组治疗前后肱动脉内径、扩张率比较    治疗组与对照组治疗前FM