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杨凡,缪华,黄荣.加味温胆汤治疗小儿单纯性肥胖的脂代谢、体质量的改善研究[J].湖南中医药大学学报,2018,38(4):470-474[点击复制] |
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| 加味温胆汤治疗小儿单纯性肥胖的脂代谢、体质量的改善研究 |
| 杨凡,缪华,黄荣 |
| (仙桃市第一人民医院儿科, 湖北 仙桃 433000) |
| 摘要: |
| 目的 探讨温胆汤在小儿单纯性肥胖中的治疗价值，分析其对患儿脂代谢、体质量的影响。方法 纳入于我院就诊的单纯性肥胖患儿108例，随机将其分成观察组、对照组各54例。对照组予以基础治疗（包括饮食控制、运动），观察组在对照组基础上采用温胆汤治疗，两组均干预12周。比较两组治疗效果，根据中医证候量表评分标准评估患者治疗前、后的各证候积分（肢体困重、肥胖度、脘腹胀满乏力、胸闷、呼吸短促），并分析两组脂代谢情况，包括甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、载脂蛋白A-1（apoA-1）、载脂蛋白B（apoB）水平以及体质量改善情况（体质量、BMI、体脂百分率），观察不良反应发生率。在疗程结束后电话随访6个月，记录反弹率。结果 观察组总有效率为92.59%，显著高于对照组的77.78%（P<0.01）；治疗后，两组中医证候积分均显著低于治疗前（P<0.01）；观察组治疗后的肢体困重、肥胖度、脘腹胀满积分均低于对照组，差异有统计学意义（P<0.01）；治疗后，两组脂代谢指标中，TG、TC、LDL、apoB显著低于治疗前，HDL显著高于治疗前（P<0.05或P<0.01）；观察组治疗后的TG、TC显著低于对照组（P<0.01）；治疗后，两组体重改善情况均优于治疗前（P<0.05或P<0.01）；观察组治疗后的体重、BMI、体脂百分率分别为均低于对照组，组间比较差异有统计学意义（P<0.05）；观察组不良反应发生率为1.85%，较对照组0%差异无统计学意义（P>0.05），随访6个月发现，观察组反弹率为9.26%，低于对照组的24.07%，两组对比差异有统计学意义（P<0.05）。结论 温胆汤能改善单纯性肥胖患儿的临床症状，通过纠正脂代谢紊乱减轻体质量，治疗安全性高，半年内反弹率低，值得临床推广。 |
| 关键词: 单纯性肥胖 温胆汤 体质量 脂代谢 |
| DOI：10.3969/j.issn.1674-070X.2018.04.027 |
| 投稿时间：2017-12-28 |
| 基金项目:湖北省医学科研基金项目（A2015010291）。 |
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| Study of Wendan Decotion on Lipid Metabolism and Body Mass of Children with Simple Obesity |
| YANG Fan,MIU Hua,HUANG Rong |
| (Department of Paediatrics, Xiantao First People's Hospital, Xiantao, Hubei 433000, China) |
| Abstract: |
| Objective To explore the therapeutic value of Wendan decoction in childhood simple obesity and analyze its effect on lipid metabolism and body mass. Methods A total of 108 children with simple obesity in our hospital, were randomly divided into the observation group and control group, 54 cases in each group. The control group was given with basic treatment (including diet control and exercise), and the observation group was given with Wendan decoction on the basis of the control group. Both groups were intervened for 12 weeks. The treatment effect in the two groups was compared. According to the TCM syndrome scale criteria evaluation, the syndrome integral in the patients before and after treatment was evaluated. The triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein A-1 (apoA-1), apolipoprotein B (apoB) level and weight were observed, and the incidence of adverse reactions was observed. After the end of the treatment, the phone was followed up for 6 months to record the rebound rate. Results The total effective rate of observation group was 92.59%, significantly lower than 77.78% of the control group (P<0.01). After treatment, TCM syndrome scores of the two groups were statistically lower than before treatment (P<0.01). The body weight, obesity and abdominal distension of the observation group were lower than the control group, and the difference was statistically significant (P<0.01). After treatment, TG, TC, LDL, apoB were significantly lower than those before treatment, and HDL was higher than that before treatment (P<0.05 or P<0.01). TG and TC in observation group were lower than those in control group (P<0.01). After treatment, the improvement situation of weight was better than that before treatment (P<0.05 or P<0.01). The weight, BMI and body fat percentage of the observation group were lower than the control group, and there was a significant difference between the groups (P<0.05). The adverse reaction rate of observation group was 1.85%, compared with the control group, the difference was not statistically significant(P>0.05). After follow-up for 6 months, rebound rate in observation group was 9.26%, was less than 24.07% of the control group, the difference in the two groups have statistical significance (P<0.05). Conclusion Wendan decoction could improve the clinical symptoms of children with simple obesity by correcting lipid metabolism disorder, with high safety, low rebound rate in half a year, and deserve clinical promotion. |
| Key words: simple obesity Wendan decoction body mass lipid metabolism |
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