中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2004年
36期
8413-8415
,共3页
背景:原发性高血压患者普遍存在胰岛素抵抗(insulin resistance,IR),因而增加了发生冠心病的危险性,中药制剂对原发性高血压患者IR的水平有何影响?目的:探讨中药制剂益脉降压流浸膏对老年气虚血瘀证型Ⅱ期原发性高血压患者IR的影响.设计:病例-对照研究.地点和对象:治疗组(n=40)来源于济南军区总医院符合1999年世界卫生组织制定的高血压诊断标准,同时符合中国中西医结合研究会制定的中医虚证辨证标准及血瘀证诊断标准辨证属气虚血瘀证型的高血压患者,对照组(n=30)为同期来济南军区总医院健康体检者,无原发性高血压、糖尿病等疾病.实验指标测定在济南军区总医院中心实验室进行.干预:治疗组口服益脉降压流浸膏(药物组成:生黄芪、党参、黄精、当归、川芎、生蒲黄、穿山龙等,每毫升含生药2.0 g,由山东济南宏济堂制药有限责任公司提供,批号:991218),10 mL/次,3次/d.疗程为8周.分别采用葡萄糖氧化酶法及放射免疫法测定治疗组治疗前后的空腹血糖、空腹血浆胰岛素(fasting plasma insulin,FPI),计算其胰岛素敏感性指数(insulin sensitivity index,ISI),并与对照组的空腹血糖、FPI、ISI进行比较.结果:治疗组治疗前空腹血糖[(4.97±0.61)mmol/L]与对照组比较,差异无显著性意义(t=1.131,P＞0.05);FPI[(13.71±4.79)mIU/L]显著高于对照组,ISI(-5.11±0.32)显著低于对照组,差异有显著性意义(t=5.393,21.714,P＜均0.01).治疗后空腹血糖无明显变化,FPI[(9.65±4.58)mIU/L]显著降低,ISI(-3.87 ±0.31)显著升高,较治疗前比较,差异均有显著性意义(t=4.962,16.257,P均＜0.01).治疗后收缩压和舒张压[(132.49±20.42)和(85.36±6.08)mm Hg,1 mm Hg=0.133 kPa],与治疗前比较,差异均有显著性意义(t=8.962,12.831,P均＜0.01).结论:老年气虚血瘀证型Ⅱ期原发性高血压患者存在高胰岛素血症、胰岛素抵抗;益脉降压流浸膏具有降低血胰岛素水平,提高胰岛素敏感性作用.
揹景:原髮性高血壓患者普遍存在胰島素牴抗(insulin resistance,IR),因而增加瞭髮生冠心病的危險性,中藥製劑對原髮性高血壓患者IR的水平有何影響?目的:探討中藥製劑益脈降壓流浸膏對老年氣虛血瘀證型Ⅱ期原髮性高血壓患者IR的影響.設計:病例-對照研究.地點和對象:治療組(n=40)來源于濟南軍區總醫院符閤1999年世界衛生組織製定的高血壓診斷標準,同時符閤中國中西醫結閤研究會製定的中醫虛證辨證標準及血瘀證診斷標準辨證屬氣虛血瘀證型的高血壓患者,對照組(n=30)為同期來濟南軍區總醫院健康體檢者,無原髮性高血壓、糖尿病等疾病.實驗指標測定在濟南軍區總醫院中心實驗室進行.榦預:治療組口服益脈降壓流浸膏(藥物組成:生黃芪、黨參、黃精、噹歸、川芎、生蒲黃、穿山龍等,每毫升含生藥2.0 g,由山東濟南宏濟堂製藥有限責任公司提供,批號:991218),10 mL/次,3次/d.療程為8週.分彆採用葡萄糖氧化酶法及放射免疫法測定治療組治療前後的空腹血糖、空腹血漿胰島素(fasting plasma insulin,FPI),計算其胰島素敏感性指數(insulin sensitivity index,ISI),併與對照組的空腹血糖、FPI、ISI進行比較.結果:治療組治療前空腹血糖[(4.97±0.61)mmol/L]與對照組比較,差異無顯著性意義(t=1.131,P＞0.05);FPI[(13.71±4.79)mIU/L]顯著高于對照組,ISI(-5.11±0.32)顯著低于對照組,差異有顯著性意義(t=5.393,21.714,P＜均0.01).治療後空腹血糖無明顯變化,FPI[(9.65±4.58)mIU/L]顯著降低,ISI(-3.87 ±0.31)顯著升高,較治療前比較,差異均有顯著性意義(t=4.962,16.257,P均＜0.01).治療後收縮壓和舒張壓[(132.49±20.42)和(85.36±6.08)mm Hg,1 mm Hg=0.133 kPa],與治療前比較,差異均有顯著性意義(t=8.962,12.831,P均＜0.01).結論:老年氣虛血瘀證型Ⅱ期原髮性高血壓患者存在高胰島素血癥、胰島素牴抗;益脈降壓流浸膏具有降低血胰島素水平,提高胰島素敏感性作用.
배경:원발성고혈압환자보편존재이도소저항(insulin resistance,IR),인이증가료발생관심병적위험성,중약제제대원발성고혈압환자IR적수평유하영향?목적:탐토중약제제익맥강압류침고대노년기허혈어증형Ⅱ기원발성고혈압환자IR적영향.설계:병례-대조연구.지점화대상:치료조(n=40)래원우제남군구총의원부합1999년세계위생조직제정적고혈압진단표준,동시부합중국중서의결합연구회제정적중의허증변증표준급혈어증진단표준변증속기허혈어증형적고혈압환자,대조조(n=30)위동기래제남군구총의원건강체검자,무원발성고혈압、당뇨병등질병.실험지표측정재제남군구총의원중심실험실진행.간예:치료조구복익맥강압류침고(약물조성:생황기、당삼、황정、당귀、천궁、생포황、천산룡등,매호승함생약2.0 g,유산동제남굉제당제약유한책임공사제공,비호:991218),10 mL/차,3차/d.료정위8주.분별채용포도당양화매법급방사면역법측정치료조치료전후적공복혈당、공복혈장이도소(fasting plasma insulin,FPI),계산기이도소민감성지수(insulin sensitivity index,ISI),병여대조조적공복혈당、FPI、ISI진행비교.결과:치료조치료전공복혈당[(4.97±0.61)mmol/L]여대조조비교,차이무현저성의의(t=1.131,P＞0.05);FPI[(13.71±4.79)mIU/L]현저고우대조조,ISI(-5.11±0.32)현저저우대조조,차이유현저성의의(t=5.393,21.714,P＜균0.01).치료후공복혈당무명현변화,FPI[(9.65±4.58)mIU/L]현저강저,ISI(-3.87 ±0.31)현저승고,교치료전비교,차이균유현저성의의(t=4.962,16.257,P균＜0.01).치료후수축압화서장압[(132.49±20.42)화(85.36±6.08)mm Hg,1 mm Hg=0.133 kPa],여치료전비교,차이균유현저성의의(t=8.962,12.831,P균＜0.01).결론:노년기허혈어증형Ⅱ기원발성고혈압환자존재고이도소혈증、이도소저항;익맥강압류침고구유강저혈이도소수평,제고이도소민감성작용.
BACKGROUND: Since it is commonly present in patients with primary hypertension, insulin resistance (IR) greatly threatens to occurrence of coronary heart disease. How do Chinese herbal preparations affect IR level in patients with primary hypertension?OBJECTIVE: To probe into the effect of Chinese herbal preparation, yimai jiangya liujingao on IR in patients with senile primary hypertension Ⅱ of qi deficiency and blood stagnation.DESIGN: Controlled study on cases.SETTING and PARTICIPANTS: The cases( n =40) in treatment group were from General Hospital of Jinan Military Area Command of Chinese PLA. They accorded with Diagnostic Standard on Hypertension determined by WHO in 1999, with Differentiating Diagnostic Standard on Deficiency Syndromes in Chinese Medicine and Diagnostic Standard on Blood Stagnation Syndromes determined by China Research Association of Collaboration of Chinese and Western Medicine. The cases of hypertension were diagnosed as qi deficiency and blood stagnation. The cases( n = 30) in the control were the people from General Hospital of Jinan Military Area Command of Chinese PLA in the same period. By general health checks, they were absent of primary hypertension and diabetes. The experimental measure determination was performed in Central Experimental Room in General Hospital of Jinan Military Area Command of Chinese PLA.INTERVENTIONS: In treatment group, yimai jiangya liujingao (Drug composition: shenghuangqi, dangshen, huangjing, danggui, chuanxiong,shen puhuang, chuangshanjia, etc. Each milliliter contains raw herb 2.0 g;provided by Shangdong Jinan Hongjitang Pharmaceuticals Co. Ltd.,No. 991218) was taken orally, 10 mL/time, 3 times daily and 8 weeks as one course. With glucose-oxidase method and radioimmunoassay, fasting blood sugar (FBS) and fasting plasma insulin(FPI) were determined respectively before and after treatment and insulin sensitivity index(ISI) was calculated. The results of FBS, FPI and ISI were compared between the treatment and the control groups.RESULTS: Compared with the control, the result of FBS[(4. 97 ±0. 61)mmol/L] before the treatment in the treatment group did not indicate significant difference(t=1. 131, P＞ 0.05); the result of FPI [(13.71± 4.79) mIU/L] was significantly higher, and of ISI ( - 5.11 ± 0. 32) was significantly lower, indicating significant difference( t = 5. 393, 21. 714, P＜ 0. 01 for both) . There was no remarkable change in fasting blood sugar after treatment. FPI[ (9.65 ± 4.58) mIU/L] was significantly reduced and ISI ( - 3.87 ± 0. 31 ) significantly increased. Compared with the results before treatment, the differences were significant( t =4. 961, 16. 257, P ＜ 0. 01 for both). Compared with the results before treatment, the systolic pressure and diastolic pressure [ ( 132.49 ± 20.42), (85.36 ± 6.08) mm Hg respectively, 1 mm Hg =0. 133 kPa] after treatment indicated significant difference( t = 8. 962, 12. 831, P ＜ 0. 01 for both).CONCLUSION: Hyperinsulinemia and IR are present in senile primary hypertension Ⅱ of qi deficiency and blood stagnation. Yimai fiangya liujin gao acted on reducing blood insulin and improving insulin sensitivity.
