小儿消脂方治疗脾虚湿盛型单纯性肥胖症患儿临床疗效观察
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摘要
目的观察小儿消脂方治疗脾虚湿盛型单纯性肥胖症患儿的临床疗效。方法采用随机对照的研究方法,将符合标准的68例患儿随机分为对照组33例和治疗组35例,对照组采用饮食和运动干预,治疗组在对照组的基础上服用小儿消脂方,每日2次,疗程为12周。治疗前后记录患者的体质量、身高、体质量指数(BMI)、血压、黑棘皮情况,检测生化全项指标,检查腹部B超。结果两组综合比较,对照组总有效率54.55%;治疗组总有效率为91.43%,明显高于对照组(P<0.05);肥胖儿童黑棘皮发生情况在治疗前组间无差异(P>0.05),治疗后两组均有下降,但治疗组明显下降,组间存在统计学差异(P<0.01);体质量治疗后均有下降趋势,但治疗组下降明显,组间存在统计学差异(P<0.05);身高增长无统计学差异(P>0.05);治疗组血压治疗后有下降趋势,且组间存在统计学差异(P<0.05);ALT、AST在治疗后有下降趋势,且存在组间差异(P<0.05),BUN、CR治疗前后均无组间差异(P>0.05);TC、TG、HDLC、LDL-C在治疗后均有所改善,且存在组间差异(P<0.05),FFA治疗前后无组间差异(P>0.05)。空腹血糖治疗后改善,存在组间差异(P<0.01),对照组患儿脂肪肝情况无改善,治疗组患儿脂肪肝均消失,组间存在统计学差异(P<0.01)。结论小儿消脂方治疗脾虚湿盛型单纯性肥胖症患儿具有一定的作用,疗效明显优于单纯饮食和运动干预。
Objective To investigate the clinical effect of Xiaoer Xiaozhi prescription in the treatment of children with simple obesity with spleen deficiency and dampness excess. Methods A total of 68 children who met the inclusion criteria were enrolled in this randomized controlled trial and randomly divided into control group with 33 children and treatment group with 35 children. The children in the control group were given diet and exercise intervention, and those in the treatment group were given Xiaoer Xiaozhi prescription twice a day for 12 weeks in addition to the treatment in the control group. Before and after treatment,body weight, body height, body mass index, blood pressure, and the condition of acanthosis nigricans were recorded, biochemical indices were measured, and abdominal ultrasound was performed. Results The treatment group had a significantly higher overall response rate than the control group(91.43% vs 54.55%, P <0.05). Before treatment, there was no significant difference in the incidence rate of acanthosis nigricans between the two groups(P>0.05); after treatment, both groups showed a reduction in theincidence rate of acanthosis nigricans and the treatment group had a significantly greater reduction than the control group(P<0.01).Both groups had a reduction in body weight after treatment, and the treatment group had a significantly greater reduction than the control group(P<0.05). There was no significant difference in the increase in body height between the two groups(P>0.05). The treatment group had a reduction in blood pressure after treatment, and there was a significant difference between the two groups(P <0.05). There were reductions in alanine aminotransferase and aspartate aminotransferase after treatment, and there were significant differences between the two groups(P<0.05). There were no significant differences in blood urea nitrogen and creatinine between the two groups before and after treatment(P>0.05). Both groups showed improvements in total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after treatment, and there were significant differences between the two groups(P<0.05); there was no significant difference in free fatty acid between the two groups before and after treatment(P>0.05).Both groups had an improvement in fasting blood glucose after treatment and there was a significant difference between the two groups(P<0.01). The control group showed no improvement in fatty liver disease, while the treatment group showed disappearance of fatty liver disease; there was a significant difference between the two groups(P<0.01). Conclusion Xiaoer Xiaozhi prescription has a certain effect in the treatment of simple obesity with spleen deficiency and dampness excess, with a significantly better clinical effect than diet and exercise intervention alone.
Objective To investigate the clinical effect of Xiaoer Xiaozhi prescription in the treatment of children with simple obesity with spleen deficiency and dampness excess. Methods A total of 68 children who met the inclusion criteria were enrolled in this randomized controlled trial and randomly divided into control group with 33 children and treatment group with 35 children. The children in the control group were given diet and exercise intervention, and those in the treatment group were given Xiaoer Xiaozhi prescription twice a day for 12 weeks in addition to the treatment in the control group. Before and after treatment,body weight, body height, body mass index, blood pressure, and the condition of acanthosis nigricans were recorded, biochemical indices were measured, and abdominal ultrasound was performed. Results The treatment group had a significantly higher overall response rate than the control group(91.43% vs 54.55%, P <0.05). Before treatment, there was no significant difference in the incidence rate of acanthosis nigricans between the two groups(P>0.05); after treatment, both groups showed a reduction in theincidence rate of acanthosis nigricans and the treatment group had a significantly greater reduction than the control group(P<0.01).Both groups had a reduction in body weight after treatment, and the treatment group had a significantly greater reduction than the control group(P<0.05). There was no significant difference in the increase in body height between the two groups(P>0.05). The treatment group had a reduction in blood pressure after treatment, and there was a significant difference between the two groups(P <0.05). There were reductions in alanine aminotransferase and aspartate aminotransferase after treatment, and there were significant differences between the two groups(P<0.05). There were no significant differences in blood urea nitrogen and creatinine between the two groups before and after treatment(P>0.05). Both groups showed improvements in total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after treatment, and there were significant differences between the two groups(P<0.05); there was no significant difference in free fatty acid between the two groups before and after treatment(P>0.05).Both groups had an improvement in fasting blood glucose after treatment and there was a significant difference between the two groups(P<0.01). The control group showed no improvement in fatty liver disease, while the treatment group showed disappearance of fatty liver disease; there was a significant difference between the two groups(P<0.01). Conclusion Xiaoer Xiaozhi prescription has a certain effect in the treatment of simple obesity with spleen deficiency and dampness excess, with a significantly better clinical effect than diet and exercise intervention alone.
引文
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[5]朱凯,林加斌,项跃林,等.温州市鹿城区儿童青少年肥胖流行病学调查[J].安徽医药,2009,13(2):184-185.
[6]全国儿童期单纯肥胖症研究协作组.全国0~6岁儿童单纯性肥胖流行病学研究[J].中华儿科杂志,2008,46(3):179-184.
[7]林元涛,杨光,王红宇,等.超重或单纯性肥胖儿童人体质量指数与心血管疾病风险因子的相关性研究[J].中华妇幼临床医学杂志(电子版),2016,12(2):148-153.
[8]方林钧,何威逊.儿童肥胖相关肾病诊断初步探讨:附8例报告[J].临床儿科杂志,2004,22(7):458-459.
[9]方昕,叶江枫,林小璎.儿童青少年超重及肥胖与代谢综合征的相关性研究[J].福建医科大学学报,2012,46(1):60-63.
[10]郑向艺,张桂菊,李凯峰,等.从“脾常不足”论儿童肥胖[J].中国中西医结合儿科学,2014,6(6):517-518.
[11]刘建忠,林连美.中医药治疗小儿单纯性肥胖症的研究进展[J].湖北中医杂志,2013,35(5):79-81.
[12]中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体质量指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[13]李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[14]李辉,宗心南,季成叶,等.中国2~18岁儿童青少年超重和肥胖筛查体质量指数界值点的研究[J].中华流行病学杂志,2010,31(6):616-620.
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[16]全国第五届肥胖病研究学术会议.单纯性肥胖病的诊断及疗效评定标准[J].中国中西医结合杂志,1997,18(5):317-319.
[17]刘应科,孙光荣.形神是中医辩证要素的首要元素-中医辩证常用20个基本要素与形神的关系[J].湖南中医药大学学报,2016,36(1):1-9.
[18]刘应科,孙光荣.以中和思想组方用药-遵循经方之旨,不泥经方用药[J].湖南中医药大学学报,2015,35(9):1-8.
[19]梁学军,朱逞,颜纯,等.肥胖伴黑色棘皮病儿童胰岛分泌功能的临床研究[J].中华儿科杂志,2004,42(6):405-407.
[20]齐丽丽.中药改善肥胖儿童肝功能损害的疗效观察[J].中外医疗,2009,27(12):112.
[21]李华,肖延风,尹春燕,等.单纯性肥胖儿童脂肪肝相关危险因素分析[J].中国妇幼健康研究,2017,28(4):366-368.
[22]李红德,孙月枝,赵文霞.中医药治疗非酒精性脂肪肝的研究进展[J].长春中医药大学学报,2008,42(1):80-81.
[2]闫银坤,程红,赵小元,等.2004和2013年北京市6~17岁儿童肥胖类型与心血管代谢异常分析[J].中华预防医学杂志,2016,50(1):34-39.
[3]马军,蔡赐河,王海俊,等.1985-2010年中国学生超重与肥胖流行趋势[J].中华预防医学杂志,2012,46(9):776-780.
[4]周蔚,夏蒨,郑薇薇.上海市杨浦区中小学生肥胖现况及影响因素分析[J].上海预防医学,2010,22(4):220-222.
[5]朱凯,林加斌,项跃林,等.温州市鹿城区儿童青少年肥胖流行病学调查[J].安徽医药,2009,13(2):184-185.
[6]全国儿童期单纯肥胖症研究协作组.全国0~6岁儿童单纯性肥胖流行病学研究[J].中华儿科杂志,2008,46(3):179-184.
[7]林元涛,杨光,王红宇,等.超重或单纯性肥胖儿童人体质量指数与心血管疾病风险因子的相关性研究[J].中华妇幼临床医学杂志(电子版),2016,12(2):148-153.
[8]方林钧,何威逊.儿童肥胖相关肾病诊断初步探讨:附8例报告[J].临床儿科杂志,2004,22(7):458-459.
[9]方昕,叶江枫,林小璎.儿童青少年超重及肥胖与代谢综合征的相关性研究[J].福建医科大学学报,2012,46(1):60-63.
[10]郑向艺,张桂菊,李凯峰,等.从“脾常不足”论儿童肥胖[J].中国中西医结合儿科学,2014,6(6):517-518.
[11]刘建忠,林连美.中医药治疗小儿单纯性肥胖症的研究进展[J].湖北中医杂志,2013,35(5):79-81.
[12]中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体质量指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[13]李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[14]李辉,宗心南,季成叶,等.中国2~18岁儿童青少年超重和肥胖筛查体质量指数界值点的研究[J].中华流行病学杂志,2010,31(6):616-620.
[15]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[16]全国第五届肥胖病研究学术会议.单纯性肥胖病的诊断及疗效评定标准[J].中国中西医结合杂志,1997,18(5):317-319.
[17]刘应科,孙光荣.形神是中医辩证要素的首要元素-中医辩证常用20个基本要素与形神的关系[J].湖南中医药大学学报,2016,36(1):1-9.
[18]刘应科,孙光荣.以中和思想组方用药-遵循经方之旨,不泥经方用药[J].湖南中医药大学学报,2015,35(9):1-8.
[19]梁学军,朱逞,颜纯,等.肥胖伴黑色棘皮病儿童胰岛分泌功能的临床研究[J].中华儿科杂志,2004,42(6):405-407.
[20]齐丽丽.中药改善肥胖儿童肝功能损害的疗效观察[J].中外医疗,2009,27(12):112.
[21]李华,肖延风,尹春燕,等.单纯性肥胖儿童脂肪肝相关危险因素分析[J].中国妇幼健康研究,2017,28(4):366-368.
[22]李红德,孙月枝,赵文霞.中医药治疗非酒精性脂肪肝的研究进展[J].长春中医药大学学报,2008,42(1):80-81.