脐疗结合饮食疗法对台湾地区高脂血症患者的康复干预疗效及其评价
|
摘要
目的：本研究旨在观察脐疗结合食疗对台湾地区高脂血症患者的康复疗效,并探讨其可能的作用机制,为高脂血症的家庭化、社区化康复提供可以借鉴的方法和思路。
方法：将59例符合纳入标准的高脂血症患者随机分为治疗组和对照组,治疗组用脐疗加泽泻降脂茶,对照组应用单纯的饮食控制治疗。12周后,观察治疗前后两组中医症状积分、中医症候总疗效、血脂变化。
结果：经统计分析,两组间总疗效比较提示在中医证候总疗效与血脂疗效比较有显着性差异(P<0.05),治疗组总体疗效优于对照组。两组治疗前后各组内在中医症状积分,血脂指标TC、TG、LDL-C降低方面均有显着性差异,提示两组均有一定疗效。通过两组间治疗后中医症状积分比较P<0.01,提示治疗组在改善中医症状积分方面优于对照组；血脂指标的比较,治疗后两组间TC的比较P<0.01,有非常显着性差异,提示在降低TC方面治疗组明显优于对照组；两组间TG、LDL-C的比较均为P<0.05,提示在降低TG、LDL-C方面治疗组优于对照组。而对HDL-C的比较显示,两组均有升高趋势,但治疗组组内比较有统计学意义,对照组组内比较无统计学意义,组间比较无统计学意义(P>0.05),提示治疗组在升高HDL-C上优势不明显。
结论：脐疗结合中医食疗方对痰湿偏盛的高脂血症病的证候改善有一定疗效；对高脂血症的TC、TG、HDL-C、LDL-C血脂指标改善有一定的疗效,具有降低TC、TG、LDL-C的作用,有一定升高HDL-C的趋势,说明该方法有较好的调脂降脂效应；此疗法为非药物疗法,且无创伤,无明显不良反应,安全有效；该研究也为其它类型高脂血症的临床康复治疗提供了参考。本疗法简便,操作性强,便于推广,有利于高脂血症及相关老年病的中医家庭化、社区化康复的开展。
Objective:This project is aimed to observe the clinical efficacy of navel therapy in combination with dietetic therapy on hyperlipidemia patients in Taiwan and to further explore its possible mechanism, trying to provide applicable measures for its family and community rehabilitation.
Method:59cases of hyperlipidemia chosen by the inclusion criteria were randomly divided into the treatment group and the control group. Patients in the treatment group were treated by naval therapy combined with rhizome alismatis lipid-lowering tea, while those in the control group only received basic diet control treatment. TCM symptom scores and blood fat indicators before and after the treatment were observed after12weeks.
Results:According to the statistical analysis, the efficacy of TCM symptoms and curative effects of lowering blood flat of laboratory indicators have significant difference (P＜0.05), the overall curative effects of the treatment group is better than the control group. The intra-group comparison in the two groups both illustrates significant difference in Chinese medicine symptom score, drop of lipid target TC, TG and LDL-C, indicating that the two groups both have therapeutic effect. Based on the inter-group comparison, the treatment group is found to be superior in decreasing the symptom score than the control group (P<0.01) and the lipid target TC (P＜0.01); Significant differences are also found in the TG and LDL-C indicators between the two groups (P<0.05), while no significant differences are found in HDL-C (P>0.05), suggesting that the treatment group shows no obvious advantages in increasing HDL-C.
Conclusion:Navel therapy combined with dietetic therapy has certain effects on phlegm-damp hyperlipidemia. Statistics shows that this combined therapy has effects in serum lipid indexes of TC,TG, HDL-C,LDL-C in hyperlipidemia, with lower TC, TG, LDL-C and higher HDL-C, suggesting that this research methods have good effect in regulating the lipid. This therapy is a non-drug therapy with no trauma, showing no significant adverse reactions, so that it is safe and effective. It proves a satisfied rehabilitation on phlegm-damp hyperlipidemia, also providing reference to clinical treatment of other types of hyperlipidemia. This therapy is simple and convenient, easy to be extended and applied, which could largely promote the development of the family and community-based rehabilitation.
方法：将59例符合纳入标准的高脂血症患者随机分为治疗组和对照组,治疗组用脐疗加泽泻降脂茶,对照组应用单纯的饮食控制治疗。12周后,观察治疗前后两组中医症状积分、中医症候总疗效、血脂变化。
结果：经统计分析,两组间总疗效比较提示在中医证候总疗效与血脂疗效比较有显着性差异(P<0.05),治疗组总体疗效优于对照组。两组治疗前后各组内在中医症状积分,血脂指标TC、TG、LDL-C降低方面均有显着性差异,提示两组均有一定疗效。通过两组间治疗后中医症状积分比较P<0.01,提示治疗组在改善中医症状积分方面优于对照组；血脂指标的比较,治疗后两组间TC的比较P<0.01,有非常显着性差异,提示在降低TC方面治疗组明显优于对照组；两组间TG、LDL-C的比较均为P<0.05,提示在降低TG、LDL-C方面治疗组优于对照组。而对HDL-C的比较显示,两组均有升高趋势,但治疗组组内比较有统计学意义,对照组组内比较无统计学意义,组间比较无统计学意义(P>0.05),提示治疗组在升高HDL-C上优势不明显。
结论：脐疗结合中医食疗方对痰湿偏盛的高脂血症病的证候改善有一定疗效；对高脂血症的TC、TG、HDL-C、LDL-C血脂指标改善有一定的疗效,具有降低TC、TG、LDL-C的作用,有一定升高HDL-C的趋势,说明该方法有较好的调脂降脂效应；此疗法为非药物疗法,且无创伤,无明显不良反应,安全有效；该研究也为其它类型高脂血症的临床康复治疗提供了参考。本疗法简便,操作性强,便于推广,有利于高脂血症及相关老年病的中医家庭化、社区化康复的开展。
Objective:This project is aimed to observe the clinical efficacy of navel therapy in combination with dietetic therapy on hyperlipidemia patients in Taiwan and to further explore its possible mechanism, trying to provide applicable measures for its family and community rehabilitation.
Method:59cases of hyperlipidemia chosen by the inclusion criteria were randomly divided into the treatment group and the control group. Patients in the treatment group were treated by naval therapy combined with rhizome alismatis lipid-lowering tea, while those in the control group only received basic diet control treatment. TCM symptom scores and blood fat indicators before and after the treatment were observed after12weeks.
Results:According to the statistical analysis, the efficacy of TCM symptoms and curative effects of lowering blood flat of laboratory indicators have significant difference (P＜0.05), the overall curative effects of the treatment group is better than the control group. The intra-group comparison in the two groups both illustrates significant difference in Chinese medicine symptom score, drop of lipid target TC, TG and LDL-C, indicating that the two groups both have therapeutic effect. Based on the inter-group comparison, the treatment group is found to be superior in decreasing the symptom score than the control group (P<0.01) and the lipid target TC (P＜0.01); Significant differences are also found in the TG and LDL-C indicators between the two groups (P<0.05), while no significant differences are found in HDL-C (P>0.05), suggesting that the treatment group shows no obvious advantages in increasing HDL-C.
Conclusion:Navel therapy combined with dietetic therapy has certain effects on phlegm-damp hyperlipidemia. Statistics shows that this combined therapy has effects in serum lipid indexes of TC,TG, HDL-C,LDL-C in hyperlipidemia, with lower TC, TG, LDL-C and higher HDL-C, suggesting that this research methods have good effect in regulating the lipid. This therapy is a non-drug therapy with no trauma, showing no significant adverse reactions, so that it is safe and effective. It proves a satisfied rehabilitation on phlegm-damp hyperlipidemia, also providing reference to clinical treatment of other types of hyperlipidemia. This therapy is simple and convenient, easy to be extended and applied, which could largely promote the development of the family and community-based rehabilitation.
引文
[1]桑海康.健脾益气、豁痰化瘀法治疗高脂血症的疗效观察[J].辽宁中医杂志,2001,28(4)：208.
[2]熊文生,曾益宏.理脾化痰降脂片对高脂血症影响的临床研究[J].中国医药学报,2000,(2)：35.
[3]狄玉文,亢秋云.降脂汤治疗高脂血症48例[J].陕西中医,1999,(8)：5.
[4]吴艳.脾经合胃经取穴针刺治疗高脂血症72例临床观察[J].中国实用医药,2012,7(17)：228-229
[5]徐竺婷.自拟九味降脂汤治疗糖尿病伴高脂血症76例[J].上海中医杂志,1999,(12)：30.
[6]陈晓云,等.调脂散胶囊治疗老年原发性高脂血症的疗效观察[J].辽宁中医杂志,2001,28(6)：353.
[7]陈炯华,王国华,符为民.临证治疗高脂血症举要[J].江西中医药,2004,3(3)：9.
[8]康凤河.针刺治疗高脂血症32例疗效观察[J].天津中医学院学报,2003,22(2)：65.
[9]廖贻球,周晓清.羲黄降脂汤治疗高脂血症34例[J].湖南中医杂志,2001,17(1)：36-37.
[10]李艳芬,等.穴位埋线治疗高脂血症的临床研究[J].辽宁中医杂志,2011,38(1)：142-146
[11]邢海辉,等.温和灸不同时间参数对高胆固醇血症患者疗效的影响[J].中国针灸,2011,30(11)：937-940
[12]常小荣,严洁,易受乡,等.隔药饼灸治疗血脂异常的临床研究[J].中华中医药学刊,2010,28(1)：8-9
[13]苗福盛,等.健身气功八段锦对高脂血症患者血脂和脂蛋白代谢的影响[J].山东体育学院学报,2009,25(10)：46-48
[14]刘俊荣,姜希娟,夏西薇,等.健身气功“八段锦”调节中老年脂质代谢的实验研究[J].中国老年学杂志,2006,26(3)：317-319
[15]刘俊荣,朱丽光,李俊杰,等.“八段锦”对不同血脂水平人群HDL和LDL水平的影响[J].天津中医学院学报.2005,24(3)：121-122
[16]闫严.健身气功·五禽戏对高脂血症患者细胞黏附分子及血脂水平的影响[J].辽宁师范大学学报(自然科学版).2009,32(03)：357-358
[17]沙鹏.健身气功五禽戏对中老年女性血脂指标及平衡能力的影响[J].陕西中医,2010,31(10)：1332-1335
[18]刘晓丹,金宏柱.健身气功易筋经对老年女性血脂和自由基代谢的影响[J].中华中医药杂志,2010,25(9)：1480-1482
[19]苏玉凤,刘晓丹.健身气功·易筋经锻炼对老年人身体机能和血脂的影响[J].南京体育学院学报(自然科学版),2012,11(2)：27-29
[20]陶名章,李慧,陈少周,等.人工空气负氧离子对高脂血症的临床疗效研究[J].临床研究,2011,8(11)：37-39
[21]徐毅君,陈祥国,曲海军,等.牛蒡茶对高脂血症大鼠的降脂作用[J].山东医药,2010,50
[22]陈运中,陈春艳,张声华.红曲有效成分洛伐他汀对高脂小鼠血脂代谢及脂蛋白脂酶mRNA表达的作用[J].中草药,2005,36(5)：713-717
[23]翟鹏贵,赵珺彦,周大兴,等.中药红曲复方制剂降脂作用的实验研究[J].浙江中医药大学学报,2012,36(1)：70-72
[24]张曼,山楂对高脂血症小鼠血脂及脂蛋白酯酶和肝酯酶的影响[J].贵阳中医学院学报,2012,34(2)：167-168
[25]黄丹,石元刚.山楂、魔芋及其复合物对高脂血症大鼠脂质代谢及血浆NO水平的影响[J].第三军医大学学报,2005,27(13)：1361-1363
[26]张卫明,姜洪芳,徐辉,等.香水莲花降血脂作用的实验研究[J].食品工业科技,2009,30(2)：111-116
[27]邱翠琼,朱胜伶,李达.姜夏脐疗法防治急性白血病化疗反应的临床观察[J].中国中西医结合杂志,2004,(7)：592.
[28]周静,谢三英,肖春玲,等.中药敷脐治疗肝炎肝硬化腹水的临床观察[J].现代护理,2004,10(7)：591.
[29]马朝群,陈德轩,朱永康,朱宏,等.加味暖脐散敷脐对手术后胃肠功能的影响[J].中国中西医结合消化杂志,2006,14(5)：328.
[30]刘卫平.中药敷脐治疗经前期失眠症56例[J].中医外科杂志,2006,15(3)：61.
[31]周志荣.中药敷脐治疗儿童哮喘326例[J].浙江中医杂志,2006,41(3)：153.
[32]吴晋蒲,贾颖,薛云峰.中药敷脐治疗前列腺增生引起的尿潴留60例[J].中医外治杂志,2006,15(6).
[33]Arnett DK,McGovern PQJacobs DR,et al.Fifteen-year trends in cardiovascular risk factors(1980-1982 through 1995-1997):the Minnesota Heart Survey.Am J Epidemiol,2002,156:929-935.
[34]Ford ES,Mokdad AH,Giles WH,et al.Serum total cholesterol concentrations and awareness,treatment,and control of hypercholesterolemia among US adults:findings from the National Health and Nutrition Examination Survey,1999 to 2000.Circulation,2003,107:2185-2189.
[35]赵文华,张坚,由悦,等.中国18岁及以上人群血脂异常流行特点研究[J].中国预防医学志,2005,39(5)：306-310.
[36]国家“九五”科技攻关课题协作组.我国中年人群心血管病主要危险因素流行现状及从80年代初至90年代末的变化趋[J].中华心血管病杂志,2001,2(2)：74-792.
[37]赵水平.高脂血症的病因及分类[J].中国冶金工业医学杂志,1997,14(5)：289-295.
[38]李景章.高脂蛋白血症的临床分类与药物治疗[J].邯郸医学高等专科学校报,2004,17(5)：407.
[39]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35：390-419.
[40]方永奇,曹建宏,方春亮.从温胆汤的方证看痰证实质.中国中医基础医学杂志,1998,4(1)：43-45.
[41]邱裕元,李巨奇,贾晓林,等.痰本质及其物质基础探讨.实用中医药杂志,2002,18(7)：47-48.
[42]苏庆民,王琦.肥胖人痰湿型体质血脂、血糖、胰岛素及红细胞Na}-K}-ATP酶活性的检测及特征.中国中医基础医学杂志,1995,1(2)；39
[43]陈伟民.首届中医体质学说研讨会论文集.158
[44]孟凡一.降脂汤配合脐疗治疗高脂血症54例[J].光明中医,1999,14(85)：49-50.
[45]孙九光,吴坚芳,杨菊,等.降脂脉安冲剂并大黄敷脐治疗脂肪肝100例临床观察[J].河北中医,2003,25(7)：494.
[46]邵敏,温凌洁,孙蓉.穴位敷贴对Ⅲ型糖尿病患者血脂水平的影响[J].上海针灸杂志,2000,19(6)：5.
[47]禹翔,吴玉泉,郑伟,等.穴位敷贴治疗老年人高脂血症的临床研究[J].临床军医杂志,2006,34(6)：675.
[48]温木生.论脐疗的治疗效应与机理[J].医学研究荟萃,2002,(2)：27-28.
[49]于华,侯喜连,孔雪萍.“蝴蝶效应”与脐疗机制探讨[J].光明中医,2007,22(8)：3.
[2]熊文生,曾益宏.理脾化痰降脂片对高脂血症影响的临床研究[J].中国医药学报,2000,(2)：35.
[3]狄玉文,亢秋云.降脂汤治疗高脂血症48例[J].陕西中医,1999,(8)：5.
[4]吴艳.脾经合胃经取穴针刺治疗高脂血症72例临床观察[J].中国实用医药,2012,7(17)：228-229
[5]徐竺婷.自拟九味降脂汤治疗糖尿病伴高脂血症76例[J].上海中医杂志,1999,(12)：30.
[6]陈晓云,等.调脂散胶囊治疗老年原发性高脂血症的疗效观察[J].辽宁中医杂志,2001,28(6)：353.
[7]陈炯华,王国华,符为民.临证治疗高脂血症举要[J].江西中医药,2004,3(3)：9.
[8]康凤河.针刺治疗高脂血症32例疗效观察[J].天津中医学院学报,2003,22(2)：65.
[9]廖贻球,周晓清.羲黄降脂汤治疗高脂血症34例[J].湖南中医杂志,2001,17(1)：36-37.
[10]李艳芬,等.穴位埋线治疗高脂血症的临床研究[J].辽宁中医杂志,2011,38(1)：142-146
[11]邢海辉,等.温和灸不同时间参数对高胆固醇血症患者疗效的影响[J].中国针灸,2011,30(11)：937-940
[12]常小荣,严洁,易受乡,等.隔药饼灸治疗血脂异常的临床研究[J].中华中医药学刊,2010,28(1)：8-9
[13]苗福盛,等.健身气功八段锦对高脂血症患者血脂和脂蛋白代谢的影响[J].山东体育学院学报,2009,25(10)：46-48
[14]刘俊荣,姜希娟,夏西薇,等.健身气功“八段锦”调节中老年脂质代谢的实验研究[J].中国老年学杂志,2006,26(3)：317-319
[15]刘俊荣,朱丽光,李俊杰,等.“八段锦”对不同血脂水平人群HDL和LDL水平的影响[J].天津中医学院学报.2005,24(3)：121-122
[16]闫严.健身气功·五禽戏对高脂血症患者细胞黏附分子及血脂水平的影响[J].辽宁师范大学学报(自然科学版).2009,32(03)：357-358
[17]沙鹏.健身气功五禽戏对中老年女性血脂指标及平衡能力的影响[J].陕西中医,2010,31(10)：1332-1335
[18]刘晓丹,金宏柱.健身气功易筋经对老年女性血脂和自由基代谢的影响[J].中华中医药杂志,2010,25(9)：1480-1482
[19]苏玉凤,刘晓丹.健身气功·易筋经锻炼对老年人身体机能和血脂的影响[J].南京体育学院学报(自然科学版),2012,11(2)：27-29
[20]陶名章,李慧,陈少周,等.人工空气负氧离子对高脂血症的临床疗效研究[J].临床研究,2011,8(11)：37-39
[21]徐毅君,陈祥国,曲海军,等.牛蒡茶对高脂血症大鼠的降脂作用[J].山东医药,2010,50
[22]陈运中,陈春艳,张声华.红曲有效成分洛伐他汀对高脂小鼠血脂代谢及脂蛋白脂酶mRNA表达的作用[J].中草药,2005,36(5)：713-717
[23]翟鹏贵,赵珺彦,周大兴,等.中药红曲复方制剂降脂作用的实验研究[J].浙江中医药大学学报,2012,36(1)：70-72
[24]张曼,山楂对高脂血症小鼠血脂及脂蛋白酯酶和肝酯酶的影响[J].贵阳中医学院学报,2012,34(2)：167-168
[25]黄丹,石元刚.山楂、魔芋及其复合物对高脂血症大鼠脂质代谢及血浆NO水平的影响[J].第三军医大学学报,2005,27(13)：1361-1363
[26]张卫明,姜洪芳,徐辉,等.香水莲花降血脂作用的实验研究[J].食品工业科技,2009,30(2)：111-116
[27]邱翠琼,朱胜伶,李达.姜夏脐疗法防治急性白血病化疗反应的临床观察[J].中国中西医结合杂志,2004,(7)：592.
[28]周静,谢三英,肖春玲,等.中药敷脐治疗肝炎肝硬化腹水的临床观察[J].现代护理,2004,10(7)：591.
[29]马朝群,陈德轩,朱永康,朱宏,等.加味暖脐散敷脐对手术后胃肠功能的影响[J].中国中西医结合消化杂志,2006,14(5)：328.
[30]刘卫平.中药敷脐治疗经前期失眠症56例[J].中医外科杂志,2006,15(3)：61.
[31]周志荣.中药敷脐治疗儿童哮喘326例[J].浙江中医杂志,2006,41(3)：153.
[32]吴晋蒲,贾颖,薛云峰.中药敷脐治疗前列腺增生引起的尿潴留60例[J].中医外治杂志,2006,15(6).
[33]Arnett DK,McGovern PQJacobs DR,et al.Fifteen-year trends in cardiovascular risk factors(1980-1982 through 1995-1997):the Minnesota Heart Survey.Am J Epidemiol,2002,156:929-935.
[34]Ford ES,Mokdad AH,Giles WH,et al.Serum total cholesterol concentrations and awareness,treatment,and control of hypercholesterolemia among US adults:findings from the National Health and Nutrition Examination Survey,1999 to 2000.Circulation,2003,107:2185-2189.
[35]赵文华,张坚,由悦,等.中国18岁及以上人群血脂异常流行特点研究[J].中国预防医学志,2005,39(5)：306-310.
[36]国家“九五”科技攻关课题协作组.我国中年人群心血管病主要危险因素流行现状及从80年代初至90年代末的变化趋[J].中华心血管病杂志,2001,2(2)：74-792.
[37]赵水平.高脂血症的病因及分类[J].中国冶金工业医学杂志,1997,14(5)：289-295.
[38]李景章.高脂蛋白血症的临床分类与药物治疗[J].邯郸医学高等专科学校报,2004,17(5)：407.
[39]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35：390-419.
[40]方永奇,曹建宏,方春亮.从温胆汤的方证看痰证实质.中国中医基础医学杂志,1998,4(1)：43-45.
[41]邱裕元,李巨奇,贾晓林,等.痰本质及其物质基础探讨.实用中医药杂志,2002,18(7)：47-48.
[42]苏庆民,王琦.肥胖人痰湿型体质血脂、血糖、胰岛素及红细胞Na}-K}-ATP酶活性的检测及特征.中国中医基础医学杂志,1995,1(2)；39
[43]陈伟民.首届中医体质学说研讨会论文集.158
[44]孟凡一.降脂汤配合脐疗治疗高脂血症54例[J].光明中医,1999,14(85)：49-50.
[45]孙九光,吴坚芳,杨菊,等.降脂脉安冲剂并大黄敷脐治疗脂肪肝100例临床观察[J].河北中医,2003,25(7)：494.
[46]邵敏,温凌洁,孙蓉.穴位敷贴对Ⅲ型糖尿病患者血脂水平的影响[J].上海针灸杂志,2000,19(6)：5.
[47]禹翔,吴玉泉,郑伟,等.穴位敷贴治疗老年人高脂血症的临床研究[J].临床军医杂志,2006,34(6)：675.
[48]温木生.论脐疗的治疗效应与机理[J].医学研究荟萃,2002,(2)：27-28.
[49]于华,侯喜连,孔雪萍.“蝴蝶效应”与脐疗机制探讨[J].光明中医,2007,22(8)：3.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |