2022 年第 4 期 第 17 卷

苍术麻黄汤对痰瘀阻滞证血脂异常患者血脂水平及体重指数影响的临床研究

Efficacy of Cangzhu Mahuang decoction on lipid levels and body mass index in patients of dyslipidemia with phlegm and blood stasis block syndrome

作者：李璐璐1胡馨2刘红旭2

英文作者：Li Lulu1 Hu Xin2 Liu Hongxu2

单位：1北京市和平里医院内分泌科，北京100013；2首都医科大学附属北京中医医院心脏中心，北京100010

英文单位：1Department of Endocrinology Beijing Hepingli Hospital Beijing 100013 China; 2Cardiac Center Beijing Hospital of Traditional Chinese Medicine Capital Medical University Beijing 100010 China

关键词：血脂异常；苍术麻黄汤；痰瘀阻滞证；体重指数

英文关键词：Dyslipidemia;CangzhuMahuanngdecoction;Phlegmandbloodstasisblocksyndrome;Bodymassindex

• 摘要：

• 目的 探讨苍术麻黄汤对痰瘀阻滞证血脂异常患者血脂水平及体重指数的影响及安全性。方法 采用前瞻性、随机、对照临床试验方法，选取2019年1月至2020年5月首都医科大学附属北京中医医院和北京市和平里医院收治的符合痰瘀阻滞证高总胆固醇血症/高低密度脂蛋白胆固醇（LDL-C）血症的患者作为研究对象。采用随机数字表法将患者分为观察组（31例）和对照组（30例）。观察组予苍术麻黄汤口服治疗，对照组予血滞通胶囊口服治疗，2组均连续治疗8周。比较2组治疗前后血常规、肝功能、血尿素氮、肌酸激酶、血脂水平及体重指数。结果 治疗前，观察组与对照组白细胞计数、红细胞计数、血小板计数、红细胞比容、血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、血尿素氮、肌酸激酶水平比较，差异均无统计学意义（均P>0.05）；总胆固醇、LDL-C、高密度脂蛋白胆固醇、三酰甘油水平及体重指数比较，差异均无统计学意义（均P＞0.05）。治疗4、8周，2组总胆固醇、LDL-C、三酰甘油水平较治疗前有下降趋势，但差异均无统计学意义，且观察组与对照组同期比较差异均无统计学意义［治疗4周：（5.7±0.5）mmol/L比（6.0±1.0）mmol/L、（3.7±0.4）mmol/L比（3.6±0.6）mmol/L、（1.9±0.7）mmol/L比（2.5±0.8）mmol/L；治疗8周：（5.5±0.8）mmol/L比（5.9±1.0）mmol/L、（3.4±0.5）mmol/L比（3.5±0.6）mmol/L、（1.9±0.7）mmol/L比（2.4±0.9）mmol/L］（均P＞0.05）；观察组体重指数较治疗前降低，且治疗8周时低于对照组［（24.0±2.7）kg/m2比（25.7±4.1）kg/m2］（均P＜0.05）；2组血常规、肝功能、血尿素氮及肌酸激酶水平比较，差异均无统计学意义（均P＞0.05）。结论 苍术麻黄汤具有潜在降低总胆固醇、LDL-C及三酰甘油水平作用，效果与血滞通胶囊相当，但具有更好的降低体重指数效果。

• Objective To investigate the efficacy of Cangzhu Mahuang decoction on blood lipid levels and body mass index (BMI) and its safety in patients of dyslipidemia with phlegm and blood stasis block syndrome. Methods This study was a prospective, randomized and controlled clinical trial. From January 2019 to May 2020, patients with hypercholesterolemia/hyper low-density lipoprotein cholesterol (LDL-C) with phlegm and blood stasis block syndrome were selected from Beijing Hospital of Traditional Chinese Medicine, Capital Medical University and Beijing Hepingli Hospital. Patients were randomly divided into observation group (31 cases) and control group (30 cases). The observation group was treated with Cangzhu Mahuang decoction orally, and the control group was treated with Xuezhitong capsules, both for 8 weeks. Levels of blood routine index, liver function, blood urea nitrogen, creatine kinase, blood lipid and BMI were compared between the two groups before and after treatment. Results Before treatment, there were no significant differences in levels of white blood cell count, red blood cell count, platelet count, hematocrit, hemoglobin, alanine amiotransferase, aspartate aminotransferase, total bilirubin, blood urea nitrogen and creatine kinase between the two groups (all P>0.05); there were no significant differences in levels of total cholesterol, LDL-C, high-density lipoprotein cholesterol, triacylglycerols and BMI between the observation group and the control group (all P>0.05). After 4 and 8 weeks after treatment, levels of total cholesterol, LDL-C and triacylglycerols gradually decreased in both groups, but the differences in the levels were not statistically significant in each of both groups and between the observation group and the control group［4 weeks after treatment:（5.7±0.5）mmol/L vs （6.0±1.0）mmol/L, （3.7±0.4）mmol/L vs （3.6±0.6）mmol/L, （1.9±0.7）mmol/L vs （2.5±0.8）mmol/L; 8 weeks after treatment:（5.5±0.8）mmol/L vs （5.9±1.0）mmol/L, （3.4±0.5）mmol/L vs （3.5±0.6）mmol/L, （1.9±0.7）mmol/L vs （2.4±0.9）mmol/L］(all P>0.05); body mass index showed a tendency to decrease in the observation group and that in the observation group was lower than that in the control group 8 weeks after treatment［（24.0±2.7）kg/m2 vs （25.7±4.1）kg/m2］(all P<0.05); there were no significant differences in blood routine index, liver function, blood urea nitrogen and creatine kinase between the two groups (all P>0.05). Conclusions Cangzhu Mahuang decoction has potential to decrease levels of total cholesterol, LDL-C and triacylglycerols, and the effect is similar to Xuezhitong capsules. In addition, Cangzhu Mahuang decoction has advance in decreasing BMI.