Clinical Study on Qinggan Zishen Formula to Regulate Irisin Levels and Mitigate Metabolic Disorders in Obesity-Related Hypertension
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摘要:
目的 观察清肝滋肾方联合常规降压西药治疗对肥胖型高血压患者的鸢尾素(Irisin)表达水平及代谢指标的影响。 方法 选择符合纳入标准的肥胖型高血压阴虚阳亢证患者80例, 随机分为观察组及对照组各40例。对照组给予生活方式干预及持续常规西医治疗, 观察组在对照组治疗基础上加用清肝滋肾方, 疗程均为8周, 观察2组患者治疗前后中医证候积分、临床疗效、人体测量学指标[收缩压(Systolic blood pressure, SBP)、舒张压(Diastolic blood pressure, DBP)、体质量(Weight, WT)、腰围(Waist circumference, WC)]、代谢特征指标[空腹血糖(Fasting blood glucose, FBG)、总胆固醇(Total cholesterol, TC)、甘油三酯(Triglyceride, TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol, LDL-C)]、鸢尾素(Irisin)、血清脂肪因子[脂联素(Adiponectin, ADP)及瘦素(Leptin, LEP)]以及安全性指标的变化情况。 结果 治疗后, 2组中医证候积分明显下降(P < 0.05, P < 0.01), 且观察组在改善头痛眩晕、急躁易怒、潮热盗汗、腰膝酸软、口燥咽干、五心烦热、便秘尿黄症状及总积分方面优于对照组(P < 0.05, P < 0.01);观察组中医临床疗效优于对照组(P < 0.05);观察组Irisin水平明显升高(P < 0.01), 优于对照组(P < 0.01);观察组SBP、DBP明显下降(P < 0.05), 优于对照组(P < 0.05);2组WT、WC、TC、TG、LDL-C、ADP、LEP水平均明显改善(P < 0.05, P < 0.01), 观察组优于对照组(P < 0.05)。治疗期间2组均未出现明显不良反应。 结论 清肝滋肾方联合常规降压西药能调节肥胖型高血压阴虚阳亢证患者Irisin表达，改善代谢紊乱。 Abstract:OBJECTIVE To observe the effects of Qinggan Zishen formula combined with conventional antihypertensive western medicine treatment on the expression level of irisin and metabolic indexes in patients with obesity-related hypertension. METHODS A total of 80 obesity-related hypertension patients with yin deficiency and yang hyperactivity who met the inclusion criteria were selected and randomly divided into 40 cases each in the observation group and the control group. In the control group, patients were given lifestyle interventions and continuous conventional western medical treatment, while the observation group was treated with oral administration of traditional Chinese medicine (TCM) decoction pieces - Qinggan Zishen formula based on the therapies in the control group. The treatment course lasted eight weeks. In addition, before and after the treatment, we observed the changing levels of TCM syndrome score, clinical efficacy, anthropometric indexes [systolic blood pressure (SBP), diastolic blood pressure (DBP), weight (WT), waist circumference (WC)], metabolic indexes [fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C)], irisin, adipokines [adiponectin (ADP) and leptin (LEP)], as well as safety indicators. RESULTS After treatment, the TCM syndrome scores of both groups were decreased significantly (P < 0.05, P < 0.01), but the result of observation group was better than that of control group in reliving the syndromes of headache and dizziness, irritability, tidal fever and night sweats, soreness and weakness of waist and knees, dry mouth and throat, feverish sensations in palms, soles and chest, constipation, as well as dark urine. Besides, the total TCM syndrome scores of observation group showed better results than those of the control group (P < 0.05, P < 0.01). In addition, the TCM clinical efficacy of the observation group was better than that of the control group (P < 0.05). The irisin level was significantly higher in the observation group (P < 0.01), so its result was better than that of the control group (P < 0.01). The levels of SBP and DBP were significantly reduced in the observation group (P < 0.05), which also showed better results than those of the control group (P < 0.05). Although both groups' results of WT, WC, TC, TG, LDL-C, ADP, and LEP were notably changed in a good way (P < 0.05, P < 0.01), the observational group showed better results than those of the control group (P < 0.05). No significant adverse reactions were observed in both groups during the treatment course. CONCLUSION Qinggan Zishen formula combined with conventional antihypertensive western medicine can regulate irisin expression and mitigate metabolic disorders in obesity-related hypertension patients with yin deficiency and yang hyperactivity. -
Key words:
- Qinggan Zishen formula /
- Irisin /
- obesity-related hypertension /
- metabolism /
- adipokines /
- traditional Chinese medicine
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表 1 2组患者基线资料比较(x±s, n=40)
Table 1. Comparison of baseline information between 2 groups of patients (x±s, n=40)
组别 男 女 年龄/岁 病程/a 收缩压/mmHg 舒张压/mmHg 观察组 24 16 56.11±7.13 4.79±1.12 124.84±11.00 71.50±12.04 对照组 19 21 57.32±7.67 5.28±1.35 126.14±11.39 75.36±8.70 组别 糖尿病 高脂血症 高尿酸血症 吸烟 饮酒 观察组 11 15 9 13 8 对照组 10 18 13 14 7 
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表 2 2组患者治疗前后中医证候积分比较(x±s, n=40)
Table 2. Comparison of TCM syndrome scores between 2 groups before and after treatment (x±s, n=40)
组别 时间 头痛眩晕 急躁易怒 潮热盗汗 腰膝酸软 口燥咽干 观察组 治疗前 2.22±0.67 2.30±0.44 2.29±0.64 1.74±0.26 2.15±0.65 治疗后 1.34±0.45**## 1.74±0.38**# 1.75±0.55**# 1.24±0.14**## 1.18±0.32**## 对照组 治疗前 2.18±0.65 2.41±0.25 2.34±0.74 1.68±0.24 2.24±0.39 治疗后 1.85±0.53* 2.04±0.62* 2.28±0.71 1.70±0.34 1.98±0.33* 组别 时间 五心烦热 便秘尿黄 失眠多梦 总积分 观察组 治疗前 2.45±0.71 1.78±0.25 2.14±0.33 17.02±4.89 治疗后 2.01±0.67*# 1.26±0.35**# 1.82±0.56* 9.46±4.65**## 对照组 治疗前 2.38±0.48 1.92±0.51 2.20±0.47 17.38±5.52 治疗后 1.88±0.29* 1.60±0.44* 1.78±0.70* 15.02±4.86* 注: 组内比较, *P < 0.05, **P < 0.01;组间比较, #P < 0.05, ##P < 0.01。
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表 3 2组患者中医临床疗效比较(n=40)
Table 3. Comparison of TCM clinical efficacy between 2 groups (n=40)
组别 显效 有效 无效 总有效率/% 观察组 10 23 7 82.50# 对照组 6 18 16 60.00 注: 组间比较, χ2=4.943, #P < 0.05。
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表 4 2组患者治疗前后Irisin水平比较[M(P25, P75), ng·mL-1, n=40]
Table 4. Comparison of Irisin levels between 2 groups before and after treatment [M(P25, P75), ng·mL-1, n=40]
组别 时间 Irisin 观察组 治疗前 57.9(51.4, 70.4) 治疗后 77.5(65.1, 88.6)**## 对照组 治疗前 62.3(55.0, 71.4) 治疗后 65.0(61.0, 79.8) 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 5 2组患者治疗前后LEP、ADP水平比较[M(P25, P75), n=40]
Table 5. Comparison of LEP and ADP levels between 2 groups before and after treatment [M(P25, P75), n=40]
组别 时间 LEP/(pg·mL-1) ADP/(μg·mL-1) 观察组 治疗前 9 186(7 789, 13 866) 3.08(2.01, 4.52) 治疗后 7 567(7 138, 11 468)*# 3.85(2.33, 5.41)*# 对照组 治疗前 9 237(7 685, 14 396) 3.11(1.95, 4.55) 治疗后 7 934(7 334, 12 548)* 3.63(2.46, 5.20)* 注: 组内比较, *P < 0.05;组间比较, #P < 0.05。
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表 6 2组患者治疗前后FBG、TG、TC及LDL-C比较(x±s, mmol·L-1, n=40)
Table 6. Comparison of FBG, TG, TC and LDL between 2 groups before and after treatment (x±s, mmol·L-1, n=40)
组别 时间 FBG TG TC LDL-C 观察组 治疗前 5.89±0.62 2.03±0.24 5.91±0.44 2.89±0.31 治疗后 5.73±0.58 1.61±0.33*# 5.18±0.60*# 2.24±0.39*# 对照组 治疗前 5.79±0.80 2.04±0.24 5.74±0.31 2.76±0.38 治疗后 5.81±0.52 1.88±0.31* 5.44±0.36* 2.53±0.41* 注: 组内比较, *P < 0.05;组间比较, #P < 0.05。
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表 7 2组患者治疗前后WT、WC、SBP及DBP比较(x±s, n=40)
Table 7. Comparison of WT, WC, SBP, and DBP between 2 groups before and after treatment (x±s, n=40)
组别 时间 WT/kg WC/cm SBP/mmHg DBP/mmHg 观察组 治疗前 78.56±5.48 90.50±6.10 124.84±11.00 71.50±12.04 治疗后 73.67±4.07**# 82.90±5.41**# 116.35±14.53*# 66.85±5.42*# 对照组 治疗前 77.52±5.19 89.77±5.58 126.14±11.39 75.36±8.70 治疗后 76.15±5.44* 86.48±6.27* 124.58±15.66 76.92±7.69 注: 组内比较, *P < 0.05, **P < 0.01;组间比较, #P < 0.05。
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[1] 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36(6): 521-545. doi: 10.3969/j.issn.1000-3614.2021.06.001The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases burden in China: An updated summary of 2020[J]. Chin Circ J, 2021, 36(6): 521-545. doi: 10.3969/j.issn.1000-3614.2021.06.001 [2] 中华医学会内分泌学分会, 中华中医药学会糖尿病分会, 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 等. 基于临床的肥胖症多学科诊疗共识(2021年版)[J]. 中华内分泌代谢杂志, 2021, 37(11): 959-972. doi: 10.3760/cma.j.cn311282-20210807-00503Society of Endocrinology, Diabetes Society of China Association of Chinese Medicine, Chinese Society for Metabolic and Bariatric Surgery, et al. Multidisciplinary clinical consensus on diagnosis and treatment of obesity (2021 edition)[J]. Chin J Endocrinol Metab, 2021, 37(11): 959-972. doi: 10.3760/cma.j.cn311282-20210807-00503 [3] WASEEM R, SHAMSI A, MOHAMMAD T, et al. FNDC5/irisin: Physiology and pathophysiology[J]. Molecules, 2022, 27(3): 1118. doi: 10.3390/molecules27031118 [4] 江宇宁, 张淑洁, 何云, 等. 清肝滋肾方对肥胖相关性高血压代谢紊乱的干预作用及其网络药理机制[J]. 中国实验方剂学杂志, 2022, 28(11): 148-155. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202211019.htmJIANG YN, ZHANG SJ, HE Y, et al. Effect of qinggan zishen prescription on metabolic disorder in obesity-related hypertension and its mechanism based on network pharmacology[J]. Chin J Exp Tradit Med Formulae, 2022, 28(11): 148-155. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202211019.htm [5] 中华医学会心血管病学分会高血压学组. 肥胖相关性高血压管理的中国专家共识[J]. 中华心血管病杂志, 2016, 44(3): 212-219. doi: 10.3760/cma.j.issn.0253-3758.2016.03.006Hypertension Group, Cardiovascular Branch, Chinese Medical Association. Chinese experts' consensus on the management of obesity-related hypertension[J]. Chin J Cardiol, 2016, 44(3): 212-219. doi: 10.3760/cma.j.issn.0253-3758.2016.03.006 [6] 郑筱萸. 中药新药临床研究指导原则: 试行[M]. 北京: 中国医药科技出版社, 2002: 73-76.ZHENG XY. Guiding Principles of Clinical Research on Noval Chinese Medicine: Trial Implementation[M]. Beijing: China medical science press, 2002: 73-76. [7] 中华人民共和国国家标准中医临床诊疗术语疾病部分(续上期)[J]. 成都中医药大学学报, 1998, 21(2): 52-54.National standards of the People's Republic of China, clinic terminnology of Chinese medical diagnosis and treatment-diseases (continued from previous issue)[J]. J Chengdu Univ Tardit Chin Med, 1998, 21(2): 52-54. [8] SAXTON SN, CLARK BJ, WITHERS SB, et al. Mechanistic links between obesity, diabetes, and blood pressure: Role of perivascular adipose tissue[J]. Physiol Rev, 2019, 99(4): 1701-1763. doi: 10.1152/physrev.00034.2018 [9] 郭杰, 余灿清, 吕筠, 等. 中国10个地区人群高血压患病率、知晓率、治疗率和控制情况分析[J]. 中华高血压杂志, 2017, 25(3): 300. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ201703035.htmGUO J, YU CQ, LYU Y, et al. Analysis of prevalence rate, awareness rate, treatment rate and control condition of hypertension in a population from 10 Chinese regions[J]. Chin J Hypertens, 2017, 25(3): 300. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ201703035.htm [10] 王滢莹, 秦俭, 程丽芳. 肥胖悖论与心血管疾病[J]. 心血管病学进展, 2022, 43(1): 52-55. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGB202201014.htmWANG YY, QIN J, CHENG LF. Obesity paradox and cardiovascular diseases[J]. Adv Cardiovasc Dis, 2022, 43(1): 52-55. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGB202201014.htm [11] 徐晓雨, 龚帆影, 张春芹, 等. 潜阳育阴颗粒对阴虚阳亢型高血压合并高脂血症患者血管弹性功能的影响[J]. 南京中医药大学学报, 2021, 37(6): 865-870. doi: 10.14148/j.issn.1672-0482.2021.0865XU XY, GONG FY, ZHANG CQ, et al. Clinical study on the effect of Qianyang Yuyin granules on vascular elasticity function of hypertension combined with hyperlipidemia with Yin deficiency and Yang excess syndrome[J]. J Nanjing Univ Tradit Chin Med, 2021, 37(6): 865-870. doi: 10.14148/j.issn.1672-0482.2021.0865 [12] 牛露娜, 荆鲁, 杨凤珍, 等. 路志正调理脾肾法治疗高血压病学术思想[J]. 中医杂志, 2021, 62(6): 472-475. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202106004.htmNIU LN, JING L, YANG FZ, et al. Professor LU zhizheng's experience for treatment of hypertension through spleen-kidney regulation theory[J]. J Tradit Chin Med, 2021, 62(6): 472-475. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202106004.htm [13] 王冰. 黄帝内经素问注[M]. 南宁: 广西科学技术出版社, 2016: 159.WANG B. Annotations on The Yellow Emperor's Inner Classic: Basic Questions[M]. Nanning: Guangxi science and technology press, 2016: 159. [14] 王叔和. 脉经[M]. 北京: 人民卫生出版社, 1956: 37.WANG SH. The Pulse Classic[M]. Beijing: People's medical publishing house, 1956: 37. [15] 孙柳, 张瑶. Irisin(鸢尾素)在心衰治疗中作用的研究进展[J]. 心血管康复医学杂志, 2021, 30(3): 329-332. doi: 10.3969/j.issn.1008-0074.2021.03.20SUN L, ZHANG Y. Research progress of role of Irisin in HF treatment[J]. Chin J Cardiovasc Rehabilitation Med, 2021, 30(3): 329-332. doi: 10.3969/j.issn.1008-0074.2021.03.20 [16] ZHANG R, FU T, ZHAO X, et al. Association of circulating Irisin levels with adiposity and glucose metabolic profiles in a middle-aged Chinese population: A cross-sectional study[J]. Diabetes Metab Syndr Obes, 2020, 13: 4105-4112. doi: 10.2147/DMSO.S275878 [17] 陈倩楠, 伍丽, 朱益民, 等. 肥胖者血清脂联素水平与代谢状况的关系[J]. 华中科技大学学报(医学版), 2021, 50(6): 778-782. doi: 10.3870/j.issn.1672-0741.2021.06.017CHEN QN, WU L, ZHU YM, et al. Relationship between serum adiponectin and metabolic status in obesity individuals[J]. Acta Med Univ Sci Technol Huazhong, 2021, 50(6): 778-782. doi: 10.3870/j.issn.1672-0741.2021.06.017 [18] 穆倩, 张志国, 张翼飞. 瘦素抵抗相关机制的研究进展[J]. 中华内分泌代谢杂志, 2020, 36(6): 515-519. doi: 10.3760/cma.j.cn311282-20190726-00297MU Q, ZHANG ZG, ZHANG YF. Research progress of leptin resistance mechanism[J]. Chin J Endocrinol Metab, 2020, 36(6): 515-519. doi: 10.3760/cma.j.cn311282-20190726-00297 [19] JIANG YH, ZHANG P, TAO YN, et al. Banxia Baizhu Tianma Decoction attenuates obesity-related hypertension[J]. J Ethnopharmacol, 2021, 266: 113453. doi: 10.1016/j.jep.2020.113453 -
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