Study On How The Treatment Of Purging Heat And Eliminating Blood Stasis, Replenishing Qi And Nourish Yin Effect On Metabolic Syndrome

The first part:Study of metabolic syndrome(MS) theory and literatureOn the common pathologic basis of IR,MS is a group of clinical syndromes(which is mainly composed of) mainly including central obesity,impaired glucose regulation, diabetes,hypertension,dyslipidemia.Both its syndrome and clinical outcome are concurrently caused by lots of dangerous elements,which contribute to diabetes and cardiovascular disease.Previous studies mainly focused on abdominal obesity,lipid toxicity and IR.Currently,the pathophysiologic mechanism of MS is not yet entirely clear, there are different understandings of its pathogenesis and it may be caused by a common mechanism.Although controversial problems still exist in both of the diagnostic criteria and clinical applications of MS,But putting forward the concept of MS not only can make people aware that the effects of multiple risk factors is not a simple overlay,as the early "early warning" and "wind vane" of diabetes and cardiovascular disease,but also can be significant in the early prevention and treatment in some degree.Therefore,in order to improve the multiple metabolic disorders caused by IR,attentions in the prevention and treatment should be paid in controlling the level of blood sugar as well as full controlling of multiple metabolic disorders.Nowadays,with trends in medical developing from pathema medicine to health medicine,medical intervention plays a more and more important part as a breakthrough point in medicine.To prevent diseases before it occur "which has some viewpoints in common with health medicine at the macro level is one of most important characteristics of Chinese medicine.So,it is feasible way to give some meaningful directions in comprehensive prevention and treatment of MS.Although a term of MS can't be found in the Chinese medicine's books,ample descriptions of some diseases related to MS can be found,such as "Diabetes","obesity", "dizziness","obstruction of chest" and so on.All of which are equivalent to MS,for differentiation of symptoms and signs for classification of syndrome is still in the exploratory stage,we are still lack of large-scale normative study of TCM,furthermore,a definitive Chinese medicine therapy has not been established yet.Hence,establishing treatment combined with the evaluation of clinical efficacy by clearing heat and eliminating stasis and supplement the vital energy according to Metabolic syndrome's main characteristics,when providing new ideas and methods for clinical treatment of MS is concerned,it shows Vast Vistas.The second part:Purging heat and eliminating blood stasis,replenishing qi and nourish yin treatment of MS in clinical researchObjective:to research the characteristics of the pathogenesis of MS and preliminarily raise a point that the main pathogenesis of MS is the theory of blood and heat Accumulation,deficiency of Qi and Yin and to encourage the application of the therapy of purging heat and eliminating blood stasis,replenishing qi and nourish yin on MS,based on the study of Chinese medicine treatment of metabolic syndrome in the literature and clinical experience of instructors.By observing the clinical efficacy of Jiangtang Sanhuang pills which were made according to the very therapy,the correctness of this theory is evidenced to provide valuable theoretical basis for the future effective application of Jiangtang Sanhuang pills.Methods:Carried out a prospective study with the clinical observation of 72 patients with metabolic syndrome in our hospital during the period from August 2008 to 2009 March.The 72 cases were randomized into two groups,the herb group(37 cases)and the Western medicine group(35 cases),and on the basis of the same treatment of eating and physical activity,the herb group received the therapy of purging heat and eliminating blood stasis,replenishing qi and nourish yin(Sanhuang Jiangtang pills) while the western medicine group received conventional Western medicine therapy(acarbose).The course of treatment was 2 months and during the period the observation of kinds of clinical diagnosis criterions of MS,OGTT,the insulin release test,IAI,TNF-α,IL-6,ADP,LP,FFA clinical symptom score and quality of life indicators such as scale points was carried out.Then compared the herb group with the Western medicine group and compared before the treatment with after the treatment respectivey,to find out the change of the data.The data process SPSS 13.0 software package,using x2 test count data,measurement data using t test. Results:(1) The total effective rate of the herb group was 78.4%,while the western medicine group was 82.9%,the difference between the two groups had no significance (P＞0.05);points between the two groups showed that the quality of life the herb group was superior to the western medicine group,and the difference was significant(P＜0.05);the cost between the two groups-the effect of the ratio,the herb group was superior to the western medicine group.(2)Through the analysis of relevant indicators from comparing before treatment and after treatment,the two groups' levels of FBG,2hPG,HbA1c,FINS, 2hINS,IAI,TC,TG,LDL-C(P＜0.05 or P＜0.01) can be reduced after treatment,but the level of HDL-C is higher than before treatment(P＜0.05 or P＜0.01).Comparing before and after treatment,there is having no significant difference at the level of BMI,WHR,SBP, DBP,(P＞0.05).(3)After treatment,there was no significant difference between the two groups in the levels of FBG,2hPG,HbA1C,FINS,2hINS,IAI,Tg and LDL-C(P＞0.05); there was a significant difference between the two groups in reducing TC and increasing HDL-C level(P＜0.05) that the western medicine group was superior to the herb group.(4) before the treatment,there was a significant difference(P＜0.05 or P＜0.01) between the two groups of patients and normal control group in the levels of TNF-α,IL-6,LP,ADP and FFA; after the treatment,the two groups' levels of TNF-α,IL-6,LP and FFA were lower than before the treatment(P＜0.05 or P＜0.01);after the treatment,the two groups' levels of ADP rose higher than before the treatment(P＜0.05);after the treatment there had no significant difference between the two groups in the levels of TNF-α,IL-6,LP,ADP,and FFA (P＞0.05).(5) Before treatment two groups of patients' SUA level was positively related to BMI,WRH,FPG,2hPG,TG,LDL-C and was negative related to with HDL-C.Conclusions and revelations:(1) The external causes of MS are incontinence diets, emotions failures,the maladjustments between work and rest,and the internal causes are inadequate gifts,viscera deficiency during its occurrence and development.In the process of this disease,dryness-heat,corrupt sputum and gore are not only its pathological products,but also its new causes.The treatment in accord with its main pathological character.The treatment of purging heat and eliminating blood stasis,replenishing qi and nourish yin can effectively intervene dangerous factors of the patients and improve their life quality.Its mechanism is related to improving the state of inflammation,adjusting the fat source of cytokines and lowing lipid composition.(2)Early treatment for MS(a cluster of the DM and CVD risky factors)is of great importance.According to the idea of treating "non-disease",the treatment for MS should be given as early as possible,eliminating the pathogenic factor and the therapy of purging heat and eliminating blood stasis could cut off the disease course.Sanhuang Jiangtang pills with its compatibility hit the main pathogenesis of MS,could achieve better clinical efficacy,its total effect was similar to the western medicine acarbose.So far,there are still many disadvantages of MS' universal education.Its early finding rate is very low,so we should increase the education on disease prevention and control efforts.Besides,in the diagnosis of MS standards,To "Endo-meridians" as the guide, accessing the distribution of fat is more comprehensive than evaluating simple BMI;At the same time,serum uric acid are closely related to MS components,which suggests that the detection of uric acid is important.Innovation:on the basis of the prospective study,clinical research is adapted to make the evaluation of Sanhuang Jiangtang pills" efficacy of MS.By observing the relevant indicators,it is found that the medical prescription of clearing heat and eliminating stasis and supplement the vital energy has a certain effect on the prevention and treatment of MS which has provided a reliable scientific basis for the expansion of Sanhuang Jiangtang pills'clinical application and expanded methods and thinking in the Chinese medicine treatment of MS.By observing this prescription's impact on the pathogenesis of MS in different lights,such as Inflammatory cytokines,fat-derived factor,lipid composition factor, etc,the Primary mechanism of Sanhuang Jiangtang pills can be expounded.