Clinical Efficacy of Modified Xiaoji Baozhong Granules Combined with Scraping in Treatment of Abdominal Obesity with Gastric Heat and Dampnes / 中国实验方剂学杂志

Objective:To evaluate the efficacy of modified Xiaoji Baozhong granules combined with scraping in the treatment of abdominal obesity with gastric heat and dampness syndrome and its effect on adipocytokines. Method:One hundred and forty-four patients were randomly divided into the control group and the observation group， 72 cases in each group. The lifestyle adjustments were conducted in both groups. The observation group was given a comprehensive traditional Chinese medicine regimen of modified Xiaoji Baozhong granules combined with scraping. The control group was given modified Xiaoji Baozhong granules combined with scraping. The course of treatment was three months. The body mass index （BMI）， body fat percentage （FP）， waist circumference （WC）， waist to hip ratio （WHR）， obesity and abdominal fat thickness of the two groups were compared before and after treatment. The levels of fasting blood glucose （FBG）， insulin resistance index （HOMA-IR）， high density lipoprotein （HDL）， low density lipoprotein （LDL）， triglyceride （TG）， total cholesterol （TC）， adiponectin， leptin， resistin， endolipid and tumor necrosis factor-α （TNF-α） were compared between the two groups before and after treatment. The clinical efficacy and safety were evaluated. Result:After treatment， the BMI， FP， obesity， WC and WHR of the observation group were lower than those of the control group （<italic>P</italic><0.01）. After treatment， the abdominal wall fat thickness and intra-abdominal fat thickness of patients in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The FBG， HOMA-IR， TG， TC and LDL of the observation group were lower than those of the control group （<italic>P</italic><0.01）， while the HDL level was higher than the control group （<italic>P</italic><0.01）. Adiponectin in the observation group was higher than the control group after treatment （<italic>P</italic><0.01）. The leptin， resistin， visfatin and TNF-α were lower than those in the control group （<italic>P</italic><0.01）. The total clinical efficacy rate of patients in the observation group was 88.24% （60/68）， which was better than 73.53% （50/68） in the control group （<italic>χ</italic>²=4.755， <italic>P</italic><0.05）. Conclusion:In addition to lifestyle adjustments， modified Xiaoji Baozhong granules combined with scraping treatment can reduce the degree of obesity and fat thickness in patients with abdominal obesity， and regulate lipid， carbohydrate metabolism and adipocytokines， with a better clinical efficacy than simple scraping therapy and the safety in practice.

Regulatory Effect of Modified Banxia Xiexintang on Insulin Resistance of Patients with Nonalcoholic Fatty Liver / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Banxia Xiexintang on nonalcoholic fatty liver （NAFLD） and the regulatory effect on insulin resistance （IR）. Method:One hundred and forty patients were randomly divided into control group and observation group. A total of 63 patients in control group completed the therapy （4 patients fell off or were lost to follow-up， 3 were eliminated）， while 65 patients in observation group completed the therapy （5 patients fell off or were lost to follow-up， none was eliminated）. Both groups' patients got lifestyle intervention， liver protection and lipid regulation. Patients in control group got Huazhi Rougan granule， 1 pack/time， 3 times/day. Patients in observation group got modified Banxia Xiexintang， 1 dose/day. And the course of treatment for the two groups was 12 weeks， and a 12 week follow-up was recorded. Before and after treatment and during the follow-up， fat content of liver was recorded by instantaneous elastic recorder， fasting blood glucose （FBG） and fasting insulin （FINS） were detected， and insulin sensitivity index （ISI）， insulin resistance index （HOMA-IR） and islet <italic>β</italic> cell function index （HOMA-<italic>β</italic>） were detected. After treatment， B-mode ultrasonography and ratio of liver/spleen CT were detected. And levels of alanine transaminase （ALT）， aspartate transaminase （AST）， total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， adiponectin， leptin， serine protease inhibitor （Vaspin）， tumor necrosis factor （TNF）-<italic>α</italic> and interleukin-6 （IL-6） were detected. And the safety was evaluated. Result:CAP and HOMA-IR in observation group were lower than those in control group after treatment and during the follow-up （<italic>P</italic><0.01）， and ISI and HOMA-<italic>β</italic> were higher than those in control group （<italic>P</italic><0.01）. Amelioration of indexes of blood lipid was better than those in control group （<italic>P</italic><0.01）. Levels of ALT， AST， FBG and FINS were lower than those in control group （<italic>P</italic><0.01）. Scores of traditional Chinese medicine （TCM） syndromes were lower than those in control group （<italic>P</italic><0.01）， ratio of liver/spleen CT and adiponectin was higher than that in control group （<italic>P</italic><0.01）. Levels of TNF-<italic>α</italic>， IL-6， vaspin and leptin were lower than those in control group （<italic>P</italic><0.01）. B-ultrasound efficacy and fat content of liver were superior to those of control group （<italic>P</italic><0.05）. There were no serious adverse events and drug-related adverse reactions. Conclusion:Modified Banxia Xiexintang can regulate glucose and lipid metabolism， improve insulin sensitivity and HOMA-<italic>β</italic> cell function， improve IR， regulate adipocytokines and inflammatory factors， relieve clinical symptoms and liver fat content， and improve CT ratio of liver/spleen， with a better clinical efficacy and safety.

Regulatory Effect of Modified Erzhu Erchentang on Patients with Polycystic Ovary Syndrome and Spleen Deficiency and Phlegm Dampness / 中国实验方剂学杂志

Objective:To observe the regulatory effect of modified Erzhu Erchentang on metabolization of polycystic ovary syndrome （PCOS） with spleen deficiency and phlegm dampness syndrome. Method:Patients 140 cases were divided into control group and observation group. Both groups were given metformin hydrochloride tablets， 500 mg/time， 3 times/day. Control group was given Yuejun Erchen pills， 0.5 g/time， 3 times/day， while observation group was given modified Erzhu Erchentang， 1 dose/day. The course of treatment lasted for 24 weeks. Before and after treatment， levels of fasting blood glucose （FBG）， fasting insulin （FINS）， glycosylated hemoglobin Alc （HbA1c）， 2-hour postprandial blood glucose （2 h PG）， blood lipid， waist circumference （WC）， body mass index （BMI）， waist hip ratio （WHR）， luteinizing hormone （LH）， follicle stimulating hormone （FSH）， serum testosterone （T）， estradiol （E₂）， dehydroepiandrosterone sulfate （DHEAS）， sex hormone binding globulin （SHBG）， leptin （LP）， adiponectin （APN）， resistin， visfatin and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） were detected. Homeostasis model assessment insulin resistance （HOMA-IR） was calculated， modified Erzhu Erchentang was scored， and recovery of menstruation and ovulation and ovarian volume were recorded. Result:Levels of FBG， 2 h PG， HbA1c， FINS， HOMA-IR， triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， LH， FSH， T， E₂， DHEAS， LP， resistin， visfatin and TNF-<italic>α</italic> in observation group were lower than those in control group （<italic>P</italic><0.01）， and levels of BMI， WC and WHR were lower than those of control group （<italic>P</italic><0.05）. And levels of high-density lipoprotein cholesterol （HDL-C）， SHBG and APN were higher than those in control group （<italic>P</italic><0.01）. Score of modified Erzhu Erchentang was lower than that in control group （<italic>P</italic><0.01）， and ovarian volume was smaller than that in control group （<italic>P</italic><0.01）. The normal rate of BMI was 49.23% （32/65）， which was higher than 30.30% （20/66） in control group （<italic>χ</italic>²=5.151， <italic>P</italic><0.05）. The normal rate of blood lipid was 93.85% （61/65）， which was higher than 81.82 % （54/66） in control group （<italic>χ</italic>²=4.418， <italic>P</italic><0.05）. The normal rate of blood glucose was 96.92% （63/65）， which was higher than 86.36% （57/66） in control group （<italic>χ</italic>²=4.474， <italic>P</italic><0.05）. Conclusion:In addition to adipocytokines， modified Erzhu Erchentang could regulate adipokines of patients of PCOS with spleen deficiency and phlegm dampness， improve glucose， lipid metabolism and overweight， adjust endocrine hormone， reduce clinical symptoms and improve ovarian structure， so as to create conditions for conception.

Clinical Efficacy of Modified Xiao Chengqitang Combined with Acupoint Catgut Implantation in Treating Diet-induced Obesity Syndrome of Stomach Heat Dampness Obstruction / 中国实验方剂学杂志

Objective:To observe the clinical efficacy and safety of modified Xiao Chengqitang combined with acupoint catgut implantation in treating diet-induced obesity （DIO） syndrome of stomach heat dampness obstruction. Method:One hundred and seventy-two patients were randomly divided into control group（84 cases） and observation group（88 cases）. Both groups of patients received diet and exercise lifestyle adjustments， and acupoint catgut implantation was performed， 10 days for 1 time， 5 days intervals and then catgut implantation again， for a total of 6 times. Patients in observation group took modified Xiao Chengqitang granular powder， 10 g/time， with lukewarm boiled water in morning and evening. Patients in control group took modified Xiao Chengqitang granular powder simulant， 10 g/time， with lukewarm boiled water， 2 times/day. The treatment courses continued 4 months in two groups. Then the body mass index （BMI）， fat percentage （F%）， obesity， waist to hip ratio （WHR） were measured before and after treatment. Color Doppler ultrasonography was used to measure abdominal fat thickness， prehepatic fat thickness （AHF）， perirenal fat thickness （PRF）， and visceral fat index （UVI）. Fasting blood glucose （FBG）， triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein-cholesterol （HDL-C）， low-density lipoprotein-cholesterol （LDL-C）， fasting insulin （FINS）， leptin （LP）， and adiponectin （APN） were detected before and after treatment， and the homeostasis model assessment of insulin resistance （HOMA-IR） index was calculated. In addition， safety evaluation was also conducted. Result:The BMI， F%， obesity degree and WHR in observation group were all lower than those in control group （<italic>P</italic><0.05 or <italic>P</italic><0.01）. Subcutaneous fat thickness， AHF， PRF and UVI in observation group were lower than those in control group （<italic>P</italic><0.01）. The TG， TC， LDL-C and FINS levels in observation group were lower than those in control group （<italic>P</italic><0.01）. The LP and HOMA-IR were also lower than those in control group （<italic>P</italic><0.01）， while the APN was higher than that in control group （<italic>P</italic><0.01）. The total effective rate in clinical application was （71/80） 88.75% in the observation group， higher than （57/75） 76.00% in the control group （<italic>χ</italic>²=4.374，<italic> P</italic><0.05）. Conclusion:Modified Xiao Chengqitang combined with acupoint catgut implantation in treating DIO syndrome of stomach heat dampness obstruction can adjust LP， APN and other factors， improve energy metabolism such as sugar and fat， and effectively control obesity with high safety， so it is worthy of clinical use.