Clinical Observation And Mechanism Of Jianpi Xiaozhi Decoction Combined With Food Restriction Therapy In Treatment Of Metabolic Syndrome

Objective: This study aims to provide a new strategy for the treatment of metabolic syndrome by regulating the balance between energy intake and consumption by regulating the brain-gut axis pathway from the perspective of traditional Chinese medicine and energy control by observing the clinical efficacy evaluation of Jianpi Xiaozhi Decoction combined with diet restriction therapy in the treatment of metabolic syndrome and its impact on neuropeptide Y(NPY)and cholecystokinin(CCK).Methods: 120 patients who met the diagnostic requirements of MS with liver depression and spleen deficiency were randomly divided into four groups,namely,routine blocking group,diet restriction group,Jianpi Xiaozhi formula group,diet restriction+Jianpi Xiaozhi formula group(30 cases each).The routine group was given comprehensive intervention treatment of western medicine(including general treatment,western medicine to control blood sugar,blood pressure and blood lipids);In the group of Jianpi Xiaozhi Recipe,we added Jianpi Xiaozhi Recipe to the treatment plan of the conventional group;The food restriction group was treated with short-term extremely low calorie food restriction therapy in hospital(9 days)+post-discharge(5+2)food restriction scheme on the basis of the conventional treatment scheme;The diet restriction+spleen-strengthening and lipid-reducing formula group was added to the treatment plan of the diet restriction group with our Xiding prescription-spleen-strengthening and lipid-reducing formula.According to the shedding standard,119 cases finally completed the test.All the four groups took 3 months as a course of treatment and observed one course of treatment.Compare the changes of body weight,WC,BMI,FPG,2h PG,Hb A1 c,HOMA-IR,TG,TC,LDL-C,SBP,DBP,serum NPY,CCK and TCM syndrome score of the four groups before and after treatment,and detect the safety indicators.Finally,use SPSS26.0 software to statistically analyze and process the data.Results:1.Comparison of basic data: the basic data of the four groups of patients were statistically tested,and the results showed that there was no difference in the gender,age,and course of disease of the included patients(P>0.05).2.Comparison of obesity indicators: intra-group comparison before and after treatment:BMI,WC and body weight in the routine group after treatment had no significant changes compared with those before treatment(P>0.05);BMI,WC and body weight of Jianpi Xiaozhi Formula group,diet restriction group and diet restriction+Jianpi Xiaozhi Formula group were significantly lower than those before treatment(P<0.05).Comparison between groups after treatment: BMI,WC and body weight of diet restriction group,Jianpi Xiaozhi Formula group and diet restriction+Jianpi Xiaozhi Formula group were lower than those of conventional group(P<0.05);BMI,WC and body weight in the diet restriction group and diet restriction+Jianpi Xiaozhi Formula group were lower than those in the conventional group and Jianpi Xiaozhi Formula group respectively(P<0.05),while BMI,WC and body weight in the diet restriction+Jianpi Xiaozhi Formula group were lower than those in the diet restriction group and Jianpi Xiaozhi Formula group(P<0.05),significantly lower than those in the conventional group(P<0.01).3.Comparison of blood glucose and islet function related indicators: intra-group comparison before and after treatment: FPG,2h PG,Hb A1 c,HOMA-IR of patients in the four groups after treatment were significantly lower than those before treatment(P<0.05).Comparison between groups after treatment: FPG,2h PG,Hb A1 c and HOMA-IR in the diet restriction group and the Jianpi Xiaozhi Formula group were lower than those in the conventional group(P<0.05),but there was no significant difference between the diet restriction group and the Jianpi Xiaozhi Formula group(P>0.05);FPG,2h PG,Hb A1 c,HOMA-IR in the diet restriction group combined with Jianpi Xiaozhi Formula group were lower than those in the diet restriction group and Jianpi Xiaozhi Formula group(P<0.05),and significantly lower than those in the conventional group(P<0.01).4.Comparison of blood lipid profile: intra-group comparison before and after treatment:TC,TG and LDL-C of patients in the four groups after treatment were lower than those before treatment(P<0.05);Comparison between groups after treatment: TC,TG and LDL-C in the diet restriction group and the Jianpi Xiaozhi Formula group were lower than those in the conventional group(P<0.05),but there was no significant difference between the diet restriction group and the Jianpi Xiaozhi Formula group(P>0.05);After treatment,the TC,TG and LDL-C in the diet restriction group combined with Jianpi Xiaozhi Formula group were lower than those in the diet restriction group and Jianpi Xiaozhi Formula group(P<0.05),and significantly lower than those in the conventional group(P<0.01).5.Comparison of blood pressure: intra-group comparison before and after treatment:SBP and DBP of patients in the four groups after treatment were significantly lower than those before treatment(P<0.05).Comparison between groups after treatment: SBP and DBP in the diet restriction group,the Jianpi Xiaozhi formula group,and the diet restriction+Jianpi Xiaozhi formula group were lower than those in the conventional group(P<0.05);There was no significant difference between diet restriction group and Jianpi Xiaozhi group(P>0.05);The SBP and DBP in the diet restriction combined with Jianpi Xiaozhi Decoction group were lower than those in the diet restriction group and Jianpi Xiaozhi Decoction group(P<0.05),and significantly lower than those in the conventional group(P<0.01).6.Comparison of serum NPY and CCK levels: intra-group comparison before and after treatment: after treatment,there was no statistical difference in NPY and CCK levels between the conventional group and before treatment(P>0.05);After treatment,the NPY level of the Jianpi Xiaozhi Formula group,the diet restriction group,and the diet restriction+Jianpi Xiaozhi Formula group decreased compared with that before treatment,and the CCK level increased,with a statistical difference(P<0.05).Comparison between groups after treatment: the NPY level of the diet restriction group,the Jianpi Xiaozhi Formula group,and the diet restriction+Jianpi Xiaozhi Formula group were lower than that of the conventional group,and the CCK level were all higher,with statistical difference(P<0.05);There was no significant difference between diet restriction group and Jianpi Xiaozhi group(P>0.05);The NPY level and CCK level in the diet restriction+Jianpi Xiaozhi Formula group were lower than those in the diet restriction group and Jianpi Xiaozhi Formula group(P<0.05),and significantly lower than those in the conventional group(P<0.01).7.Comparison of TCM syndrome score: intra-group comparison before and after treatment: the TCM syndrome score after treatment in the conventional group,the Jianpi Xiaozhi Formula group,the diet restriction group,and the diet restriction+Jianpi Xiaozhi Formula group were significantly lower than that before treatment(P<0.01).Comparison between groups after treatment: the levels of Jianpi Xiaozhi Decoction group,diet restriction group and diet restriction+Jianpi Xiaozhi Decoction group were lower than those of the conventional group(P<0.05);There was no significant difference between the Jianpi Xiaozhi Decoction group and the diet restriction group(P>0.05);Compared with the Jianpi Xiaozhi Decoction group and the restricted diet group,the diet in the restricted diet+Jianpi Xiaozhi Decoction group was lower(P<0.05),and significantly lower than that in the conventional group(P<0.01).8.Comparison of total effective rate:The total effective rate of the routine group after treatment was 76.7%;The total effective rate of Jianpi Xiaozhi Decoction group was86.7%;The total effective rate of the food restriction group was 86.2%;The total effective rate of the diet restriction+Jianpi Xiaozhi Decoction group was 96.7%.There was statistical difference between groups(P<0.05).The clinical effect of diet restriction+Jianpi Xiaozhi Decoction group was significantly better than the other three groups;The Jianpi Xiaozhi Decoction group and the restricted food group were superior to the conventional group respectively;There was no significant difference between the Jianpi Xiaozhi Decoction group and the diet restriction group.9.Safety analysis: The safety indicators of the four groups of patients before and after treatment were normal,and no serious adverse reactions occurred.Conclusion: Both Jianpi Xiaozhi Recipe and diet restriction therapy can significantly improve various metabolic indexes of MS patients with liver-qi stagnation and spleen-deficiency type.Compared with the conventional group,it has better effects on weight loss,glucose reduction,lipid regulation,blood pressure reduction,and can improve insulin resistance.The mechanism may be that the balance between appetite and energy consumption can be adjusted by affecting the level of brain-gut peptide(reducing the level of serum NPY,increasing the level of CCK)through the brain-gut axis pathway,So as to achieve the effect of improving the components of metabolic syndrome.The combination of the two has a synergistic effect,which has better curative effect than the single Chinese medicine group or the diet restriction group,and improves the compliance of patients,so as to achieve more ideal metabolic control,so it is an effective method for treating MS.