加味血府逐瘀湯對高脂血症患者之臨床療效評估

Evaluation of Clinical Efficacy of Jia-Wei-Xue-Fu-Zhu-Yu-Tang on the Hyperlipidemic Patients

本研究以清•王清任醫林改錯中活血化瘀名方「血府逐瘀湯」為主，再加桑寄生、何首烏、蒲黃及草決明等方藥組成血府逐瘀湯加味，針對14例臨床上具有高脂血症，並經中醫辨症屬肝腎陰虛兼有瘀血症之患者給予長期治療，以膽固醇(cholesterol)、三酸甘油脂(triglyceride)、高密度脂蛋白膽固醇(HDL-C)、載脂蛋白Al(Apo Al)、載脂蛋白B(Apo B)為療效指標，同時測定血中sGOT、sGPT、BUN、creatinine、血糖以探討其可能之副作用，進行臨床療效評估。血府逐瘀湯加味對於高脂血症患者，於治療第八週後開始具有降低血清中膽固醇及三酸甘油脂的作用；治療後具有升高高密度脂蛋白膽固醇(HDL-C)的功效；治療後於第八週血清中Apo Al雖有上升，血清中Apo B雖有下降，然無明顯統計學意義，但對Apo Al/Apo B比值則有升高。給藥第十二週後血清中Apo Al明顯的上升，血清Apo B明顯的下降，並具顯著統計學差異，但對Apo Al/Apo B比值升高效果更顯著。且本方藥在長期治療中對於血液、肝臟及腎臟機能並無明顯的副作用產生。綜合以上結果，顯示血府逐瘀湯加桑寄生、何首烏、蒲黃及草決明具有顯著降血脂作用，其作用機理可能與增加血中高密度脂蛋白膽固醇(HDL-C)濃度有關。

In this study, we evaluated the clinical efficacy of long-term administration of Jia-Wei-Xue-Fu-Zhu-Yu-Tang (JWXZT) on the hyperlipidemic patients. We detected the serum levels of cholesterol, triglyceride, HDL-C, Apo Al and Apo B as the therapeutic index, the serum levels of sGOT, sGPT, BUN, creatinine, blood sugar, as the index of side effects. JWXZT relieved symptoms such as lumbago, weakness of the lower limbs, insomnia, numbness of the limbs and fatigue. JWXZT decreased the serum levels of C, TG and Apo A1 increased the serum levels of HDL-C and Apo B, and increased the ratio of Apo A1/Apo B after 8-week treatment, but with no statistical significance. JWXZT increased the serum level of Apo Al and the ratio of Apo A1/Apo B, decreased the serum level of Apo B after 12-week treatment. JWXZT did not affect the blood, liver and kidney functions alter long-term treatment. These results suggest that the hypolipidemic effect of JWXZT may be related to the inhibition of the accumulation of blood lipids through promoting blood circulation and removing blood stasis, or the increase in the serum level of HDL-C.