【摘要】 目的 评价中西医结合阶梯疗法治疗单纯性肥胖的临床效果和安全性。方法 选择2021年12月1日—2023年3月1日至上海市嘉定区中医医院肥胖与代谢性疾病专病门诊就诊的单纯性肥胖患者90例，予中西医结合阶梯疗法，疗程3个月。观察其体质量、腰围、体质量指数（BMI）、胰岛素抵抗指数（HOMA-IR）、糖化血红蛋白（HbA1c）、血脂[总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、中医证候疗效。结果 经治疗，患者体质量、BMI、腰围随时间变化下降，且HOMA-IR、HbA1c、TC、LDL-C较治疗前下降（P<0.05）。但治疗前后TG、HDL-C水平比较，差异无统计学意义（P>0.05）。治疗总有效率为90.00%(81/90)，无严重不良反应发生。结论 中西医结合阶梯疗法可以降低单纯性肥胖患者的体质量，改善其血糖、胰岛素抵抗及血脂代谢指标，且安全性较好。更多还原

【Abstract】 Objective To evaluate the clinical efficacy and safety of stepwise therapy of integrated traditional Chinese and Western medicine in the treatment of simple obesity. Methods A total of 90 patients with simple obesity who visited the Specialty Clinic for Obesity and Metabolic Diseases of Jiading District Hospital of Traditional Chinese Medicine from December 1, 2021, to March 1, 2023, were selected. They were given a stepwise therapy of integrated traditional Chinese and Western medicine, with a treatment course of 3 months. The indicators such as body weight, waist circumference, body mass index(BMI), homeostasis model assessment of insulin resistance(HOMA-IR), glycated hemoglobin(HbA1c), blood lipids [total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C)], and the curative effect of traditional Chinese medicine syndromes were observed. Results After treatment, the patients’ body weight, BMI, and waist circumference decreased over time, and HOMA-IR, HbA1c, TC, and LDL-C were lower than those before treatment(P<0.05). However, there was no statistically significant difference in the levels of TG and HDL-C before and after treatment(P>0.05). The total effective rate of treatment was 90.00%(81/90), and no severe adverse reactions occurred. Conclusion The stepwise therapy of integrated traditional Chinese and Western medicine can reduce the weight of simple obesity patients, improve blood glucose and insulin resistance, as well as blood lipid metabolism indicators, and has good safety.更多还原