Danh gia tac dung cua cao long HSN trong dieu trj benh nhan roi loan chuyen hoa Lipid mau
EVALUATE THE EFFECT OF HSN LIQUID EXTRACT IN TREATMENT FORPATIENTS WITH BLOOD TRANSFORM DISORDER
Tran Thj H o n g Ngai Hoc vien Y Duoc hoc c6 truven Viet N a m
TOMTAT
Mtfc Hiu: Nghiin ciiu du^c tdc di^ngdHu chinh rdi logn chuyin hda lipid mdu cda Cao longHSNtren ldm sdng. Ddnhgid dUdc mdtsd tdc dung khdng mong mudn cua Cao IdngHSN trin ldm sdng.
PhUdngphdp nghiin ctiu: Nghien cHu dUdc thiit Id theo md hinh tha nghiem ldm sdng cd ddi chitng (so sdnh trUdc vd sau diiu try so sdnh giUa ba nhdm nghiin cilu).
Kit qud: Vi hiiu qud diiu iri rdi logn lipid mdu ciia cao IdngHSN trin ldm sdng: Sau 30 ngdy diing thudc cao Idng HSN liiu 1 OOml/ngdy co tdc dgng diiu chinh rdi logn lipid mdu d nhUng benh nhan RLLPM: Gidm 16.6% TC,gidm24.6% TG, gidm 16.5% LDL-C, tdng7.3% HDL-C, gidml9.6% TC/HDL-C vd gidm 18.0%
LDL-C/HDL-C. Hiiu qud diiu tri RLLPM cua cao long HSN theo tiiu chudn YHHD: Dgt kit qud tdt 58%, khd Id 26%, khdnghiiu qud Id 10% vd hiiu qud xdu la 6%. Hiiu qud diiu tri cua cao IdngHSN theo thibinh ciia YHCT, nhom sUdung cao Idng HSN cho ty li binh nhdn dgt hieu qud tdt nhdt d thibinh Ddm trgc H tre.
Vi tdc dgng khdng mong mudn cua cao IdngHSN tren ldm sdng: Sau 30 ngdy sil dung thudc, cao IdngHSN khong gdy cdc tdc dungphg trin ldm sdng cdng nhUcdn ldm sdng nhu thay ddi chUc nanghe thing tgo mdu, chile ndng gan, thdn d cdc binh nhdn rdi logn chuyin hda lipid mdu.
TU khda: Rdi logn chuyin hda Lipid, bdi thudc HSN, tdc dtfng cao IdngHSN trin ldm sdng.
SUMMARY
Objective: Stydy on the effect of regulating blood transform disorder of HSN liquid extract in clinical.
Evaluate some unexpected effect of HSN liquid in clinical.
Method: The study was designed in a controlled clinical trial (comparative before and after treatment, comparison between the three study groups).
Result: About the effectiveness of treatment of blood transform disorder of HSN liquid in clinical After 30 days of high-dose HSN 100ml / day have effect of regulating blood transform disorder inpatients with RLLM:
Ngay nhdn bai. 6/12/2018 Ngayphdnbien 10/12/2018 Ngdy chdp nhan dang 10/12/2018
TAP C H I Y D U O C C 6 TRUYEN V i e T N A M E a B B f f i
BAI NGHIEN CCU
decrease to 16.6% TC, 24.6% TG and 16.5% LDL-C, increase 7.3% HDL-C, 19.6% TC/HDL-C and 18.0%
LDL-C/HDL-C. The effect of RLLPM treatment of HSN liquid extract according to traditional medicine standard achieved good result 58%, quite 26%, ineffective 10% and had result 6%. The sputum stagnant disease got highest effect with patients usingHSN liquid extract.
About unexpected of HSN liquid extract in clinical After 30 days drinking, HSN liquid extract didn't cause side effect in clinical and subclinical such as changing the function ofthe hematopoietic system, liver or kidney function in patients with blood transform disorder.
Key worlds: blood transform disorder, HSN remedy, effect of HSN in clinical
DAT VANDE
Thi ky 21 la the ky eua eic binh ndi tilt va rdi loan chuyen hda. Xa hdi hien dgi ngiy cing phat trien, ti 11 mac cac benh chuyin hda ngiy cing gia ting. Rdi loan ehuyen hda Upid la danh tfl dung de mieu t i mdt hdi ehflng binh man tinh dflde die trflngbdi sfl thay ddi cae ehi sd Upid trong miu. Khi hpi ehflng niy xuat hiln dong nghia vdi viee ngfldi benh phii ginh chiu rit nhilu ylu td nguy cd mac cic b|nh ly nguy hiem nhfl: Vfla xd ddng maeh, nhdi miu cd tim... Bai thudc HSN Ii mdt bii thude dflde tao thinh bdi sfl phdi ngu ciia 6 vi thudc nam cd tic dung trfl thip, hda dim. Day Ii mdt bai thudc ke thfla tfl kit qui cua mdt nghien eflu di cd eua nhdm nghiin cflu do Bac si Nguyen The Thinh da thfle hiln de tii ed sd nam 1996: "Bfldc diu dinh gia tac dung cua bii thude HSN trong dieu tri benh tang Upid miu" va trin cd sd ke thfla tri thflc y hpc bin dia eua cpng ddng K'Ho. Tuy nhiin, bii thude HSN ehfla dflde nghien eflu day du ve tinh an toan vi ed ehi tie dung eua bii thude. Chiing tdi tien hinh dl tai "Danh gia tic dung ciia cao Idng HSN trong dieu tri benh nhin rdi loan chuyen hda Upid mau" vdi hai muc tilu:
- Nghien eflu dfldc tac dung dilu chinh rdi logn chuyin hda lipid miu cua Cao Idng HSN tren lam sang.
- Dinh gii dflde mdt sd tie dung khdng mong mudn cua Cao Idng HSN trin lim sang.
Odi TUDNG VA PHUDNG PHAP NGHIEN CUU D6i tfldng nghien cflu
Nghiin eflu gdm 150 benh nhin, cie BN diu dflde lim benh in, khai thie ky tiln sfl, b|nh sfl, khim lim sing toan dien vi thfle hiln eie xet nghi|m vi ehia lim 3 nhdm:
Nhdm 1: Dimg HSN 100ml/ ngiy dung 1 lin, sau in, trong 30 ngay
Nhdm 2: Dung Fenofibrat 200mg, dimg 1 lin, sau in, trong 30 ngay
Nhdm 3: Nhdm phdi hcfp: Dung Fenofibrat 200mg, 1 vien/ngiy kit hpp vffi HSN 100ml/ ngiy, trong 30 ngiy
Tat ei benh nhin (BN) den kham va dieu tri ndi tni hogc ngoai tni tai Khoa YHCT Binh vien Da khoa H i Ddng tfl nguyen tham gia nghien eflu, ddng y Iam xet nghiim diy du, tuin thu dung phae do vi Ulu trinh dieu tri-
Phfldng phap nghiin ciiu
Nghiin cflu dfldc thilt ke theo md hinh thfl nghiim lim sing ed ddi chiing (so sinh trflde vi sau dilu tri, so sinh giiia ba nhdm nghien cflu).
Xvif ly sd lieu
Sd Ulu dfldc nhap va xfl ly bang phfldng phip va thuat toin thdng kl y sinh hoc trin phin mIm Microsoft: office Excel, spss 20.0. Sd Ueu dflde bilu diln dfldi dang X ± SD.
KET QUA VA BAN LUAN
20 I TAP CHI Y DUOC CO TRUYeN VI&T NAM
Bangl. Sii thay ddi Cholesterol vd Triglycerid cua binh nhdn sau diiu tri
\ Nhom
Thdi \
aim \
TC
TG D»
D ,
P Dn
D„
p
Cao long HSN (n=50) (X±SD) (mmol/l) 6,08±0,82
5,07+0,84 Mi!c giam(%)
Il6,6%
P,.30< 0,001 2,97±1,2S
2,24+0,96 | 2 4 6 %
Po.j»<0,01
Fibrat (n=50) (X + SD) (mmol/I) 5,88+0,76
5,02±0,96 Mac giam(%)
-1-14,6*
Puo< 0,001 3,31+1,30
2,38+1,05 | 2 8 , 1 %
Po.)D< 0,001
Phoi hop (n=50) (X + SD) (mmol/1) 6,15±0,92
S,I3±0,95 Miic giam(%)
4-16,5%
Puo< 0,001 3,28+1,43
2,4I±1,02 4-26,5%
P„o< 0,001
P
P,.j>0,05 P„>0,05 Pu>0,05
Pi.,>0,05 Pi-j>0,05 P,.j>0,05
Nhgn xet: Sau 30 ngay dieu tri, ci 3 nhdm NC phdi hpp. Va d ca 3 nhdm NC eiing lim giim rd ret deu lim giim ro ret ndng dd TC so vdi tnfdc dilu ndng dd TG so vffi trflde dilu tri. Nhdm Fibrat lim tri, sfl khie biet lied ynghia thdngklvffip< 0,001. giim28,l%sovffi26,5%dnhdmphdihdpva24,696 Trong do, nhdm HSN lam giam TC nhieu nhat vffi d nhdm HSN. Tuy nhiin sfl khie bilt li khdng cd y 16,6% vi 16,5% d nhdm phdi hdp vi 14,6% nhdm nghia thdng ke khi gifla cie nhdm vdi p > 0,05.
Bdng 2. Sti thay ddi HDL-C, LDL-C cda binh nhdn sau diiu tri
^. Nhom
Thdi ^ v (film \ y
HDL-C
LDL-C D .
D «
D„
D3,
Cao long HSN (n=50) (X+SD) (mmol/l) 1,23+0,35
1,32+0,44
% thay doi
t7,3%
Pojo>0,05 3,64±0,98
3,04+0,85 4l6,S%
P „ < 0 , 0 0 1
Fibrat (n.50) (X±SD) (mmol/l) 1,14+0,25
1,19+0,31
%thayd6i
43%
Po3.>0,05 3,33±0,99
2,82+0,84 4-15,3%
Ptuo<0,01
Phdi hop (n-SO) (X±SD) (mmol/1) 1,27+0,27
1,37+0,65
% thay doi
T7,9%
P. JO > 0,05 3,50+1,14
2,89+0,87 4-17,4%
Po-30 < 0,01 P
P,-2>0,05 Pi-3>0,05 P,-3>0,05
Pi-i>0,05 P2-3>0,0S P,j>0,0S
TAP CHIY DUPC C 6 TRUYEN VIET NAM ^
BAI NGHIEN CLTU -
Nh^n xet: Sau 3 0 ngay d i l u tri, n d n g d p hfldng g i i m , sfl thay d d i la c d y nghia t h d n g k l sau H D L - C d n h d m u d n g cao Idng H S N v i phdi h d p 3 0 n g i y d i l u tri. T r o n g dd, n h d m p h d i h d p g i i m cd xu hfldng t i n g l l n vffi 7,3% d n h d m H S N va chiem ty le cao nhit vffi 17,4%, t i l p d e n l i n h d m 7,9% d n h d m p h d i h c ^ . T u y n h i l n sfl k h i c b i l t H S N 16,5%. Tuy n h i e n sfl k h i c biet gifla 3 n h d m gifla cac n h d m Ii k h d n g cd y nghia t h d n g k l vffi p l i k h d n g ed y nghia t h d n g ke vdi p > 0,05.
> 0,05. \ ^ n d n g dp L D L - C d c i 3 n h d m deu ed xu
• Phdihi^
• Caol6ngHSN
T6t Khi Khfinghieuqui Biiu do 1. Kit qud diiu tri rdi logn lipid mdu theo tieu chudn YHHD
Nhdn xit: Sau 3 0 ngay dung thude, n h d m eao d u n g thudc phdi h d p cho ket q u i dieu tri l i n Ifldt Idng H S N cho k i t q u i d i l u tri tdt la 58%, k h i la nhfl sau: Tdt ( 4 8 % ) , k h i ( 2 2 % ) , k h d n g h i | u q u i 26%, khdng hieu q u i Ii 16%; n h d m Fibrat cho k i t ( 3 0 % ) . Tuy nhien, k h d n g cd sfl k h i e b i l t cd f nghia q u i d i l u tri tdt va kha lan Iflpt la 56% v i 20,0%; t h d n g k l d e i 3 n h d m vffi p > 0,05.
trong khi do, k h d n g h i | u qua la 24%; n h d m sfl
• Ph6ilii?p
• Fibrat
• Cao IdngHSN
Tdt Khd Khong hi|u qua Biiu dd 2. Ket qud diiu tri rdi logn lipid mdu theo tiiu chudn YHCT
22 I TAP CHI Y DUOC C 6 TRUYEN VI^T NAM
J".
Nhgn xit: Tfl bieu dd 2 nhsin thay; sau 30 ngiy dung Fibrat vi nhdm phdi hdp. Trong dd, nhdm die'u tri ehiing tdi nhan thay d nhdm binh nhin sfl Fibrat 30% binh nhan dat ket qui tdt, 42% binh dung cao Idng HSN, benh nhin dat hieu qui tdt Ii nhin dat ket qui khi vi ty ll niy d nhdm phdi hdp 38% va 46% d?it hieu qua khi, khdng dat hilu qui li 32% tdt, 48% kha, 20,0% khdng hieu qui.
ehilm 16%. Kit qui niy tdt hdn ket qua nhdm sfl Bdng 3. Thay ddi mdtsd chi sd huyit hgc, sinh hoa sau dieu tri
\ ^ Nhom
Chisd ^ x Glucose (mmol/i) Ure (mmol/1) Creatinin (nmol/l) AcidUnc (nunol/l) AST (U/L) ALT (U/L) SL hong c^u
(T/l)
Hemoglobin (g/l) S6 Iddng bach
cau (G/l)
S 6 k d n g t i &
cau (G/l)
Cao longHSN (n-SO) ( X ± S D ) D j
5,86±0,75 D j ,
5,95±1,12 P H . > 0,05 5,22+1,34 5,45+1,07
Po-30 > 0,05 74,0+13,65 1 76,68+11,96
Po-3D>0,05 372,2+87,0 1 358,3+89,5
Po-3G>0,05 28,28+8,65 1 26,78+5,99
Po-30 > 0,05 28,S3±17,11 1 25,9+7,93
Po.3.>0,05 4,12±0,32 4,21+0,28
Po-30 > 0,05 125,43
±14,21 124,12 +12,26 Po.,o>0,05 6,23+1,23 6,34+1,31
P»3o>0,OS 246,12
±43,21 223,11
±45,28 P.-3.>0,05
Fibrat (n=SO) (X + SD)
D„
626+1,52 D j ,
6,16±1,35 P M O > 0 , 0 5
5,56±1,11 P^30>
78,88+1412 Po.30>
379,5+86,9 Po-3.>
32,3±12,36 Po-30 >
33,0+19,84 Po-30 >
4,33+0,41
5,52+1,40 0,05
78,5±1483 0,05
3S4,6±101,1 0,05
3I,18±10,84 0,05
30,94±16,14 0,05
4,52+0,22 Po.3o>0,05 123,25
±14,11
126,43
±11,65 Po3o>0,05 6,73±1,23 1 6,84±1,62
Po-30 > 0,05 251,32
±32,61
248,32
±40,21 P..jo>0,05
Phffihop(n=50) CX±SD) D j
6,08±1,22
D„
6,21+1,26 P„.>0,05 5,49+1,4
P»30>
75,86+13,82 P H O >
346,24±97,6 Po-30 ^
28,84+9,22 P»3«>
246±9,39
5,66+1,26 0,05
75,74+13,57 0,05
337,68+99,3 0,05
29,8+11,21 0,05
28,2+14,98 P M . > 0 , 0 5
4,45+0,62 4,42±0,4<
Po3o>0,05 121,41
±15,15
123,43
±14,29 Po.30>0,05 6,49±1,72 1 6,53+1,13
Po-30 > 0,05 240,19 +42,65
246,52
±45,76 Po-30 > 0,05
TAP CHlY DUOC CO TRUYtN VIIT NAM ^ 23
BAI NGHIEN CUU
\ A
Nh4n xit:
- Sau 30 ngiy dieu tri, cie chi sd huyet hpe khdng ed sii thay doi sau khi dilu tri, sfl thay ddi khdng ed y ngjiia thdng ke vffi p > 0,05.
Bdng 4. Mdt sd tdc dting khdng mong mudn
- Sau 30 ngiy sfl dung thudc, tat ca cie chi sd hda sinh glucose, ure, creatinin, acid uric, ALT, AST cd biln ddi trflde va sau khi dilu tn. Tuy nhiln, gii tq eie ehi sd vin nam trong giffi han binh thfldng.
Tri|u chutag
M | t mdi DaucO Man ngfla
Khd tilu la chay
Tao bon
Cao IdngHSN (n-SO) SdBN
1 0 0 2 1 0
Tyl«(%) 2%
0%
0%
4%
2%
0%
Fibrat (n=50) S6BN
2 1 0 1 0 0
Tyle(%) 4%
2%
0%
2%
0%
0%
Phdi hop (n=50) S6BN
1 1 0 1 1 0
Tyl4(%) 2%
2%
0%
2%
2%
0%
Tdngsd (n=150) SdBN
4 2 0 4 2 0
Tyte(%)
2,67%
1,33%
0% 2,67%
1,33%
0% Nh4n xet: Tfl bang 4, nhan thay trong qui trinh
dilu tri, ed 3 benh nhin d nhdm eao Idng HSN cd bilu hiln rdi loan tilu hda ehiem 6% vi 1 benh nhin ed bieu hien met mdi chilm ty II 2%. Cie trilu ehiJtng d mfle do nhe vi tfl khdi sau vii ngiy mi khdng can dilu tn. O 2 nhdm Fibrat va nhdm phdi hdp mdi nhdm cd 4 benh nhan xuit hiln cac tic dung phu nhfl: mlt mdi, dau ed, khd tilu, ia chiy. Ngoii ra ehung tdi chfla nhan thiy eic tic dung khdng mong mudn khic trin lim sing.
KETLUAN
Ve hi^u qua dilu tn rdi loan lipid miu cua cao Idng HSN tren lam sing
- Sau 30 ngay dimg thude eao Idng HSN Ulu lOOml/ngiy cd tic dung dilu chinh rdi l o ^ lipid miu d nhflng benh nhin RLLPM: Giim 16.6%
TC, giam 24.6% TG, giim 16.5% LDL-C, tang 7.3% HDL-C, giiml9.6% TC/HDL-C vi giim
18.0% LDL-C/HDL-C.
- Hieu qui dilu tri RLLPM eua cao Idng HSN theo tilu chuan YHHD: Dgit kit qui tdt 58%, khi Ii 26%, khdng hilu qua li 10% va hieu qui xau la 6%.
- Hilu qui dieu tri cua cao Idng HSN theo the benh eua YHCT, nhdm sfl dung eao Idng HSN eho ty ll binh nhin dgit hieu qui tdt vi khi d thi binh Dim troc fl tre tdt hdn d the benh Ty dian dfldng hfl vi Can thin am hfl. Trong dd, nhdm sfl dung cao Idng HSN dat hilu qua tdt va khi chilm 88.2%
d the benh Dim troc fl tre.
VI tac dung khdng mong mu6n cua cao Idng HSN trin lim sing
Sau 30 ngiy sfl duing thudc, cao Idng HSN khdng gay cic tic dung phu tren lim sang cung nhfl can lim sang nhfl thay ddi ehfle nang he thdng tao miu, ehflc ning gan, than d cic benh nhin rdi loan ehuyin hda hpid miu.
24 I TAP CHI Y D U O C C O T R U Y E N VlgT NAM M
J".
TAI LIEU T H A M KHAO
1. H o ^ g Bao Chau (1997), Dim am, Npi khoa Yhoc co truyin, Nhixuitbin Yhoc, tr. 326-343.
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10. Hpi Tim mfchhpc Qudc gia Viet Nam (2015), "Khuyen cio ve ehan doin vi dilu tn 2015".
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13. Hai Thfldng Lan Ong (1997), Hii thfldng y tdng tim linh - Quyen 1, Nha xuat ban Y hpc, tr.
561-562.
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15. Asmann G (1993), Lipid metabohsm disorders and coronary heart disease, MMV medicine, Munchen, pp. 57-59.
16. GlobalData (2016), EpiCast Report: Dyslipidemia-Epidemiology Forecast to 2015 DUtfc di& iitf«c CHND TiTmg Hoa (2015). Nha xuat ban Khoa hoc ky thuat Y Dildc Trang Qudc.
TAP CHiY DUaC C 6 TRUYEN VIIT NAM ^
