Nghien cdu YDHCT Viet Nam
B l / d C DAU DANH GIA T A C D ^ N G CUA C 6 M TAN TIEU PHI LINH TRfeN BpNH NHAN R 6 I L O ^ N LIPID MAU
Evaluate the effect of "Ticu phi linh"
remedy on treatment for Lipid Metabolism Disorders
* Chu Qu6c Trirdrng, ** Nguyen Thj Van Anh v i CS B^nh vi4n Y hpc c6 truyin Trung uang Tdm tdt:
Tdng huyet dp Id bfnh phd bicn iren the gi&i vd Vifl Nam.
Rdi logn lipid mdu la binh phd biin trin Ihi gi&i cung nhu d Vifl Nam Mgc tiSu nghiin cdu: Ddnh gid Idc d\fng cua dm tan "Tidu phi linh" tren benh nhdn cd hdi chung rii logn lipid mdu vd tdc difng khdng mong muon ciia cdm tan "Tieu phi linh ". Phirang phdp nghiin cuu: nghien cuu tien cihi, so sdnh trudc vd sau diiu trf. Nghien cdu du^c lien hdnh trin 30 b^nh nhan. Liiu trinh dieu tri kio ddi 45 ngdy. Ket qud nghiin cuu: dgt 80% lit vd khd vd 20% chua c6 tdc dvng. Kit lu^n: com tan lieu phi Imh kit qud diiu Iri til vd an todn cho benh nhdn rdi logn lipid mdu.
Tir kli6a: TiSu phi linh, roi lo^n lipid mdu
I. D ^ T VAN Bt
Ngdy nay cung vdi sy phdt trian nhanh cua nen kinh te vd ddi sdng xd hgi, cdc b^nh ve rdi loyn chuyen hda trong dd cd r6i loyn lipid mdu ngdy cdng gia tdng. rdi loyn lipid mdu (RLLPM) dugc coi Id mdt ylu to nguy ca quan trpng nhdt din sy hinh thdnh vd phdt triln cua bpnh tim mych [2], [5].
Hipn nay, y hgc hipn dyi (YHHD) da dp dyng nhilu bipn phdp dl dieu trj cd hipu qud.Tuy nhian thudc dilu trj thudng kao ddi gdy nSn tdc dyng khdng mong muon vd gdy ton kam.
Theo YHCT, RLLPM thudc chimg ddm thap vd dugc chia thdnh nhilu thl b§nh khdc nhau. Tir xua dd cd nhiJng vj thu6c,
bdi thuoc dilu trj chimg b§nh ndy. C6m tan Tiau phi linh dugc sdn xuat dya tren co sb bdi thu6c kinh nghipm gdm nhthig v) thulc sSn cd trong nudc, gid thdnh re, dyng chi phSm rat thuyn ti^n cho vipc sir dyng [1], [3], [4].
De gdp phin Idm phong phu them cdc san ph^m YHCT dilu yj RLLPM, chiing tdi tiln hdnh de tdi ndy nhdm myc dfch:
/. Ddnh gid tdc dung ^iu trf cua c6m tan "Tiiuphi link" trin b^nh nh&n c6 hpi chuTtg rSi logn lipid mdu
2. Theo ddi tdc diing khdng mong muon cua com tan "Tieuphi linh"
Phdn bipn khoa hpc: PGS.TS. Nguyin Nhugc Kir * PGS.TS; ** TS.BS
Journal of research in viet nam traditional medicine and pharmacy No 33 • 2012
II. D 6 I TU'giNG PHU'ONG PHAP NGHIEN ClTU
2.1. Bdi thu6c NC: Bai "Tieu phi linh " cd cdng thuc nhu sau:
Thdo quylt minh 4g Ha thu d 6g San tra 8g Nga yu§t 6g Trych ta 8g Hddipp 8g Td dugc vira du
Tdc dyng: Bd can thyn, dudng huyet, trir ddm, Igi thdp
Dang bdo chi: c6m tan
Lilu diing 5g/g6i x 4 gdi/ngdy chia 2 lan sang, chieu sau dn
2.2. Ddi tugng nghien cihi 2.2.1. Tieu chudn chpn bpnh nhan:
*Theo YHHD
- 40 tudi y d lan khdng phdn bipt gidi tinh
- xat nghipm mdu luc ddi cd:
- Cholesterol todn phdn > 6,5mmoI/I, hoac LDL-C > 3,9 mmol/l, ho3c Triglycerid
> 2,3mmol/I, ho&c Cholesterol todn phdn fix 5,2-6,5 mmol/l [6].
- Chua dimg thudc ha lipid mdu ldn ndo bode da ngimg thudc > 3 thdng.
* Theo YHCT Chpn b^nh nhdn thupc thl ddm thdp va thl can thyn am hu
2.2.2. Tiiu chudn logi trir - Rdi loyn lipid mdu thi> phdt sau cdc bpnh khdc: thilu nSng tuyln gidp, hpi
chdng th§n hu, ddi thdo dudng, giit, sau dimg corticoid, oestrogen...
- Dang mSc cdc b$nh: Tai biln mych mdu ndo d p , nhilm triing c4p, suy gan...
suy th^n, phy nd- cd thai vd cho con bu...
- Trong qud trinh dilu trj dp dyng cdc phuang phdp dilu trj cd tdc dyng giam lipid mdu
2.3. Phuong phip nghien cuu: thu nghipm lam sdng md, ddnh gid trudc va sau dilu trj.
2.3.1. C&mdu nghien cu-u:
Bao gom 30 bpnh nhdn 2.3.2. Cdc chi tieu nghiin ciru:
* Lam sdng: Can ndng,Chi sd BMl, Huylt dp, mach
Tripu chiing chii quan: dau ddu, chdng mdt, mdt ngu, giam hi nhd, dau ngyc, dj cam.
- Bilu hi|n bat thudng: min ngua, dau ddu, budn ndn, ndn, dau thugng vi, dai tipn ldng.
* C$n ldm sdng:
Cholesterol todn phdn (CT), yiglycerid (TG), HDL-C, LDL-C
- ALT vd AST huylt thanh, Glucoza, ure, creatinin huyet thanh
* Tri§u chiing ldm sang dugc ddnh gid trudc vd sau 15, 30, 45 ngay
Chi sd sinh hda mdu (lipid mdu) dugc ddnh gia vdo trudc vd sau 15, 30, 45 ngdy.
2.3.3. Tiiu chudn ddnh gid theo YHHD: tran cdc thdnh phan lipid mdu
Nghiin cihi YDHCT Viil Nam Si'33-2012
• IliC'u q u i rat t6t: sau di^u trj cdc xit nghicm trcV vc gid trj binh thtrfrng.
• Hicu q u i tot: lipid m i u d?t bk l<y mOt chi ticu sau;
Cholesterol giam > 2 0 % Triglycerid g i i m > 4 0 % H D L - C tang > 0 , 2 6 m m o l / l L D L - C g i i m dat < 3,9 m m o l / l
• C6 hicu q u i : Ichi dgt mOt trong c i c chi tiSu sau:
10% < cholesterrol giira < 2 0 % 2 0 % < triglycerid giam < 4 0 % H D L - C tang 0,12 m m o l / l - 0,26 m m c l / l so vdi trudc dieu t r i .
L D L - C g i i m d j t 4,0- 4,9 mmol/l
• Kh6ng hi^u q u i : Cholesterrol g i i m < 10%
Triglycerid giim <20%
H D L - C t i n g < 0,12mmol/l L D L - C c6n > 4,9 m m o l / l 2.4. X t r l y so li^u
C i c s6 lieu nghidn c i m dirtyc phan tich x u ly tren m i y tfnh theo chucmg trinh SPSS.
I U . KtT Q U A N G H I E N C U U B i n g 3 . 1 , S ^ tbay doi t h i n h phan lipid m i u sau rngt dtjrt 45 n g i y dieu tri
Thong so
Do D,5 Thay doi %
P D O - D 4 5
CT (mmol/l) 6,52 ± 1,09 5,67 ± 0,98 13,03%
<0,01
Thinh TG (mmol/l) 2,61 ± 1,18 2,04 ± 0,8
21,84%
<0,01
>han lipid miu HDL-C (mmoi/1)
1,26 ±0,33 1,31 ±0,23
4%
>0,05
LDLC (mmol/l) 3,57 ± 0,83 3,39 ±1,03
5%
>0,05 Ket qud d bdng 3.1 cho thiy:
Sau mpt dgt diau trj 45 ngdy cholesterol tp gidm 13,03% vdi p < 0,01 triglycerid mdu gidm 21,84 % vdi p <0,0I
- LDL-C vd HDL-C thay ddi chua c6 y nghTa thdng ke vdi p > 0,05
Bang 3.2. Sy thay ddi thanh ph^n lipid mdu sau mpt dgt 45 ngdy dieu tri d nhdm ddm th^p
Thong so
Do D4S Thay d6i %
Thinh phan lipid miu CT (mraol/1)
6,48 ±1,06 5,85 ± 0,82 9,7%
TG (mmol/l) 2,2 ± 1,10 1,91 ±0,86 13,4%
HDL-C (mmol/I) 1,34 ±0,36 1,35 ±0,31
0,5%
LDLC (mmol/l) 3,65 ± 0,83 3,58 ±1,16
1,9%
Journal of research in viet nam traditional medicine and pharmacy No 33 - 26
Bang 3.3. Su thay doi thdnh phan lipid mdu sau mpt dpi 45 ngdy dicu tri if nhdm can than am hu
Thdng so Do D4S Thay doi %
Thinh phan lipid miu CT (mmol/l)
6,57 ± 1,16 5,46 ± 1,12
17%
TG (mmol/l) 3,09± 1,13 2,19 ±0,73 28,9 %
HDL-C (mmol/l) 1,18±0,27 1.28 ±0,32 8,7 %
LDLC (mmol/l) 3,49 ±0,86 3,18 ±0,85 8,8 % Kel qua d bdng 3.2 vd 3.3 cho thdy: sau mpt dgt dilu trj, chi sd cholesterol dau giam d 2 nhdm the ddm thdp vd the can thyn dm hu, trong dd d the can than am hu gidm (17%) nhieu han so vdi thl ddm thdp (9,7%).
Chi sd triglyceride deu giam d 2 nhdm the ddm thap vd the can thdn dm hu. Tuy nhien the can than dm hu gidm (28,9%) nhieu hem so vdi the ddm thdp (13,4%)
Bdng 3.4. Su thay ddi trieu chung YHCT sau dieu trj Trieu chirng
Co th6 ning n6 Day chudng bgng Met moi Dau diu Chdng mat Buon non
S6BN
16 12 15 21 9 4
Het n 5 7 5 7 3 4
%
31,3 58,3 33,3 33,3 33,3 100
Giam n 8 3 8 13 4 0
%
50 25 53,3 61,9 44,4 0
Khong thay doi n 3 2 3 1 2 0
%
18,7 16,7 20 4,8 22,3
0 Kit qud d bdng 3.4. cho thdy: Sau diau trj, trieu chimg budn ndn va ddy chudng bung khdi chilm ty Ip cao 100% vd 58,3%.
Bang 3.5. Hipu qua dieu tri Tdng so BN
30
Rat tot n 12
%
40
HQt6t n 05
%
16,7
Cd hieu qua n 07
%
23,3
Khong hieu qua n 06
%
20 Kit qud d bang 3.17. cho thay: Thudc cd hipu qud chiem 80%
Nghiin cdu YDHCT Viit Nam Sd33 • 2012
IV. BAN LUAN
* Hi^u qud diiu trl trin cdc ihdnh plihn lipid mdu
Kit qud nghian cuu cho th^y c6m tan
"Tiau phi linh" cd tdc dyng dilu chinh lipid mdu d nhdng b$nh nhdn cd r6i loyn lipid mdu.
Sau 45 ngdy dilu trj, chi s6 cholesterol, Triglycerid gidm so vdi trudc dilu trj vdi p<0,01.
Theo nghian cim ciia YHHD: Hd thii 6, thdo quylt minh cd tdc dyng tdng cudng nhu dpng rudt, thiic day sy bdi tiet lipid, giam hap thu lipid tir ben ngodi vdo, san tra, thdo quylt minh cd tdc dyng gidm cholesterol vd triglycerid, trych td tdm hy cholesterol.
* Hi^u qud diiu tri fr^" ^'^^ thdnh phhn lipid mdu d 2 thi ldm sang
Nhu vyy qua kit qud budc ddu chiing tdi thay com tan tiau phi linh c6 tdc dyng cdi thipn tinh tryng roi loyn lipid mdu d nhdm can th§n dm hu t6t hem nhdm ddm thdp (bdng 3.2 vd 3.3). Kit qud ndy cd thl dugc 1^ gidi Id trong bdi thudc cd hd thu 6 cd tdc dyng b6 fch can thyn, tu am, Thdo
quylt minh thanh can hda, Hd dipp thdng thanh tdn ir, cdc vj thu6c tr6n cd tdc dyng tu bh can thfin.
* Tdc dgng trin cdc tri$u chung ca ndng
- Dau dSu: Id tri$u chdng thudng g(lp trong b$nh nhdn r6i loyn lipid mdu. Trong nhdm nghien ciru cd 25 bpnh nhSn (83%) cd dau dau, ty 1$ gidm sau dieu trj Id 95,2%.
Theo YHCT, dfiy Id chtmg dau th6ng do ddm trgc thjnh, uki kit l^i, che md thanh ducmg md gdy dau diu, ho$c do can thyn dm hu Idm cho can ducmg vugng cung dan tdi dau dau [I], [3],[4]. Trong bdi thudc c6 Hd dipp thdng thanh tin ir, scm tra hda ddm, trych t i Igi nipu trir ddm, Thao quylt minh cd tic dyng binh can. H i thiJ 6 bd can thyn dm, duOng huylt nSn giim dau dau.
- Chdng m$t: Trong nhdm nghian ciiu cd 9 bpnh nhdn chdng m§t chilm ty Ip 30%
bpnh nhdn, ty 1$ khdi vi gidm sau dilu trj la 77,7%.
C6m tan "Tifiu phi Iinh"c6 cic vj tu bl can th^n, binh can, trir ddm vi vyy tripu chimg chdng m$t gidm nhilu.
D^y chudng byng, ngyc sudn d4y tiJrc: cd 12 b§nh nhfin chilm ty 1$ 40%, sau
Journal of research in viet nam traditional medicine and pharmacy No 33 - 2012
dieu yj ty I§ khdi vd giim d^t t^ 1§ 92%, sau dilu yj hdu hit bpnh nhan hit vd gidm dky chudng byng. Trong sich Kim quy ylu luge (Truang Trpng Cdnh) cd ghi: "tdm hy cd ddm thi ngyc sudn diy tire". Cdm tan
"Tiau phi linh" cd son ha tieu dim, Nga yuyt hoyt huylt tiau tr?, trych td Igi nipu trir ddm, nan b§nh nhan dugc cii thipn tdt tri§u
chdng ngyc sudn diy tu'c, day chudng byng.
V. KfeT LUAN
- Com tan Tiau phi Iinh c6 hipu qud trong dieu trj RLLPM dyt 80%
Thulc khdng cd tic dyng khdng mong muon tran ldm sdng
TAI L I t U THAM KHAO 1. Hoing Bao Chau (1997), "Ddm
dm ", Ngi khoa YHCT, Nhi xudt bin Y hpc, trang 326-343.
2. Pham Tii- Dugng (1994), "Hgi chiing tdng lipid mdu ", Bdch khoa thu bpnh hgc, typ 2, hang 289-294.
3. Nguyen Nhugc Kim (1996), "Ddm vd phirang phdp diiu tri ^dm qua cdc bdi c6 phirang", Typ chi YHCT Vipt Nam, s6 l I , y a n g 7 - 8 .
Summary
4. Le Huu T r i e (1987), Hdi thufmg y tong tdm Imh, typ 2, Nhd xudt bdn Y hpc.
5. Assman G (1989), lipid Metabolism Disorders and Coronary Heal Disease, MMV Medizin Verlap, pp 112
6. Mahley R.W, Weirgaber K.H, et al (1998), "Disorder of lipid metabolish", Williamtext book of endocrinology, Vol 23, pp 1099-1153.
EVALUATE THE EFFECT OF «TIEU PHI LINH"
REMEDY ON TREATMENT FOR LIPID METABOLISM DISORDERS Lipid Metabolism Disorders are common conditions in the world as well as in Vietnam. Objective: To evaluate the effect of 'Tieu phi linh" remedy in treatment for Lipid Metabolism Disorders and evaluate the side effect of this remedy. Method: Perspective clinical trial with a comparison of pre - post treatment. 30 patients were recruited for the study. The treatment course was 45 days. Results: Totally, 80% of patients gained good result, 20% of patients had no effect. There were no side effects. Conclusion: 'Tieu phi Hnh"
remedy is effective in treatment for Lipid Metabolism Disorders and safe for patients.
Keywords: Lipid Metabolism Disorder, Tieu phi linh
