摘要
目的 观察复方芪麻胶囊联合辛伐他汀对气虚痰浊型颈动脉粥样硬化（CAS）患者血管损伤的影响并评价其用药安全性.方法 采用随机平行对照研究方法,将广东省第二中医院2016年1月至12月收治的99例气虚痰浊型CAS患者分为西药组（给予辛伐他汀）、中药组（给予复方芪麻胶囊,由黄芪、天麻、茯苓、白术、法半夏、陈皮、杜仲、川芎等组成）和联合治疗组（给予辛伐他汀联合复方芪麻胶囊）,每组33例.12周为1个疗程,每2周随访1次.比较各组患者治疗前后血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、丙氨酸转氨酶（ALT）等的变化,并监测治疗前后各组患者双侧颈动脉内膜-中膜厚度（IMT）、血清脂联素（APN）、氧化修饰低密度脂蛋白（ox-LDL）、血凝素样氧化型低密度脂蛋白受体1（LOX-1）水平的变化;同时观察用药期间患者不良反应发生情况.结果 各组治疗12周后血清TG、TC、LDL-C、IMT、ox-LDL、LOX-1水平均较治疗前明显降低,且以联合治疗组的下降程度较中药组和西药组更显著〔TG（mmol/L）：1.50±0.15比2.34±0.31、1.98±0.22,TC（mmol/L）：4.62±0.46比5.39±0.52、5.01±0.59,LDL-C（mmol/L）：1.96±0.11比2.41±0.17、2.12±0.19,IMT（mm）：1.11±0.13比1.16±0.12、1.14±0.12,ox-LDL（μg/L）：3.72±0.39比4.37±0.51、4.13±0.43,LOX-1（mg/L）：154.28±18.37比173.46±19.25、167.09±18.90,均P〈0.05〕,西药组治疗后ALT较治疗前明显升高,中药组治疗前后ALT无明显差异,联合治疗组治疗后ALT较治疗前明显降低,故联合治疗组治疗后ALT明显低于中药组和西药组（U/L：24.61±4.22比31.26±4.87、40.64±3.96,P〈0.05）.各组治疗后APN和HDL-C水平均较治疗前明显升高,以联合治疗组的升高程度较中药组和西药组更显著〔APN（mg/L）：7.96±1.20比7.02±0.84、7.34±0.98,HDL-C（mmol/L）：1.41±0.12
Objective To observe the effects of compound Qima capsule combined with simvastatin on vascular injury in patients with qi-deficiency phlegm-turbidity type carotid atherosclerosis （CAS） and to evaluate its drug safety. Methods A random parallel control study was conducted, 99 patients admitted to Guangdong Second Traditional Chinese Medicine （TCM） Hospital from January to December 2016 with qi-deficiency phlegm-turbidity type CAS were divided into three groups： western medicine group （given simvastatin）, traditional Chinese medicine （TCM） group （given compound Qima capsule, which comprises radix astragali, rhizoma gastrodiae, poria cocos, atractylodes, pinellia, dried tangerine, eucommia bark, rhizoma ligustici, etc） and the combined treatment group （simvastatin combined compound Qima capsule）, 33 cases in each group. One therapeutic course was 12 weeks, follow-up once every 2 weeks. Before and after treatment, the changes of levels of serum triglyceride fiG）, total cholesterol tiC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, alanine aminotransferase （ALT）, etc. were observed in all groups; and the changes of levels of bilateral carotid intima-media thickness （IMT）, serum adiponectin （APN） and oxidized modified low-density lipoprotein （ox-LDL）, hemagglutinin type oxidized low-density lipoprotein receptor 1 （LOX-1） were monitored before and after treatment; at the same time, the adverse reactions of the patients were observed. Results After treatment for 12 weeks, the serum TG, TC, LDL-C, IMT, ox-LDL and LOX-1 levels of each group were significantly decreased compared with those before treatment, and the degrees of decline in combined treatment group were more obvious than those in either the TCM group or the western medicine group [TG （mmol/L）： 1.50 ± 0. 15 vs. 2.34± 0.31, 1.98 ±0.22, TC （mmol/L）： 4.62± 0.46 vs. 5.39± 0.52, 5.01± 0.59, LDL-C（mmol/L）： 1.96＋0.11 vs. 2.41±0.17, 2.12±0
作者
梁文坚
王清海
Liang Wenfian;Wang Qinghai(Guangdong Second Traditional Chinese Medicine（TCM）Hospital,Guangzhou 510095,Guangdong,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第5期489-493,共5页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家中医临床研究基地业务建设计划项目（JDZX2015145）
广东省中医药局中医药强省专项资金医院中药制剂建设项目（粤中医办函[2015]102）
广东省中医药局科研课题（20151010）
关键词
复方芪麻胶囊
辛伐他汀
颈动脉粥样硬化
内膜损伤
中西医结合治疗
Compound Qima capsule
Simvastatin
Carotid atheroselerosis
Intima injury
Integrative Chinese and western medicine
