摘要
目的 分析补阳还五汤黄芪不同配比组方对冠状动脉粥样硬化斑块稳定性和炎症因子的影响。方法选取海南省中医院2019年12月—2021年12月收治的189例首次确诊冠心病的患者,按照随机数字表法分为4组,对照组,补阳还五汤低、中、高剂量组。对照组患者采用常规阿托伐他汀片治疗(47例),其他3组均在常规治疗基础上服用补阳还五汤,低剂量组47例选择黄芪30 g/剂,中剂量组47例选择黄芪60 g/剂,高剂量组48例选择黄芪90 g/剂,疗程均为3个月。通过光学相干断层成像技术(OCT)对4组治疗前后的斑块稳定性进行分析,并检测各组患者治疗前后的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果 各组患者治疗后OCT参数纤维帽厚度、脂质核心角度和巨噬细胞浸润率均较治疗前改善(P<0.05),联用补阳还五汤组患者纤维帽厚度、脂质核心角度和巨噬细胞浸润率改善程度优于对照组(均P<0.05),中剂量组与低剂量组脂质核心角度比较差异无统计学意义(P>0.05),中、高剂量组纤维帽厚度改善程度均优于低剂量组,高剂量组纤维帽厚度与脂质核心角度改善程度均优于中剂量组(均P<0.05),联用补阳还五汤黄芪不同剂量组间巨噬细胞浸润率比较差异无统计学意义(P>0.05)。各组患者治疗后TC、TG、LDL-C、hs-CRP、IL-6和TNF-α水平较治疗前均降低(均P<0.05),联用补阳还五汤组患者各因子改善程度优于对照组,且中、高剂量组各因子水平改善优于低剂量组,高剂量组各因子水平改善优于中剂量组(均P<0.05)。结论 补阳还五汤能够改善冠心病患者冠状动脉粥样硬化斑块稳定性,降低炎症因子水平,效果优于单用西药;该研究表明增加黄芪剂量可改善疗效,黄芪为90 g/剂时疗效最佳。
Objective To analyze the effects of Buyang Huanwu Decoction(补阳还五汤)Huangqi(Astragali Radix)with different dosages on the stability of coronary atherosclerotic plaque and inflammatory factors.Methods A total of 189 patients with coronary heart disease diagnosed for the first time who were admitted to Hainan provincial hospital of traditional Chinese medicine from June 2021 to December 2021 were selected and divided into 4 groups(the control group and Buyang Huanwu Decoction low-dose,middle-dose,high-dose groups)according to the random table method.The patients in the control group were treated with atorvastatin tablets(47 cases),and the other groups were treated with Buyang Huanwu Decoction on the basis of conventional treatment.The low-dose group 47 cases were selected as 30 g/dose of Huangqi(Astragali Radix),and the middle-dose group 47 cases were selected as 60 g/dose of Huangqi(Astragali Radix),the high-dose group 48 cases were selected as 90 g/dose of Huangqi(Astragali Radix),and the course of treatment was 3 months.The plaque stability of the four groups before and after treatment were analyzed by optical coherence tomography(OCT).The levels of TC,TG,LDL-C,hs-CRP,IL-6 and TNF-αin the four groups of patients before and after treatment were detected.Results The OCT parameters(fiber cap thickness,lipid core angle and macrophage infiltration rate)in the 4 groups after treatment were improved compared with those before treatment(P<0.05).The improvement of fibrous cap thickness,lipid core angle and macrophage infiltration rate in the combined Buyang Huanwu Decoction group were better than that in the control group(all P<0.05).There was no difference between the middle-dose and the low-dose in the lipid core angle(P>0.05),and the improvement of the thickness of the fibrous cap in the middle-dose and high-dose groups were better than that in the low-dose group,the improvement degree of fiber cap thickness and lipid core angle in high-dose group were better than that in medium dose group(all P<0.05).There w
作者
王转转
顾民华
李光智
余洪
WANG Zhuanzhuan;GU Minhua;LI Guangzhi;YU Hong(Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou 570203,Hainan,China)
出处
《辽宁中医药大学学报》
CAS
2023年第7期60-63,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(82160899)
海南省自然科学基金高层次人才项目(821RC1128)。
关键词
补阳还五汤
黄芪配比
冠状动脉粥样硬化
斑块稳定性
炎症因子
Buyang Huanwu Decoction(补阳还五汤)
different dosages of Huangqi(Astragali Radix)
coronary atherosclerotic
plaque stability
inflammatory factor
