摘要
目的:探讨加用自拟通脉消斑丸治疗湿热瘀阻型颈动脉硬化伴易损斑块临床效果及安全性。方法:将60例颈动脉硬化伴易损斑块患者按随机数字表法分为对照组30例与治疗组30例。对照组口服阿司匹林、瑞舒伐他汀钙片治疗,治疗组在对照组治疗的基础上应用自拟通脉消斑丸(由金银花20 g、黄柏10 g、麸炒苍术10 g、薏苡仁15 g、土茯苓15 g、黄芪20 g、玄参12 g、当归20 g、水蛭5 g、全蝎5 g、甘草6 g组成)治疗,两组均治疗3个月。比较两组患者治疗前后颈动脉中层内膜厚度、易损斑块面积、中医证候积分及同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平,并观察临床疗效及安全性。结果:与治疗前比较,两组治疗后颈动脉中层内膜厚度明显减少,易损斑块面积明显缩小,中医证候积分明显下降,Hcy、hs-CRP、Lp-PLA2水平显著下降(均P<0.01),且治疗组改善程度优于对照组(P<0.05或P<0.01);治疗组总有效率为76.67%,对照组总有效率为20.00%,两组比较差异有统计学意义(P<0.01)。两组患者治疗期间未见严重不良反应,安全性良好。结论:加用通脉消斑丸治疗颈动脉硬化伴易损斑块临床疗效确切,可显著缩小易损斑块面积,减少中层内膜厚度,同时降低中医证候积分,其机理可能与降低Hcy、hs-CRP、Lp-PLA2水平有关。
Objective:To investigate the clinical effect and safety of Tongmai Xiaoban Pill in the treatment of damp-heat stasis type carotid atherosclerosis with vulnerable plaque.Methods:60 patients with carotid atherosclerosis and vulnerable plaques were divided into control group(30 cases)and treatment group(30 cases)according to the random number table method.The control group was treated with aspirin and rosuvastatin calcium tablets.The treat-ment group was treated with self-made Tongmai Xiaoban Pill(composed of honeysuckle 20 g,phellodendron 10 g,bran fried atractylodes 10 g,coix seed 15 g,soil poria cocos 15 g,astragalus 20 g,radix scrophulariae 12 g,angelica 20 g,leech 5 g,scorpion 5 g,licorice 6 g)on the basis of the control group.Both groups were treated for 3 months.The carot-id intima-media thickness,vulnerable plaque area,TCM syndrome score,homocysteine(Hcy),high-sensitivity C-re-active protein(hs-CRP)and lipoprotein-associated phospholipase A2(Lp-PLA2)levels were compared between the two groups before and after treatment,and the clinical efficacy and safety were observed.Results:Compared with be-fore treatment,the carotid intima-media thickness was significantly reduced,the vulnerable plaque area was signifi-cantly reduced,the TCM syndrome score was significantly decreased,and the levels of Hcy,hs-CRP and Lp-PLA2 were significantly decreased in the two groups after treatment(both P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.05 or P<0.01).The total effective rate was 76.67%in the treat-ment group and 20.00%in the control group.The difference between the two groups was statistically significant(P<0.01).No serious adverse reactions were found in the two groups during the treatment,and the safety was good.Conclusion:Tongmai Xiaoban Pill has a definite clinical effect in the treatment of carotid atherosclerosis with vulnera-ble plaques.It can significantly reduce the area of vulnerable plaques,reduce the thickness of middle intima,and re-duce the score of TCM synd
作者
邢良飞
卞显辉
朱永强
王之利
刘红玲
周会
马奎军
XING Liangfei;BIAN Xianhui;ZHU Yongqiang;WANG Zhii;LIU Honging;ZHOU Hui;MA Kuijun(Bozhou Hospital of Traditional Chinese Medicine,Bozhou Anhui,236800)
出处
《广西中医药》
2023年第5期6-10,共5页
Guangxi Journal of Traditional Chinese Medicine
关键词
颈动脉硬化
易损斑块
通脉消斑丸
中医药疗法
Carotid atherosclerosis
Vulnerable plaque
Tongmai Xiaoban Pill
TCM treatment
