益气祛风通络法治疗高血压颈动脉粥样硬化的临床疗效观察  

Observe ation of the clinical efficacy of Yiqi Qufeng Tongluo therapy in the treatment of hypertensive patients with carotid atherosclerosis

作　　者：白雪[1] 杨思进[1] 王承刚[1] 张德绸[1] 赵立志[1] 

机构地区：[1]泸州医学院附属中医医院心脑病科,四川泸州646000

出　　处：《泸州医学院学报》2014年第1期52-55,共4页Journal of Luzhou Medical College

基　　金：四川省中医药管理局(200643);四川省医学会施惠达基金(川学会医学【2012】73号)

摘　　要：目的:观察益气祛风通络法治疗高血压颈动脉粥样硬化患者的临床疗效。方法:选择符合纳入标准病例共90例,采取随机、对照、双盲法,分为对照组、蛭龙活血试验组1(简称试验组1)和联合冶疗试验组2(简称试验组2),每组30例。治疗方案:对照组,辛伐他汀片+安慰剂A+基础治疗;试验组1,蛭龙活血通瘀胶囊+安慰剂B+基础治疗;试验组2,基础治疗+辛伐他汀片+蛭龙活血通瘀胶囊。观察颈动脉内中膜厚度(IMT)和中医证候疗效、冶疗前后中医临床症状积分。结果:①试验组2中医证候疗效总有效率为96.7%;试验组1总有效率80.0%;对照组总有效率76.7%。试验组2与试验组1、对照组比较,差异有统计学意义(P<0.05)。试验组1虽然总疗效率优于对照组,但差异无统计学意义(P>0.05);②三组患者的预动脉内中膜厚度、斑块总积分均较冶疗前减少(P<0.05),其中试验组2各指标的降低与对照组、试验组1比较有差异统计学意义(P<0.05)。③2个试验组冶疗后心烦、眩晕、头痛、神疲乏力、气短、舌脉象等均有明显改善,差异有统计学意义(P<0.05),且试验组2上述主要中医临床症状的改善更加明显;对照组仅头痛、心烦易怒、眩晕项有所改善(P<0.05)。结论:益气法风通络法能显著改善高血压颈动脉粥样硬化患者中医临床症状,降低颈动脉内中膜厚度和斑块总积分,与辛伐他汀合用临床疗效更加显著。Objective：To observe the clinical efficacy of Yiqi Qufeng Tongluo therapy in hypertensive patients with carotid atherosclerosis. Methods： According to strict standard, the selected 90 cases were randomly and double-blindedly divided into control group （simvastatin）, experiment group 1 （Zhilong Huoxue Tongyu capsule） and experimental group 2 （simvastatin＋Zhilong Huoxue Tongyu,30 patients each .The carotid artery intima-media thickness （IMT）,curative effectiveness of TCM syndrome and scores of clinical symptoms before and after treatment were observed. Results： ①The total effectiveness of TCM syndrome of the experiment group 2 （96.7%）,was significantly higher than that of the experiment grup 1 （80%） and the control group （76.7%） （P 〈0.05）; the difference between the control groaup and experiment group was not statistically significant （P 〉 0.05）; ②The carotid artery IMT and plaque scores of all the, groups were better after treatment （P〈0.05）,and the experiment group 2 was the best （P〈0.05））. ③After the treatment,vexation, dizziness, wraparound feeling of head, headache, lassitude, shortness of breath and, the manifestation of tongue and pulse were improved （P〈0.05）, and the main symptoms in the experiment group 2 were more pronounced. In the control group,the improvements were found only in headache, irritability, and dizziness （P〈0.05）. Conclusion：Yiqi Qufeng Tongluo therapy can significantly improve the TCM clinical symptoms in patients with hypertensive carotid atherosclerosis , and reduce the internal carotid artery intima-media thickness and plaque scores. If it is combined with simvastatin , the clinical efficacy will be more significant.

关 键 词：高血压颈动脉粥样硬化 炎性反应 蛭龙活血通瘀胶囊 辛伐他汀片 

分 类 号：R544.1[医药卫生—心血管疾病] R242[医药卫生—内科学]