温和灸辅助阿托伐他汀、阿司匹林治疗老年颈动脉粥样硬化的预后观察  

Prognosis of mild moxibustion combined with atorvastatin and aspirin in the elderly carotid atherosclerosis

作　　者：李洁芳[1] 吴丹 伍亚男 刘君 胡灿 李茜 戚晶敏 李红果 肖玉坤[1] LI Jie-fang;WU Dan;WU Ya-nan;LIU Jun;HU Can;LI Qian;QI Jing-min;LI Hong-guo;XIAO Yu-kun(Department of Traditional Chinese Medicine,The Fourth Hospital of Changsha,Changsha Hunan 41006)

机构地区：[1]长沙市第四医院中医科

出　　处：《世界中西医结合杂志》2020年第1期115-118,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：长沙市科技计划项目(kq1706006)

摘　　要：目的研究温和灸辅助阿托伐他汀、阿司匹林治疗老年颈动脉粥样硬化(CAS)患者的疗效。方法纳入2016年2月—2018年2月长沙市第四医院92例老年CAS患者作为研究对象,采用完全随机化分组方法,将患者分为观察组和对照组,各46例。对照组行阿托伐他汀+阿司匹林治疗,观察组在对照组基础上加用温和灸干预。分别在治疗前后记录颈动脉内膜-中膜厚度(IMT)和硬化斑块指数(PI),比较两组治疗前后血清淀粉样蛋白(SAA)、肿瘤坏死因子-α(TNF-α)及Th1/Th2水平,记录治疗期间不良反应,随访比较两组患者治疗后半年不良事件发生率。结果两组患者治疗后IMT和PI评分较治疗前均显著降低,差异有统计学意义(P<0.05),治疗后观察组IMT和PI均低于对照组,差异均有统计学意义(P<0.05)。两组胃肠道反应、肌肉酸痛、肝功能异常及皮肤瘙痒等不良反应严重程度比较,差异无统计学意义(P>0.05)。治疗后两组患者SAA、TNF-α、Th1/Th2均低于治疗前,差异均有统计学意义(P<0.05)。治疗后观察组SAA、TNF-α、Th1/Th2均显著低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后半年不良事件发生率为2.17%,对照组为10.87%,观察组治疗后不良事件发生率低于对照组,但两组间比较,差异无统计学意义(P>0.05)。结论温和灸辅助阿托伐他汀、阿司匹林治疗老年CAS有助于减轻血管狭窄,减少脑血管不良事件,这可能与其控制局部炎症,改善细胞免疫状态有关。Objective To study the effect of mild moxibustion combined with atorvastatin and aspirin in the treatment of elderly carotid atherosclerosis(CAS).Methods 92 elderly CAS patients admitted to the fourth hospital of Changsha from February,2016 to February,2018 were included and randomly divided into the observation group and the control group,with 46 cases in each group.The control group was given atorvastatin and aspirin,while the observation group was additionally given mild moxibustion on the basis of the control group.The carotid intima-media thickness(IMT)and sclerotic plaque index(PI)were recorded before and after treatment respectively.The serum levels of amyloid A protein(SAA),tumor necrosis factor-α(TNF-α)and Th1/Th2 were compared between the two groups before and after treatment.The adverse reactions during the treatment were recorded,and the incidence of adverse events was compared between the two groups half year after the treatment.Results After treatment,the IMT and PI scores in both groups decreased,with significance(P<0.05).The IMT and PI scores in the observation group were lower than those in the control group after treatment,with significance(P<0.05).There was no significant difference in the severity of adverse reactions of gastrointestinal reaction,muscular soreness,abnormal liver function and skin itching between the two groups(P>0.05).The SAA,TNF-αand Th1/Th2 of the two groups after treatment were lower than those before treatment,with significance(P<0.05).After treatment,the SAA,TNF-αand Th1/Th2 in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse events half year after treatment in the observation group was2.17%and the control group was 10.87%.The incidence of adverse events in the observation group was lower than that in the control group,without significant difference between the two groups(P>0.05).Conclusion The mild moxibustion combined with atorvastatin and aspirin in the treatment of elderly CAS is helpful to alleviate v

关 键 词：温和灸 阿托伐他汀 阿司匹林 颈动脉粥样硬化 

分 类 号：R543.4[医药卫生—心血管疾病]