黄连降脂合剂对痰湿内阻型高血压病人血脂、血清炎症因子及颈动脉斑块的影响  

Influences of Huanglian Jiangzhi Decoction on Blood Lipids,Inflammatory Cytokine and Carotid Atherosclerotic Plaque in Patients with Hypertension of Phlegm-dampness Resistance Type

作　　者：余志华[1] 祝炜[1] 余浩[1] 文飞[1] 冯莹[1] 陈昌贵 田立群[1] 郑琼莉[1] YU Zhihua;ZHU Wei;YU Hao;WEN Fei;FENG Ying;CHEN Changgui;TIAN Liqun;ZHENG Qiongli(Wuhan Hospital of Traditional Chinese and Western Medicine,Wuhan 430022,Hubei,China)

机构地区：[1]武汉市中西医结合医院

出　　处：《中西医结合心脑血管病杂志》2020年第1期95-98,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：武汉市“步长杯”心血管病科研基金项目(No.20150103)

摘　　要：目的观察黄连降脂合剂对痰湿内阻型高血压病人血脂水平、颈动脉斑块及血清炎症因子水平的影响。方法选取2014年1月—2016年2月武汉市中西医结合医院心内科收治的高血压合并颈动脉斑块病人120例,采用随机数字表法分为治疗组(58例)和对照组(62例)。两组均按指南给予积极降压治疗。治疗组采用黄连降脂合剂治疗,每次100 mL,每日1次;对照组给予辛伐他汀片每次20 mg,每日1次,晚上服用。两组疗程均为24周。检测治疗前后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素6(IL-6)水平,同时观察颈动脉内膜中层厚度及斑块面积变化情况。结果治疗24周后,两组病人TC、LDL-C水平均较治疗前明显降低(P<0.05),但两组治疗后TC、LDL-C水平比较差异无统计学意义(P>0.05);两组hs-CRP、TNF-α、IL-6均较治疗前明显降低(P<0.05),且治疗组较对照组降低更为明显(P<0.05);治疗组颈动脉内膜中层厚度及斑块面积较治疗前及对照组有明显改善(P<0.05)。结论黄连降脂合剂能有效改善痰湿内阻型高血压病人颈动脉内膜中层厚度及斑块面积,其机制可能与降脂和改善相关炎症因子水平有关。Objective To evaluate the clinical effect of Huanglian Jiangzhi decoction on blood lipids,inflammatory cytokine,and carotid plaque in patients with hypertension of phlegm-dampness resistance type.Methods One hundred and twenty patients of hyperten-sion with carotid atherosclerosis were selected,and randomly divided into control group(n=62)and treatment group(n=58).The pa-tients in the two groups were all treated by antihypertensive therapy actively according to standards in guideline.Patients in therapy group received Huanglian Jiangzhi decoction,100 mL/time,1 time/day.Patients in control group received simvastatin tablets at night,20 mg/time,1 time/day.Course of treatment lasted for 24 weeks in both groups.The total cholesterol(TC),low-density lipoprotein-C(LDL-C),high-density lipoprotein-C(HDL-C),triglyceride(TG),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and in-terleukin-6(IL-6)were detected,meanwhile intima-media thickness(IMT)and area of plaque were detected by color Doppler ultrasonic diagnostic apparatus before and after treatment.Results After 24 weeks treatment,the levels of TC,LDL-C were decreased than those before treatment in both groups(P<0.05),but there was no significant difference in TC and LDL-C levels between two groups after treatment(P>0.05);the levels of hs-CRP,TNF-α,and IL-6 were decreased than those before treatment in both groups(P<0.05),and that in the treatment group was significantly lower than those in control group(P<0.05).The IMT and area of plaque in treatment group were improved compared with those in control group and before treatment(P<0.05).Conclusion Huanglian Jiangzhi Decoc-tion could reduce IMT and area of plaques in patients of hypertension combined with carotid plaque,and its mechanism might be relat-ed to its actions in reducing lipid and Improving the related inflammatory factor levels.

关 键 词：高血压 黄连降脂合剂 颈动脉斑块 血清炎症因子 血脂 颈动脉内膜中层厚度 

分 类 号：R544.1[医药卫生—心血管疾病] R289.5[医药卫生—内科学]