阿托伐他汀联用脂康颗粒或强肝胶囊用于脑梗死二级预防效果比较  

Effectiveness comparison between atorvastatin combined with Zhikang granule and atorvastatin combined with Qianggan capsule in the secondary prevention for cerebral infarction

作　　者：郭明升[1] 刘娟[1] 郭英杰 籍芳华 郝艳爽 GUO Mingsheng;LIU Juan;GUO Yingjie;JI Fanghua;HAO Yanshuang(General Hospital of Jizhong Energy Fengfeng Group Co., LTD., Handan 056200, Hebei, China)

机构地区：[1]冀中能源峰峰集团有限公司总医院,河北邯郸056200

出　　处：《现代中西医结合杂志》2020年第22期2400-2404,2446,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：邯郸市科学技术研究与发展计划项目(1823208019ZC);河北省医学科学研究重点课题计划(20181744)。

摘　　要：目的探讨阿托伐他汀联合脂康颗粒或强肝胶囊对脑梗死二级预防的影响。方法将2018年2—11月冀中能源峰峰集团有限公司总医院收治的217例急性脑梗死患者随机分为阿托伐他汀组72例、脂康颗粒组73例和强肝胶囊组72例。所有患者在常规治疗基础上给予阿托伐他汀钙片20 mg/d口服,脂康颗粒组同时口服脂康颗粒,强肝胶囊组同时口服强肝胶囊,3组疗程均为6个月。检测3组治疗前及治疗3个月和6个月后血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、谷丙转氨酶(ALT)和颈动脉内膜中层厚度(IMT),记录3组治疗6个月后LDL-C达标率和脑梗死复发率。结果治疗3个月后,脂康颗粒组TG水平明显低于阿托伐他汀组(P<0.05);治疗6个月后,脂康颗粒组和强肝胶囊组TG水平均明显低于阿托伐他汀组(P均<0.05);治疗3个月和6个月后,脂康颗粒组TC和LDL-C水平均明显低于阿托伐他汀组和强肝胶囊组(P均<0.05);治疗6个月后,强肝胶囊组TC水平明显低于阿托伐他汀组(P<0.05)。治疗3个月后,3组ALT水平均明显高于治疗前和治疗6个月后(P均<0.05);治疗3个月和6个月后,强肝胶囊组ALT水平均明显低于阿托伐他汀组和脂康颗粒组(P均<0.05)。治疗3个月和6个月后,3组IMT均明显低于治疗前(P均<0.05);治疗6个月后,脂康颗粒组IMT明显低于阿托伐他汀组和强肝胶囊组(P均<0.05),阿托伐他汀组和强肝胶囊组比较差异无统计学意义(P>0.05)。阿托伐他汀组LDL-C达标率为30.6%(22/72),脂康颗粒组为84.9%(62/73),强肝胶囊组为33.3%(24/72),脂康颗粒组明显高于阿托伐他汀组和强肝胶囊组(P均<0.05)。阿托伐他汀组复发率为12.5%(9/72),脂康颗粒组为5.5%(4/73),强肝胶囊组为11.1%(8/72),3组比较差异均无统计学意义(P均>0.05)。结论阿托伐他汀联合使用脂康颗粒更有利于降低脑梗死患者LDL-C和改善动脉粥样硬化,而联合使用强肝胶囊安全性更好。Objective It is to compare the effectiveness of atorvastatin combined with Zhikang granule and atorvastatin combined with Qianggan capsule in the secondary prevention for atherosclerotic cerebral infarction(ACI).Methods Two hundred and seventeen patients with ACT treated in General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.from February to November 2018 were randomly divided into atorvastatin group(72 cases),Zhikang granule group(73 cases)and Qianggan capsule group(72 cases).All patients were given atorvastatin calcium tablets 20 mg/d orally on the basis of conventional treatment.The Zhikang granules group was also given Zhikang granules,and the Qianggan capsule group was also given Qianggan capsules at the same time.All the three groups were treated for 6 months.Blood lipids[triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)],alanine aminotransferase(ALT)and neck arterial intima-media thickness(IMT)before treatment and 3 months and 6 months after treatment were detected in the three groups,the LDL-C compliance rate and the recurrence rate of cerebral infarction after 6 months of treatment were recorded.Results After 3 months of treatment,the TG level in the Zhikang granule group was significantly lower than that in the atorvastatin group(P<0.05);after 6 months of treatment,the TG level in the Zhikang granule group and the Qianggan capsule group was significantly lower than that in the atorvastatin group(P<0.05);after 3 and 6 months of treatment,the levels of TC and LDL-C in the Zhikang granule group were significantly lower than those in the atorvastatin group and the Qianggan capsule group(P<0.05);after 6 months of treatment,the TC level of the Qianggan capsule group was significantly lower than that of the atorvastatin group(P<0.05).After 3 months of treatment,the ALT levels of the three groups were significantly higher than that before and after 6 months of treatment(all P<0.05);after 3 and 6 months of treatment,the ALT levels of the Qianggan capsule group were signif

关 键 词：脑梗死 二级预防 阿托伐他汀 脂康颗粒 强肝胶囊 

分 类 号：R743.33[医药卫生—神经病学与精神病学]