血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的临床观察  

Clinical Observation of Xuefu Zhuyu Decoction and Wendan Decoction Combined with Western Medicine in the Treatment of Hypertensive Carotid Atherosclerosis

作　　者：辛琳 姜雨欣 马新军 XIN Lin;JIANG Yuxin;MA Xinjun(Department of Internal Medicine of traditional Chinese Medicine, Liaocheng traditional Chinese Medicine Hospital,Liaocheng 252000,China;Weifang Medical University,School of Clinical Pharmacy, Weifang 261000,China)

机构地区：[1]山东省聊城市中医院中医内科,聊城252000 [2]潍坊医学院临床药学系,潍坊261000

出　　处：《世界中医药》2020年第17期2598-2601,2607,共5页World Chinese Medicine

基　　金：山东省中医药管理局科研项目(2018091B)。

摘　　要：目的:观察血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的效果。方法:选取2017年6月至2018年6月聊城市中医院收治的高血压颈动脉硬化患者92例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组46例。对照组患者给予左旋氨氯地平+阿托伐他汀口服,观察组在对照组基础上加用血府逐瘀汤合温胆汤加减口服。观察患者血压、血脂控制情况,测定颈动脉内膜中层厚度(IMT)、斑块面积、血管皮内皮功能、血清蛋白酶分子水平。结果:与对照组比较,观察组治疗后的血压SBP、DBP及血脂TG、TC、LDL-C等指标更低(P<0.05);颈动脉粥样硬化斑块IMT厚度、斑块面积明显缩小(P<0.05),血管内皮功能指标ET-1、AngⅡ、TXB2水平明显降低,NO水平明显升高(P<0.05);血清CatK、MMP-9水平明显降低(P<0.05);观察组不良反应发生率8.70%明显低于对照组不良反应发生率21.74%(P<0.05)。结论:血府逐瘀汤合温胆汤加减联合西药更利于控制高血压颈动脉硬化患者的血压,调节脂质代谢,改善血管内皮功能,降低血清蛋白酶分子的含量,用药安全。Objective:To observe the effect of Xuefu Zhuyu decoction and Wendan decoction combined with Western medicine in the treatment of hypertensive carotid atherosclerosis.Methods:A total of 92 patients with hypertensive carotid atherosclerosis admitted to Liaocheng traditional Chinese Medicine Hospital from June 2017 to June 2018 were collected,and were randomly divided into control group and observation group according to the random number table method,with 46 cases in each group.Patients in the control group were given Levamlodipine+atorvastatin orally,and the observation group was added with Xuefu Zhuyu decoction and Wendan decoction on the basis of the control group.The patient′s blood pressure and blood lipid control were observed,and the carotid artery intima-media thickness(IMT),plaque area,vascular endothelial function,and serum protease molecular level were detected.Results:Compared with the control group,the observation group had lower blood pressure SBP,DBP and blood lipids TG,TC,LDL-C and other indicators after treatment(P<0.05);carotid atherosclerotic plaque IMT and plaque area were significantly reduced(P<0.05),the levels of vascular endothelial function indexes ET-1,AngⅡ,and TXB2 were significantly reduced,and the level of NO was significantly increased(P<0.05);the levels of serum CatK and MMP-9 were significantly reduced(P<0.05);the adverse reactions in the observation group(8.70%)was significantly lower than the control group(21.74%)(P<0.05).Conclusion:Xuefu Zhuyu decoction and Wendan decoction combined with Western medicine is more beneficial to the control of blood pressure in patients with hypertensive carotid atherosclerosis,the regulation of lipid metabolism,the improvement of vascular endothelial function,the reduction of serum protease molecule content,and the safety of drug use.

关 键 词：高血压 颈动脉硬化 血府逐瘀汤 温胆汤 左旋氨氯地平 阿托伐他汀 血管壁内皮功能 血清蛋白酶分子 

分 类 号：R255.3[医药卫生—中医内科学] R544.1[医药卫生—中医学]