补肾法对颈动脉粥样硬化患者脂代谢的影响  

Effect of kidney-tonifying method on lipid metabolism in patients with carotid atherosclerosis

作　　者：孙卫华[1] 顾耘[1] 高爽[1] SUN Weihua;GU Yun;GAO Shuang(Department of Geriatrics,Longhua Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai200032,China)

机构地区：[1]上海中医药大学附属龙华医院老年科,上海200032

出　　处：《中国医药导报》2020年第26期134-138,共5页China Medical Herald

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目——“林水淼全国名老中医传承工作室”项目;上海市科学技术委员会科研计划项目(14401972505)。

摘　　要：目的评价补肾法对老年颈动脉粥样硬化(CAS)患者脂代谢的影响。方法收集2015年1月—2016年7月就诊于上海中医药大学附属龙华医院病房和门诊的肾精亏虚型CAS患者122例,按随机数字表法将其随机分为对照组与治疗组,各61例。对照组给予辛伐他汀片治疗,治疗组给予益肾口服液治疗,疗程为24周。治疗前后评价并比较两组患者的中医证候积分、血脂指标[三酰甘油(TG)、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)],并观察两组患者治疗期间的不良反应发生情况。结果对照组脱落3例,共完成58例,治疗组脱落4例,共完成57例,进入统计学分析115例。对照组治疗前后中医证候总积分比较,差异无统计学意义(P>0.05);治疗后,治疗组中医证候总积分较治疗前降低(P<0.05),且治疗组低于对照组(P<0.05);治疗后,治疗组中医证候疗效明显优于对照组(P<0.05);治疗后,对照组HDL-C水平较治疗前降低(P<0.05),治疗组HDL-C水平较治疗前升高(P<0.05),且治疗组水平高于对照组(P<0.05);治疗后,两组患者TC水平均较治疗前降低(P<0.05),治疗组TC水平高于对照组(P<0.05)。治疗前后,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论补肾法能调节颈动脉粥样硬化患者血脂代谢,降低胆固醇,尤其在升高HDL-C方面与对照组相比具有显著优势,能有效改善中医证候,无明显不良反应,安全性好。Objective To evaluate the effect of kidney-tonifying method on lipid metabolism in elderly patients with carotid atherosclerosis(CAS).Methods One hundred and twenty-two CAS patients with syndrome of deficiency of kidney essence from January 2015 to July 2016 in Longhua Hospital of Shanghai University of Traditional Chinese Medicine were randomly divided into control group and treatment group by random number table method,with 61 cases in each group.The control group was treated with Simvastatin Tablets,the treatment group was treated with Yishen Oral Liquid.The treatment duration of both groups was 24 weeks.The traditional Chinese medicine(TCM)syndrome scores of both groups were evaluated and compared before and after treatment,and the levels of the blood lipid indexes(triacylglycerol[TG],total cholesterol[TC],low density lipoprotein cholesterol[LDL-C]and high density lipoprotein cholesterol[HDL-C])were detected.At the same time,the adverse reactions were observed.Results In the control group,three cases fell off with 58 cases completed and in the treatment group,four cases fell off with 57 cases completed,115 cases were involved in statistical analysis.There was no significant difference of the total TCM syndrome scores in the control group before and after treatment(P>0.05).After treatment,the total TCM syndrome score in the treatment group was lower than that before treatment(P<0.05),and lower than that in the control group(P<0.05);after treatment,the efficacy of TCM syndrome in the treatment group was better than that in the control group(P<0.05).After treatment,the HDL-C level in the control group was lower than before treatment(P<0.05),the HDL-C level in the treatment group was higher than before treatment(P<0.05),and higher than that in the control group(P<0.05).After treat ment,the TC levels in both groups were lower than that before treatment(P<0.05),and the TC level in treatment group was higher than that in control group(P<0.05).Before and after treatment,there were no significant differences in advers

关 键 词：颈动脉粥样硬化 补肾法 益肾口服液 血脂 中医证候积分 

分 类 号：R543.4[医药卫生—心血管疾病]