温和灸联合西医治疗颈动脉粥样斑块患者有效性研究  

Study on the effectiveness of mild-warm moxibustion combined with western medicine in treating patients with carotid atherosclerotic plaque

作　　者：吴丹 李洁芳[1] 刘君 胡灿 李茜 伍亚男 WU Dan;LI Jiefang;LIU Jun;HU Can;LI Xi;WU Yanan(Department of Traditional Chinese Medicine,Changsha Fourth Hospital,Changsha 410006,China)

机构地区：[1]长沙市第四医院中医科,长沙410006

出　　处：《长春中医药大学学报》2021年第2期373-376,共4页Journal of Changchun University of Chinese Medicine

基　　金：长沙市科技计划项目(kq1706006)。

摘　　要：目的探讨温和灸联合西医治疗颈动脉粥样斑块患者有效性。方法选取92例颈动脉粥样斑块患者,根据随机数字表达法分为西药组(阿司匹林肠溶片+阿托伐他汀钙片治疗)、中西医结合组(阿司匹林肠溶片+阿托伐他汀钙片+温和灸),各46例。比较2组中医证候疗效、血脂、炎性因子及颈动脉粥样斑块情况等指标。结果中西医结合组中医证候疗效结果(95.65%,44/46)明显高于西药组(80.43%,37/46)(P<0.05);2组治疗后动脉硬化指数(AI)、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、白介素-8(IL-8)、基质金属蛋白酶-9(MMP-9)、血管紧张素II(AngII)、单核细胞趋化蛋白(MCP-1)水平均较治疗前明显降低(P<0.05),HDL-C较治疗前明显升高(P<0.05);中西医结合组治疗后LDL-C、TC、TG、AI、hs-CRP、IL-8、AngII、MCP-1、MMP-9明显低于西药组(P<0.05),HDL-C明显高于西药组(P<0.05);2组治疗后颈动脉斑块面积、IMT明显缩小(P<0.05);且中西医结合组治疗后颈动脉斑块面积、IMT缩小更显著(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论温和灸联合西医治疗颈动脉粥样斑块中医证候疗效显著,能有效抑制动脉粥样斑块炎性因子表达,改善血脂代谢异常,促进斑块消退,具有良好的药物安全性。Objective To explore the effectiveness of mild-warm moxibustion combined with western medicine in the treatment of carotid atherosclerotic plaque. Methods 92 patients with carotid atherosclerotic plaque were randomly divided into western medicine group(aspirin enteric-coated tablets + atorvastatin calcium tablets) and integrated traditional Chinese and western medicine group(aspirin enteric-coated tablets + atorvastatin calcium tablets + mild-warm moxibustion), 46 cases each. The curative effect of TCM syndrome, blood lipid, inflammatory factors and carotid atherosclerotic plaque were compared between the two groups. Results The curative e ect of TCM syndrome in the integrated traditional Chinese and western medicine group was significantly higher than that in the western medicine group(95.65% vs 80.43%)(P <0.05). After treatment, the levels of arteriosclerosis index(AI), cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high sensitivity C-reactive protein(hs-CRP), interleukin-8(IL-8), matrix metalloproteinase-9(MMP-9), angiotensin Ⅱ(AngⅡ), monocyte chemotactic protein(MCP-1) were all significantly lower(P <0.05), yet HDL-C significantly higher than before treatment(P <0.05). After treatment, in the integrated traditional Chinese and western medicine group, LDL-C, TC, TG, AI, hs-CRP, IL-8, Ang Ⅱ,MCP-1 and MMP-9 were significantly lower(P<0.05) and HDL-C was significantly higher than those of western medicine group(P <0.05). The carotid plaque area and IMT were significantly reduced after treatment in both groups(P <0.05) and the integrated traditional Chinese and western medicine group was much more significantly reduced(P <0.05). There was no statistically significant di erence in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Mild-warm moxibustion combined with western medicine, in the treatment of carotid atherosclerotic plaque, has a significant effect on TCM syndromes. It can effectively inhibit the expression of inflammatory factors in caroti

关 键 词：颈动脉粥样斑块 温和灸 阿司匹林肠溶片 阿托伐他汀钙片 血脂 炎性因子 

分 类 号：R541[医药卫生—心血管疾病]