四妙勇安汤对颈动脉粥样硬化瘀热内郁证患者血清高敏C反应蛋白水平的影响  

Effect of Simiao Yongan Decoction(四妙勇安汤)on Serum High-sensitivity C-reactive Protein in Carotid Atherosclerosis Patients with Stasis-heat Interior Constraint Pattern

作　　者：苏文全 杜雅薇[1] 吴圣贤[1] SU Wenquan;DU Yawei;WU Shengxian(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700)

机构地区：[1]北京中医药大学东直门医院,北京市100700

出　　处：《中医杂志》2021年第6期505-509,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(30873255)。

摘　　要：目的评价四妙勇安汤对颈动脉粥样硬化瘀热内郁证患者血清高敏C反应蛋白(hs-CRP)水平的影响。方法回顾性收集2019年6月至12月就诊于东直门医院脑病科门诊,运用四妙勇安汤治疗颈动脉粥样硬化瘀热内郁证伴hs-CRP≥2mg/L患者共30例。按照治疗期间是否合并服用他汀类药物,分为合并他汀组12例,不合并他汀组18例。所有患者均接受四妙勇安汤汤剂或颗粒剂治疗2周,水煎服或冲服,每日2次,早晚分服。比较治疗前后各病例的血清hs-CRP水平、血压、血脂、血糖的变化,观察中医证候疗效及安全性,分析他汀类药物对疗效的影响。结果治疗后30例患者血清hs-CRP水平均较治疗前下降,其中合并他汀组及不合并他汀组血清hs-CRP水平均较治疗前明显下降(P<0.01),但两组间比较差异无统计学意义(P>0.05)。治疗后30例患者的中医证候的总有效率为93.33%,其中合并他汀组的有效率为91.67%,不合并他汀组为94.44%,两组比较差异无统计学意义(P>0.05)。30例患者治疗前后的收缩压、舒张压、空腹血糖、血脂(包括总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)、肝功能(包括丙氨酸氨基转移酶、天门冬氨酸氨基转移酶)、肾功能(包括肌酐、尿素氮)均无明显变化(P>0.05)。治疗期间2例患者出现大便稀溏、次数增加,未见严重不良反应。结论四妙勇安汤能有效降低颈动脉粥样硬化瘀热内郁证患者的血清hs-CRP水平,并可改善临床症状,暂未见他汀类药物对其疗效具有明显影响。Objective To evaluate the effect of Simiao Yongan Decoction(四妙勇安汤)on the serum level of high-sensitivity C-reactive protein(hs-CRP)in carotid atherosclerosis patients with stasis-heat interior constraint pattern.Methods A retrospective study was conducted to collect data on carotid atherosclerosis patients who were admitted to encephalopathy department of Dongzhimen hospital from June to December,2019.Patients having stasis-heat interior constraint pattern and hs-CRP level higher than 2 mg/L were included,and were classified into statins group(12 patients)and non-stains group(18 patients)according to whether stains were used.All patients were treated with herbal decoction or granules,2 times a day,in morning and evening,for 2 weeks.Serum hs-CRP levels,blood pressure,blood lipids,and blood sugar were compared before and after treatment.The traditional Chinese medicine(TCM)syndrome effect and safety were assessed,and were compared between with or without use of statins.Results The serum hs-CRP levels of 30 patients were significantly decreased after treatment,and similar changes were seen in stains group and non-stains group when separately analyzed(P<0.01),but the differences between group were not statistically significant(P>0.05).The total effectives rate on TCM syndromes was 93.33%,while that of stains group and non-stains group was 91.67%and 94.44%,respectively,with no significant differences between groups(P>0.05).After treatment,there were no obvious changes in systolic blood pressure,diastolic blood pressure,fasting blood glucose,blood lipids including total cholesterol,triglycerides,low-density lipoprotein cholesterol,and high-density lipoprotein cholesterol,liver function including alanine aminotransferase and aspartate aminotransferase and renal function including creatinine and urea nitrogen(P>0.05).During the treatment,two cases of loose stools with increased frequency occurred,and no serious adverse events were seen.Conclusion Simiao Yongan Decoction can effectively reduce the serum hs-CRP l

关 键 词：颈动脉粥样硬化 四妙勇安汤 瘀热内郁证 炎症因子 高敏C反应蛋白 

分 类 号：R277.7[医药卫生—中医学]