化痰通络汤对颈动脉粥样硬化患者血管内皮功能及斑块稳定的影响  

Effect of Huatan Tongluo Decoction on vascular endothelial function and plaque stability in patients with carotid atherosclerosis

作　　者：刘欣燕 杨延龙 顾秦五风 黄雪强 王宏飞 崔丽 LIU Xinyan;YANG Yanlong;GU Qinwufeng;HUANG Xueqiang;WANG Hongfei;CUI Li(The First Affiliated Hospital of Naval Military Medical University,Shanghai 200433,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]海军军医大学第一附属医院,上海200433 [2]上海中医药大学附属曙光医院,上海201203 [3]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《现代中西医结合杂志》2021年第35期3925-3929,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨化痰通络汤对颈动脉粥样硬化患者血管内皮功能及斑块稳定的影响。方法将2019年6月—2020年11月在海军军医大学第一附属医院和上海中医药大学附属上海市中西医结合医院治疗的82例颈动脉粥样硬化患者随机分成2组。对照组41例长期口服拜阿司匹林肠溶片+辛伐他汀片治疗,观察组联合化痰通络汤治疗8周。观察2组治疗8周后中医症状积分(头晕目眩、头重如裹、胸闷、手足肢麻、失眠、心悸)、血管内皮功能[内皮素(ET-1)、一氧化氮(NO)]、血脂水平[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、斑块指标[颈动脉内膜中层厚度(IMT)、斑块数量、斑块面积]的变化,比较2组疗效及治疗安全性。结果治疗后2组各项中医症状积分及ET-1、TG、TC、LDL-C水平和颈动脉IMT、斑块面积均明显降低(P均<0.05),NO、HDL-C水平均明显升高(P均<0.05),斑块数量均明显减少(P均<0.05),且观察组以上指标改善程度均明显优于对照组(P均<0.05);观察组和对照组总有效率分别为90.2%(37/41)和73.2%(30/41),观察组明显高于对照组(P<0.05);2组治疗过程中均未出现严重不良反应。结论化痰通络汤短期应用联合常规西药治疗颈动脉粥样硬化能明显减轻患者症状,调控血管内皮功能和血脂水平,有助于稳定粥样斑块,可提高临床疗效。Objective It is to explore the effect of Huatan Tongluo Decoction on vascular endothelial function and plaque stability in patients with carotid atherosclerosis.Methods Eighty-two patients with carotid atherosclerosis treated in the First Affiliated Hospital of Naval Military Medical University and Shanghai Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from June 2019 to November 2020 were randomly divided into 2 groups.41 patients in the control group were treated with aspirin enteric-coated tablets+simvastatin tablets for a long time,and the ones in the observation group were treated with Huatan Tongluo Decoction for 8 weeks.The changes in the scores of Traditional Chinese Medicine symptoms(dizziness,head weight,chest tightness,numbness of hands,feet and limbs,insomnia,palpitations),vascular endothelial function[endothelin(ET-1),nitric oxide(NO)],blood lipid level[triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],plaque indexes[carotid artery intima-media thickness(IMT),the number of plaques,the area of plaques]after 8 weeks of treatment were observed in the two groups,the efficacy and safety of the two groups were compared.Results After treatment,the scores of each TCM symptom and the levels of ET-1,TG,TC,LDL-C,carotid artery IMT and plaque area of the two groups were significantly reduced(all P<0.05),and the levels of NO and HDL-C were significantly increased(all P<0.05),the number of plaques was significantly reduced(all P<0.05),and the improvement of the above indicators in the observation group was significantly better than that of the control group(all P<0.05);the total effective rates of the observation group and the control group respectively were 90.2%(37/41)and 73.2%(30/41),the observation group was significantly higher than the control group(P<0.05);there were no serious adverse reactions during the treatment in the two groups.Conclusion Sh

关 键 词：颈动脉粥样硬化 化痰通络汤 斑块稳定 血管内皮功能 血脂 

分 类 号：R543.5[医药卫生—心血管疾病]