人迎穴贴敷联合针刺治疗颈动脉斑块的临床观察  

Clinical Observation of Renying (ST9) Acupoint Application Combined with Acupuncture in Treating Carotid Plaque

作　　者：柯金菊 虢周科[1,2] 李薇[1] 林松俊[1,2] 孔繁鑫[1,2] KE Jin-Ju;GUO Zhou-Ke;LI Wei;LIN Song-Jun;KONG Fan-Xin(The Fourth Clinical Medical School,Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深训518033

出　　处：《广州中医药大学学报》2021年第12期2640-2646,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(编号:81804004);广东省中医药局科研项目(编号:20211327);深圳市卫生计生系统科研项目(编号:SZFZ2018013)。

摘　　要：【目的】观察通脉消斑膏贴敷人迎穴联合针刺治疗痰瘀互结型颈动脉斑块的临床疗效。【方法】将66例痰瘀互结型颈动脉斑块患者随机分为治疗组和对照组,每组各33例。治疗组给予通脉消斑膏贴敷人迎穴联合针刺风池、人迎、血海、丰隆、足三里、太冲穴治疗,对照组给予口服阿司匹林肠溶片、阿托伐他汀钙片治疗,疗程为12周。观察2组患者治疗前后中医证候积分、血脂水平及颈动脉内膜中层厚度(IMT)的改善情况,评价2组患者的中医证候疗效、颈动脉IMT改善疗效和安全性。【结果】(1)研究过程中,2组各脱落3例,最终各有30例患者完成试验。(2)中医证候疗效:治疗12周后,治疗组的总有效率为86.67%(26/30),对照组为60.00%(18/30),组间比较,治疗组的总体疗效和总有效率均明显优于对照组(P<0.05或P<0.01)。(3)颈动脉IMT改善疗效:治疗12周后,治疗组的总有效率为56.67%(17/30),对照组为26.67%(8/30),组间比较,治疗组颈动脉IMT改善疗效的总有效率明显优于对照组(P<0.05)。(4)治疗后,2组患者的中医证候积分和颈动脉IMT值均较治疗前明显降低(P<0.01),且治疗组对中医证候积分的降低作用明显优于对照组(P<0.05),但2组颈动脉IMT值比较,差异无统计学意义(P>0.05)。(5)治疗后,2组患者的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高(P<0.05),但组间比较,差异均无统计学意义(P>0.05)。(6)治疗过程中,2组患者的血常规、肝功能、肾功能等安全性指标均无明显异常。【结论】通脉消斑膏贴敷人迎穴联合针刺治疗对痰瘀互结型颈动脉斑块患者具有良好的临床疗效,能减少颈动脉IMT,改善血脂水平,降低中医证候积分。Objective To observe Renying(ST9) acupoint application of Tongmai Xiaoban Adhesive Plaster combined with acupuncture in treating carotid plaque of phlegm blended with blood stasis type. Methods Sixty-six patients with carotid plaque of phlegm blended with blood stasis type were randomly divided into treatment group and control group, 33 cases in each group. The treatment group was treated with Tongmai Xiaoban Adhesive Plaster at Renying(ST9)acupoint combined with acupuncture treatment at Fengchi(GB20), Renying(ST9),Xuehai(SP10), Fenglong(ST40), Zusanli(ST36)and Taichong(LR3)points, while the control group was treated with oral use of Aspirin Enteric-coated Tablets and Atorvastatin Calcium Tablets. The course of treatment lasted 12 weeks. The improvement of traditional Chinese medicine(TCM)syndrome scores,blood lipid level and carotid intima-media thickness(IMT)in the two groups were observed before and after treatment,and the TCM syndrome efficacy,efficacy for improving IMT and clinical safety in the two groups were evaluated. Results(1)During the trial,3 cases in each group fell off,and 30 patients in each group eventually completed the trial.(2)After12 weeks of treatment,the total effective rate for TCM syndrome efficacy in the treatment group was 86.67%(26/30),and that in the control group was 60.00%(18/30). The intergroup comparison showed that the overall curative effect and total effective rate of the treatment group were significantly superior to those of the control group(P < 0.05 or P < 0.01).(3)After 12 weeks of treatment,the total effective rate for carotid IMT improvement in the treatment group was 56.67%(17/30),and that in the control group was 26.67%(8/30). The intergroup comparison showed that the total effective rate in the treatment group was significantly superior to that in the control group(P < 0.05).(4)After treatment,TCM syndrome scores and carotid IMT value of the two groups were significantly decreased compared with those before treatment(P < 0.01),and the treatment group had stronger effe

关 键 词：颈动脉斑块 通脉消斑膏 穴位贴敷 针刺疗法 人迎穴 风池穴 血海穴 颈动脉内膜中层厚度(IMT) 

分 类 号：R246.6[医药卫生—针灸推拿学]