清脂化瘀方联合阿托伐他汀治疗痰瘀互结证冠心病的临床研究  

The Effect of Qingzhi Huayu Prescription Combined with Atorvastatin on the Phlegm-blood Stasis Syndrome in Coronary Heart Disease

作　　者：沙琬婧 朱迪晖 王田 瞿惠燕[1] 杨涛[1,2] 周华 SHA Wanjing;ZHU Dihui;WANG Tian;QU Huiyan;YANG Tao;ZHOU Hua(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海市中医临床重点实验室,上海201203

出　　处：《中西医结合心脑血管病杂志》2022年第1期86-90,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家高技术研究发展计划(863计划)项目(No.2012AA02A610);上海市科委项目(No.18401900700);上海市申康医院发展中心新兴前沿技术联合攻关项目(No.SHDC120180125);上海市科委科技支撑项目(No.20S21901800)。

摘　　要：目的观察清脂化瘀方对常规他汀类药物治疗后血脂仍未达标的冠心病痰瘀互结证病人血脂、血液流变学及炎性因子的影响。方法选取2018年5月—2019年12月上海某三级甲等医院心血管内科门诊及住院治疗的冠心病痰瘀互结证病人72例,均经常规他汀类药物治疗后血脂仍未达标。按照随机数字表法分为对照组和治疗组,各36例,对照组给予西药常规治疗(阿托伐他汀及其他冠心病二级预防药物)加用安慰剂,治疗组给予西药常规治疗(阿托伐他汀及其他冠心病二级预防药物)及清脂化瘀方治疗。观察两组治疗前后血脂[小而密低密度脂蛋白胆固醇(sdLDL-C)、血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]、血液流变学[全血黏度(高切、低切)、纤维蛋白原(FIB)及红细胞比容]、炎性因子[白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]的变化,比较两组中医证候疗效。结果治疗组中医证候疗效总有效率高于对照组(88.9%与63.9%,P<0.05)。治疗后,治疗组sdLDL-C、TC、LDL-C、FIB、红细胞比容、TNF-α、IL-6均低于对照组(P<0.05);两组治疗后TG、HDL-C、全血高切黏度、全血低切黏度比较差异均无统计学意义(P>0.05)。结论对于常规他汀类药物治疗后血脂仍未达标的冠心病痰瘀互结证病人,加用清脂化瘀方可进一步降低血清sdLDL-C、TC、LDL-C、FIB、红细胞比容、TNF-α、IL-6水平,改善中医证候。Objective To observe the effects of Qingzhi Huayu Prescription on blood lipid,hemorheology,and inflammatory factors in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome,who failed to reach the standard blood lipid after conventional statins treatment.Methods A total of 72 coronary heart disease patients with phlegm-blood stasis syndrome who failed to reach the standard blood lipid levels after routine statin therapy were selected.The patients were divided into control group and treatment group,with 36 patients in each group.The patients in control group were given western medicine(atorvastatin and other secondary prevention drugs for coronary heart disease)plus placebo.The patients in treatment group were given western medicine conventional treatment(atorvastatin and other secondary prevention drugs for coronary heart disease)plus Qingzhi Huayu Prescription.The blood lipid[small and low density lipoprotein cholesterol(sdLDL-C),total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterin(LDL-C),and high density lipoprotein cholesterol(HDL-C)],hemorheology[whole blood viscosity(high and low shearing),fibrinogen(FIB),and hematocrit(HCT)],inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and traditional Chinese medicine(TCM)syndrome effect were compared between two groups.Results The total effective rate of TCM syndrome in treatment group was higher than that in control group(88.9%and 63.9%,P<0.05).After treatment,the levels of sdLDL-C,TC,LDL-C,Fib,HCT,TNF-α,and IL-6 in treatment group were lower than those in control group(P<0.05).There were no significant differences in TG,HDL-C,whole blood high shear viscosity,and whole blood low shear viscosity between the two groups after treatment(P>0.05).Conclusion Qingzhi Huayu Prescription combined with conventional western medicine can reduce the levels of sdLDL-C,TC,LDL-C,Fib,HCT,TNF-α,and IL-6,and improve the TCM syndrome in coronary heart disease patients with phlegm-blood stasis syndrom,who failed to rea

关 键 词：冠心病 痰瘀互结证 清脂化瘀方 血脂 血液流变学 炎性因子 

分 类 号：R54[医药卫生—心血管疾病]