穴位埋线联合阿托伐他汀钙治疗老年人高脂血症的随机对照试验  

Acupoint Catgut Embedding Combined with Atorvastatin Calcium in the Treatment of Hyperlipidemia in the Elderly:a Randomized Controlled Trial

作　　者：刘美玲 赵天易 顾吉 郭义[2] LIU Meiling;ZHAO Tianyi;GU Ji;GUO Yi(Department of Traditional Chinese Medicine,Malu Community Health Service Center of Jiading District,Shanghai 201801,China;Tianjin University of Traditional Chinese Mdeicine,Tianjin 301617,China)

机构地区：[1]上海市嘉定区马陆镇社区卫生服务中心中医科,201801 [2]天津中医药大学,天津市301617

出　　处：《中国全科医学》2024年第5期535-546,共12页Chinese General Practice

基　　金：上海市进一步加快中医药事业发展三年行动计划项目[ZY(2018-2020)-ZYBZ-46];嘉定区第三批中医药重点学科(专科)建设项目(2020-JDZYYZDXM-02)。

摘　　要：背景2012年我国成年人血脂异常患病率达40.4%,血脂异常是动脉粥样硬化性心血管疾病(ASCVD)发生的独立危险因素,老年人又是血脂异常和慢性病的高危人群,前期调查结果显示上海市马陆辖区老年人血脂异常患病率达63%,故有效控制血脂异常的意义重大。目的探索采用穴位埋线联合阿托伐他汀钙干预马陆辖区老年人高脂血症的协同作用,为防治老年人高脂血症提供依据,指导临床实践。方法本研究为单中心随机对照试验,于2020-05-10—08-04在上海市嘉定区马陆镇社区卫生服务中心门诊招募老年高脂血症患者119例。采用随机简单数字分组方法将患者分为埋线组(n=59)和对照组(n=60)。埋线组采用穴位埋线联合阿托伐他汀钙治疗,埋线每2周1次,4次1个疗程,同时口服10 mg/d阿托伐他汀钙片;对照组仅口服10 mg/d阿托伐他汀钙片,干预周期为8周。主要观察指标为低密度脂蛋白胆固醇达标率和血脂水平改善情况,并探索该治疗方案在不同人群中的效应。结果主要结局指标:两组治疗后低密度脂蛋白胆固醇达标率分别为79.5%(35/44)、71.4%(30/42);两组总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇治疗前后差值以及随访1个月时水平比较,差异均无统计学意义(P>0.05)。次要结局指标:两组载脂蛋白A、载脂蛋白B、脂蛋白a、空腹血糖和糖化白蛋白治疗前后差值比较,差异均无统计学意义(P>0.05);两组BMI治疗前后差值、治疗后、随访1个月比较,差异均无统计学意义(P>0.05);治疗后埋线组中医证候积分高于对照组(P<0.001)。不良反应:埋线组谷氨酰转移异常升高率低于对照组(P<0.05)。结论穴位埋线联合阿托伐他汀钙可以调节老年人的血脂水平,在改善中医证候积分和减轻阿托伐他汀钙的不良反应方面有优势。Background The prevalence of dyslipidemia among adults in China reached 40.4%in 2012,and dyslipidemia is an independent risk factor for atherosclerotic cardiovascular diseases(ASCVD),and the elderly are at high risk for dyslipidemia and chronic diseases.The results of the previous survey showed that the prevalence of dyslipidemia among the elderly in the Malu district of Shanghai was 63%,therefore,it is of great significance to control dyslipidemia effectively.Objective To explore the synergistic effect of using acupoint catgut embedding combined with atorvastatin calcium to intervene in hyperlipidemia among the elderly in Malu district,so as to provide a basis for preventing and treating hyperlipidemia in the elderly and guide clinical practice.Methods As a single-center randomized controlled trial,a total of 120 elderly patients with hyperlipidemia recruited in the outpatient clinic of Malu Community Health Service Center of Jiading District from 2020-05-10 to 2020-08-04 were randomly divided into the treatment(n=59)and control groups(n=60)in a 1∶1 ratio by using simple random digit grouping methods.The treatment group was treated with acupoint catgut embedding combined with atorvastatin calcium,and the embedding was performed once every 2 weeks,4 times for a course of treatment,while taking 10 mg of oral atorvastatin calcium tablets daily;the control group received only 10 mg of oral atorvastatin calcium tablets daily for 8 weeks of the intervention cycle.The main observational indexes were LDL cholesterol compliance and improvement in lipid levels,and the effect of this treatment regimen in different populations were explored.Results The primary outcome indicators included that the LDL cholesterol compliance rates were 79.5%and 71.4%in the two groups after treatment,respectively;there was no significant difference in the comparison of total cholesterol,triglycerides,low density lipoprotein cholesterol and high density lipoprotein cholesterol before and after treatment and 1 month of follow-up in the two gro

关 键 词：高脂血症 老年人 穴位埋线疗法 阿托伐他汀钙 随机对照试验 

分 类 号：R589.2[医药卫生—内分泌]