调脂通脉颗粒对原发性高血压伴颈动脉粥样硬化患者血脂水平及血清RBP-4、SPARC的影响  

Effect of Tiaozhitongmai Granules on blood lipid level,serum RBP-4 and SPARC in patients with essential hypertension and carotid atherosclerosis

作　　者：杨会林 户宗英 徐岩 YANG Hui-lin;HU Zong-ying;XU Yan(Department of Yuehua Internal Medicine,Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102499,China)

机构地区：[1]北京中医药大学房山医院月华内科,北京102499

出　　处：《临床和实验医学杂志》2024年第8期805-809,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市科技计划项目(编号:B2020001965)。

摘　　要：目的 观察调脂通脉颗粒对原发性高血压伴颈动脉粥样硬化(CAS)患者血脂水平及血清视黄醇结合蛋白-4(RBP-4)、富含半胱氨酸的酸性分泌蛋白(SPARC)的影响。方法 前瞻性选取2021年5月至2023年5月于北京中医药大学房山医院收治的116例原发性高血压伴CAS患者作为研究对象,按照随机数字表法将其分为对照组和试验组,每组各58例。两组均给予苯磺酸氨氯地平片、辛伐他汀片治疗,试验组在常规基础上给予调脂通脉颗粒治疗,对照组在常规基础上给予安慰剂治疗,连续用药4周。检测并比较两组治疗前和治疗4周后的血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、RBP-4、SPARC、脂蛋白相关磷脂酶A2(Lp-PLA2)、颈动脉血流动力学[颈总动脉舒张期峰流速(EDV)、收缩期峰流速(PSV)、搏动指数和阻力指数]水平、颈动脉内膜中层厚度(IMT)、斑块厚度及中医症状评分,并记录两组患者治疗期间的不良反应发生情况。结果 治疗4周后,试验组总胆固醇、甘油三酯、LDL-C水平分别为(4.21±0.69)、(1.87±0.31)、(2.21±0.42) mmol/L,均低于对照组[(4.89±0.81)、(2.24±0.39)、(2.67±0.54) mmol/L],HDL-C水平为(1.32±0.30)mmol/L,高于对照组[(1.21±0.27)mmol/L],差异均有统计学意义(P<0.05)。治疗4周后,试验组RBP-4、SPARC、Lp-PLA2水平分别为(36.58±5.77) mg/L、(2.16±0.35) ng/mL、(163.32±38.74) ng/L,均低于对照组[(43.86±6.95) mg/L、(2.31±0.40) ng/mL、(180.74±45.61) ng/L],差异均有统计学意义(P<0.05)。试验组治疗4周后EDV、PSV分别为(24.52±2.27)、(67.27±5.27) cm/s,均高于对照组[(22.14±2.30)、(59.13±5.04) cm/s],搏动指数、阻力指数分别为0.65±0.21、0.55±0.15,均低于对照组(0.87±0.25、0.73±0.21),差异均有统计学意义(P<0.05)。试验组治疗4周后IMT、斑块厚度、中医症状评分分别为(0.86±0.11) mm、(1.63±0.32) mm、(8.02±1.12)分,均低于对照组Objective To observe the effects of Tiaozhitongmai Granules on blood lipid level,serum retinol-binding protein-4(RBP-4) and secreted protein acidic and rich in cysteine(SPARC) in patients with essential hypertension and carotid atherosclerosis(CAS).Methods A total of 116 patients with essential hypertension and CAS admitted to Fangshan Hospital,Beijing University of Chinese Medicine from May 2021 to May 2023 were prospectively selected as the study subjects.They were divided into the control group and the experimental group according to the random number table method,with 58 cases in each group.Both groups were treated with amlodipine besylate tablets and simvastatin tablets,the experimental group was treated with Tiaozhitongmai Granules on the basis of routine treatment,and the control group was treated with placebo on the basis of routine treatment for 4 weeks.The blood lipid[total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],RBP-4,SPARC,lipoprotein-associated phospholipase A2(Lp-PLA2),carotid hemodynamics[end diastolic flow velocity(EDV),peak systolic flow velocity(PSV),pulsatile index,and resistance index] level,carotid intima-media thickness(IMT),plaque thickness,and TCM symptom score before treatment and after 4 weeks of treatment were detected and compared between the two groups.The occurrence of adverse reactions during treatment was recorded for both groups of patients.Results After 4 weeks of treatment,the total cholesterol,triglycerides,and LDL-C levels in the experimental group were(4.21±0.69),(1.87±0.31),and(2.21±0.42) mmol/L,respectively,which were lower than those in the control group [(4.89±0.81),(2.24±0.39),and(2.67±0.54) mmol/L],the HDL-C level was(1.32±0.30) mmol/L,which was higher than that in the control group [(1.21±0.27) mmol/L],and the differences were statistically significant(P<0.05).After 4 weeks of treatment,the levels of RBP-4,SPARC,and Lp-PLA2 in the experimental group were(36.58±5.77) mg/L,(2.16±0.35) ng/

关 键 词：调脂通脉颗粒 原发性高血压 颈动脉粥样硬化 血脂 颈动脉血流 

分 类 号：R259[医药卫生—中西医结合]