血府逐瘀汤联合阿托伐他汀钙治疗高脂血症痰湿内阻证临床观察  

Clinical Observation on Xuefu Zhuyu Tang Joined with Atorvastatin Calcium in the Treatment of Hyperlipidemia of Phlegm-dampness Internal Obstruction Pattern

作　　者：郁文恺 王凯 曹凯峰 倪静 常琎文 YU Wenkai;WANG Kai;CAO Kaifeng;NI Jing;CHANG Jinwen(Linfen Road Street Community Health Service Center of Jing'an District Affiliated to Shanghai University of TCM,Shanghai 200040,China;Dongjing Community Health Service Center of Songjiang District,Shanghai 201607,China;Shanghai Third Rehabilitation Hospital,Shanghai 200040,China)

机构地区：[1]上海中医药大学附属静安区临汾路街道社区卫生服务中心,上海200040 [2]上海市松江区洞泾镇社区卫生服务中心,上海201607 [3]上海市第三康复医院,上海200040

出　　处：《西部中医药》2024年第9期150-153,共4页Western Journal of Traditional Chinese Medicine

基　　金：2019年上海市“医苑新星”青年医学人才培养计划(沪卫人事〔2020〕87号)。

摘　　要：目的:观察血府逐瘀汤加减联合阿托伐他汀钙治疗高脂血症痰湿内阻证的临床疗效。方法:将高脂血症痰湿内阻证患者74例按照随机数字表法分为对照组和观察组各37例,对照组口服阿托伐他汀钙治疗,观察组口服阿托伐他汀钙+血府逐瘀汤加减治疗,两组患者均以4周为1个疗程,共治疗2个疗程。比较两组患者血脂指标[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)]、血管内皮功能指标[内皮素1(endothelins-1,ET-1)、一氧化氮(nitric oxide,NO)、6-酮-前列腺素F-1α(6-keto-PGF-1α)、血栓素B2(thromboxane B2,TXB2)]水平变化情况及临床疗效与不良反应发生情况。结果:治疗后两组患者LDL-C及TG、TC水平较治疗前降低(P<0.05),HDL-C较治疗前升高(P<0.05),组间比较差异有统计学意义(P<0.05);治疗后观察组患者6-keto-PGF-1α、NO水平较治疗前升高(P<0.05),TXB2、ET-1水平较治疗前降低(P<0.05),组间比较差异有统计学意义(P<0.05);观察组总有效率为94.6%(35/37),高于对照组的78.4%(29/37)(P<0.05);观察组不良反应发生率为27.0%(10/37),低于对照组的8.1%(3/37)(P<0.05)。结论:阿托伐他汀钙联合血府逐瘀汤可改善高脂血症痰湿内阻证患者血脂、血管内皮功能,提高临床疗效,降低不良反应发生率。Objective:To observe clinical effects of modified Xuefu Zhuyu Tang(Xuefu stasis-removing decoction)combined with atorvastatin calcium in the treatment of hyperlipidemia of phlegm-dampness internal obstruction pattern.Methods:All 74 patients were allocated to the control group and the observation group according to random number table method with 37 cases in each group,the control group was treated by atorvastatin calcium tablets,and the observation group took atorvastatin calcium tablets and modified Xuefu Zhuyu Tang,four weeks were one course of the treatment,and both groups were treated for two courses of the treatment.To compare the levels of blood lipid indicators including TC,TG,LDL-C and HDL-C,the indexes of vascular endothelial function such as ET-1,NO,6-keto-PGF-1αand TXB2,curative effects and the incidences of adverse reactions between the two groups.Results:After the treatment,LDL-C,TG and TC levels in the two groups were lower than before the treatment(P<0.05),HDL-C levels elevated than pre-treatment levels(P<0.05),and the differences had statistical meaning between the groups(P<0.05),after the treatment,the levels of 6-keto-PGF-1αand NO went up than pre-treatment level in the observation group(P<0.05),TXB2 and ET-1 levels reduced than pre-treatment level(P<0.05),and the differences had statistical meaning between the groups(P<0.05),total effective rate of the observation group was 94.6%(35/37),higher than 78.4%(29/37)of the control group of the control group(P<0.05);the incidences of adverse reaction of the observation group was 27.0%(10/37),lower than 8.1%(3/37)of the control group(P<0.05).Conclusion:Atorvastatin calcium and Xuefu Zhuyu Tang could improve blood lipid,vascular endothelial function,and clinical effects,and decrease the incidences of adverse reaction in treating phlegm-dampness internal obstruction type of hyperlipidemia.

关 键 词：高脂血症 痰湿内阻证 血脂 血管内皮功能 阿托伐他汀钙 血府逐瘀汤 

分 类 号：R243[医药卫生—中医临床基础]