五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果  

Study on prevention and treatment of restenosis after vertebrobasilar artery stenting with Wuchong Tongluo Capsule

作　　者：牟磊 徐东成 韩鑫 徐长江[1] 韩坤锜 薛叶潇 牟媛 秦文玲 刘相静[1] 陈哲[1] 高楠[1] Mou Lei;Xu Dongcheng;Han Xin;Xu Changjiang;Han Kunqi;Xue Yexiao;Mou Yuan;Qin Wenling;Liu Xiangjing;Chen Zhe;Gao Nan(Department of Neurology,Rizhao Hospital of Traditional Chinese Medicine Affiliated to Jining Medical College,Rizhao Hospital of Traditional Chinese Medicine Affiliated to Shandong University of Chinese Medicine,Rizhao 276800,China)

机构地区：[1]山东中医药大学附属日照市中医医院、济宁医学院附属日照市中医医院脑病科,山东日照276800

出　　处：《中华脑血管病杂志（电子版）》2024年第5期467-472,共6页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：山东省中医药科技发展计划项目(2019-0807)。

摘　　要：目的探讨五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果。方法选择2019年10月至2021年9月在山东中医药大学附属日照市中医医院确诊的中风病风痰瘀阻证型椎动脉开口支架置入的患者150例,采用双色球分组方式将患者均分为2组,即采取常规西药治疗的对照组(75例)和增加五虫通络胶囊治疗的观察组(75例)。(1)比较2组患者手术前后血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]、血清炎症因子水平[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、收缩期峰值流速(PSV)、舒张末期流速(EDV)、颈动脉内膜中层厚度(IMT)、斑块数量、斑块大小积分、中医证候积分、再狭窄率情况进行比较;(2)比较2组患者手术前后肝酶指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ谷氨酰转移酶(GGT)]及血清肌酐(SCr)指标;(3)比较2组患者手术前后胃肠道反应发生情况。结果2组术前的PSV、EDV、IMT、斑块数量、斑块大小积分、中医证候积分等比较,差异均无统计学意义(P均>0.05);术后6个月,观察组TC、TG、LDL-C、IL-6、TNF-α、hs-CRP、PSV、EDV、IMT、斑块数量、斑块大小积分、中医证候积分、再狭窄率等均低于对照组,差异均有统计学意义(P均<0.05)。2组术前以及术后6个月ALT、AST、GGT、SCr及胃肠道反应比较,差异均无统计学意义(P均>0.05)。结论对于椎动脉开口支架术后患者的治疗,常规西药基础上增加五虫通络胶囊能有效改善血流动力学,减少斑块,改善中医证候,调节炎症因子及血脂水平,对再狭窄的发生具有良好的防治作用。Objective To investigate the effect of Wuchong Tongluo Capsule in preventing and treating restenosis after vertebrobasilar artery stenting.Methods One hundred and fifty patients diagnosed with vertebrobasilar artery stenting,exhibiting the traditional Chinese medicine syndrome of wind,phlegm,and blood stasis due to stroke,were enrolled at our hospital from October 2019 to September 2021.These patients were randomly assigned to two groups using a double-blind method:a control group(75 cases)treated with conventional Western medicine and a treatment group(75 cases)additionally administered Wuchong Tongluo Capsule.The blood lipid levels[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)],serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)],peak systolic flow velocity(PSV),and diastole of the two groups before and after treatment were compared end-stage flow velocity(EDV),carotid intima media thickness(IMT),plaque number,plaque size score,TCM syndrome score and restenosis rate were compared.At the same time,liver enzyme indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),γglutamyl transferase(GGT)],serum creatinine(Scr)were compared between the two groups before and after treatment.Gastrointestinal reactions before and after treatment were also compared.Results There were no significant differences in PSV,EDV,IMT,plaque number,plaque size score and TCM syndrome score between the two groups before surgery(P>0.05).6 months after surgery,the values of TC,TG,LDL-C,IL-6,TNF-α,hs-CRP,PSV,EDV,IMT,plaque number,plaque size integral,TCM syndrome volume and restenosis rate in the treatment group were lower than those in the control group(P<0.05).There was no significant difference in ALT,AST,GGT,Scr and gastrointestinal reaction between the two groups before and after 6 months treatment(P>0.05).Conclusion In the postoperative treatment of patients with vertebrobasilar artery stenting,the addition of Wuchong

关 键 词：五虫通络胶囊 椎动脉开口支架术 再狭窄 炎症因子 血脂水平 

分 类 号：R743.3[医药卫生—神经病学与精神病学]