二陈汤合泽泻汤治疗高脂血症的疗效及对颈动脉斑块、血清TNF-α、IL-1β表达的影响  

The therapeutic effect of Erchen decoction and Zexie decoction on hyperlipidemia and its influences on carotid plaque,serum TNF-αand IL-1βexpression

作　　者：方明珠 陈代平[1] 徐艳秋[2] FANG Mingzhu;CHEN Daiping;XU Yanqiu(Department of Nephrology,Jinshan Branch,Shanghai Sixth People's Hospital,Shanghai 201500,China;Department of Nephrology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海市第六人民医院金山分院肾内科,上海201500 [2]上海中医药大学附属岳阳中西医结合医院肾内科,上海200437

出　　处：《四川中医》2024年第12期97-100,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市金山区医药卫生科技创新资金项目(编号2022-WS-37)。

摘　　要：目的:探究二陈汤合泽泻汤治疗高脂血症的疗效及对颈动脉斑块、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)表达的影响。方法:选择2022年6月~2023年2月我院收治的60例气虚痰瘀互结型高脂血症患者,利用随机数字表法分为对照组(30例,采用阿托伐他汀钙进行治疗)与研究组(30例,采用阿托伐他汀钙联合二陈汤合泽泻汤进行治疗),收集患者的临床资料并比较两组患者的临床疗效、血脂水平、颈动脉内-中膜厚度(IMT)、颈动脉内膜斑块面积、血清TNF-α、IL-1β水平及不良反应发生率。结果:与对照组相比,研究组的总有效率显著增加(P<0.05)。治疗前,两组高脂血症患者的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、IMT、颈动脉内膜斑块面积、TNF-α及IL-1β水平比较差异均不显著(P>0.05);治疗后,两组高脂血症患者的TG、TC、LDL-C、IMT、颈动脉内膜斑块面积、TNF-α及IL-1β均降低,HDL-C升高(P<0.05),且上述指标研究组改善的效果更为显著(P<0.05)。与对照组相比,研究组不良反应的总发生率降低,但两组之间差异不显著(P>0.05)。结论:二陈汤合泽泻汤治疗高脂血症患者的疗效确切,可缩小患者颈动脉斑块面积,改善患者血脂水平,并抑制炎症反应,安全性好,值得推广。Objective:To investigate the therapeutic effect of Erchen decoction and Zexie decoction on hyperlipidemia and its influences on carotid plaque,serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)expression.Methods:From June 2022to February 2023,60patients with hyperlipidemia of Qi deficiency phlegm blood stasis type admitted to our hospital were randomly divided into the control group(30cases,treated with atorvastatin calcium)and the study group(30cases,treated with atorvastatin calcium combined with Erchen decoction and Zexie decoction),the clinical data of patients were collected,and the clinical efficacy,blood lipid level,carotid intima-media thickness(IMT),carotid intima plaque area,serum TNF-α,IL-1βlevel and adverse reaction rate of the two groups were compared.Results:Compared with the control group,the total effective rate of the study group was obviously higher(P<0.05).Before treatment,there was no obvious difference in total cholesterol(TC),triacylglycerol(TG),highdensity lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),IMT,carotid intimal plaque area,TNF-αand IL-1βlevels between the two groups(P>0.05);after treatment,the levels of TG,TC,LDL-C,IMT,carotid intimal plaque area,TNF-αand IL-1βin hyperlipidemia patients in both groups decreased,the level of HDL-C increased(P<0.05),the improvement effect of the above indicators in the study group was more obvious(P<0.05).Compared with the control group,the total incidence of adverse reactions in the study group decreased,but there was no obvious difference between the two groups(P>0.05).Conclusion:Erchen decoction combined with Zexie decoction has a definite effect on hyperlipidemia patients.It can reduce the area of carotid plaque,improve the blood lipid level,and inhibit inflammatory reaction.It is safe and worthy of promotion.

关 键 词：高脂血症 二陈汤合泽泻汤 颈动脉斑块 阿托伐他汀钙 肿瘤坏死因子-Α 

分 类 号：R589.2[医药卫生—内分泌]