活血通脉化痰方对冠心病合并高脂血症(痰浊血瘀)型患者血脂、MHR、NLR、PLR、CIMT的影响  

Effect of Huoxue Tongmai Huatan Decoction on blood lipid,MHR,NLR,PLR and CIMT in patients with coronary heart disease complicated by hyperlipidemia(Intermingled Phlegm and Blood Stasis Syndrome)

作　　者：颜靖文 沈艺 王岸 陆瑞峰 郭锦荣 张鞠华 YAN Jingwen;SHEN Yi;WANG An(Department of traditional Chinese medicine,Zhoupu Hospital Affiliated to Shanghai Health College,Shanghai 201318,China;Department of General Practice,Zhoupu Hospital Affiliated to Shanghai Health College,Shanghai 201318,China;Department of Pneumology,Zhoupu Hospital Affiliated to Shanghai Health College,Shanghai 201318,China)

机构地区：[1]上海健康医学院附属周浦医院中医科,上海201318 [2]上海健康医学院附属周浦医院全科,上海201318 [3]上海健康医学院附属周浦医院呼吸科,上海201318

出　　处：《四川中医》2025年第2期123-128,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会卫生行业临床研究专项(编号:20204Y0166);上海市浦东新区科技发展基金民生科研专项基金(编号:PKJ2022-Y100);上海市浦东新区卫生系统学科带头人培养计划(编号:PWRd2023-18)。

摘　　要：目的:探讨活血通脉化痰方对冠心病合并高脂血症(痰浊血瘀)型患者血脂、单核细胞计数/高密度脂蛋白胆固醇比值(MHR)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、颈动脉内膜中层厚度(CIMT)的影响。方法:选取2021年6月~2023年6月本院收治的冠心病合并高脂血症120例,随机分为对照组和观察组各60例。对照组给予常规西药,观察组在对照组的基础上加用活血通脉化痰方。8周后检测两组治疗前后血脂、MHR、NLR、PLR、CIMT的变化,并统计两组中医证候积分以及临床治疗总有效率,监测治疗安全性。结果:治疗后两组高密度脂蛋白胆固醇(HDL-C)较前升高,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、MHR、CIMT、中医证候积分降低(P<0.05);观察组NLR、PLR降低(P<0.05);组间比较发现,观察组血脂指标(HDL-C除外)MHR、NLR、PLR、CIMT、中医证候积分均低于对照组,HDL-C高于对照组(P<0.05);观察组和对照组总有效率分别为96.7%(58/60)和85%(51/60)(P<0.05);两组治疗过程中安全指标正常,未出现严重不良反应。结论:活血通脉化痰方联合常规西药治疗冠心病合并高脂血症可改善血脂、外周炎症指标、CIMT,有效调控LDL-C,减轻炎症反应,提高临床疗效。Objective:It is to explore the effects of Huoxue Tongmai Huatan Decoction on blood lipid,MHR,NLR,PLR and CIMT in patients with coronary heart disease complicated by hyperlipidemia(Intermingled Phlegm and Blood Stasis Syndrome).Methods:The patients(n=120)with coronary heart disease complicated by hyperlipidemia admitted to our hospital from June 2021to June 2023were randomly divided into control group and observation group,with 60patients in each group.The control group was given conventional western medicine,and the observation group was given Huoxue Tongmai Huatan decoction on the basis of the control group.After 8weeks,the changes of blood lipid,MHR,NLR,PLR and carotid IMT before and after treatment were detected in the two groups,and the TCM syndrome scores and the total clinical treatment effective rate of the two groups were counted,and the treatment safety was monitored.Results:After treatment,high-density lipoprotein cholesterol(HDL-C)increased,while total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),monocyte-to-high-density lipoprotein cholesterol ratio(MHR),carotid intima-media thickness(CIMT)and TCM syndrome score decreased in both groups(P<0.05).Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were decreased in the observation group(P<0.05).The comparison between groups showed that blood lipid index(except of HDL-C),MHR,NLR,PLR,CIMT and TCM syndrome score in observation group were lower than those in control group,and HDL-C was higher than those in control group(P<0.05).The total effective rate of observation group and control group was 96.7%(58/60)and 85%(51/60)(P<0.05).There were no serious adverse reactions during the treatment in the two groups.Conclusion:Huoxue Tongma Huatan Decoction combined with conventional western medicine in the treatment of CHD complicated by hyperlipidemia can improve blood lipids,peripheral inflammatory indicators,carotid IMT,effectively regulate LDL-C,reduce inflammation and improve clinical efficacy.

关 键 词：活血通脉化痰方 冠心病 高脂血症 低密度脂蛋白胆固醇 外周炎症 颈动脉内中膜厚度 

分 类 号：R256.2[医药卫生—中医内科学]