益气活血化痰方治疗老年下肢动脉粥样硬化疾病

Efficacy of Yiqi Huoxue Huatan Decoction for Aged Lower Extremity Atherosclerotic Disease

目的:观察益气活血化痰方对老年下肢动脉粥样硬化疾病(LEAD)中医证候积分、血脂[总胆固醇(TC),甘油三脂(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C)],血浆D-二聚体(D-Di),C反应蛋白(CRP),股动脉内-中膜厚度(IMT),踝臂指数(ABI)及肱踝脉搏波速度(ba PWV)的影响。方法:选取符合纳入标准的患者66例,随机分成治疗组和对照组,各33例。对照组予辛伐他汀片40 mg,qd,拜阿司匹林片100 mg,qd;治疗组在对照组基础上加用益气活血化痰方治疗,并随访12周,观察治疗前后两组患者中医证候评分,血脂,D-Di,CRP,股动脉IMT,ABI,ba PWV的变化,并监测血、尿、便常规及肝、肾功能。结果:治疗后两组患者中医证候评分均低于治疗前(P<0.05),治疗组低于对照组(P<0.05)。与治疗前比较,治疗后两组患者LDL-C,D-Di,ba PWV水平均明显下降(P<0.05),且治疗组低于对照组(P<0.05)。结论:益气活血化痰方联合辛伐他汀、拜阿司匹林能够有效地改善老年下肢动脉粥样硬化患者中医证候评分,降低LDL-C,D-Di,ba PWV,可能对改善动脉僵硬度有益。

Objective： To observe the effect of Yiqi Huoxue Huatan decoction on traditional Chinese medicine （TCM） syndrome scores, blood lipid indicators [ total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein cholesterol （ HDL-C ） , low-density lipoprotein cholesterol （ LDL-C ） ] , D-dimer （D-Di） , C-reactive protein （CRP） , intra media thickness （IMT） , ankle brachial index （ABI） and brachial-ankle pulse wave velocity （baPWV） in aged patients with lower extremity atherosclerotic disease （LEAD）. Method： The 66 eligible patients were randomly divided into treatment group （33 cases） and control group （33 cases）. Patients in control group were treated with simvastatin tablets （40 rag, qd） and asprin tables （100 mg, qd） , patients in treatment group additionally received Yiqi Huoxue Huatan decoction based on the treatment in control group. Patients were followed up for 12 weeks to observe the changes in TCM symptom scores, blood lipid indicators, D-Di, CRP, IMT, ABI and baPWV before and after treatment. In addition, the hepatic and renal functions were monitored and three routine tests （blood, urine and stool） were conducted. Result： TCM symptom scores in both groups were lower than those before treatment （P 〈 0.05 ） , and TCM symptom scores in treatment group were lower than those in control group after treatment （P 〈 0.05）. LDL-C, D-Di and baPWV levels in both groups were significantly lower than those before treatment （P 〈 0.05） , and the above levels in treatment group were lower than those in control group after treatment （P 〈 0.05）. Conclusion： Yiqi Huoxue Huatan decoction combined with simvastatin and asprin can effectively improve the TCM symptom scores, and reduce LDL-C, D-Di and baPWV levels in aged patients with lower extremity atherosclerotic disease （LEAD） , and it may be helpful to improve arterial stiffness.