通心络治疗颈动脉粥样硬化30例临床分析

A Clinical- Contral Intervention Study On The Patents With Carotid Atheosclerosis

目曲探讨通心络是否对颈动脉粥样硬化的发展有抑制作用。方法30例诊断“脑供血不足”的门诊病人，经Hpsonos5500型超声仪，证实颈动脉内膜有硬化改变或硬化斑块，随机进入通心络治疗或对照组。治疗组投给通心络胶囊4粒，3／d，对照组投给阿斯匹林75mg／d、舒降之20mg／d，均连服180天。试验前后测定血清氧化低密度脂蛋白（OX-LDL）、单核细胞趋化因子（MCP-1）水平的变化，彩超检查颈动脉粥样硬化情况，观察内-中膜厚度（IMT）、内皮表面情况及硬化斑的变化。结果（1）服药半年后两组血浆OX-LDL及MCP-1含量均显著下降（P〈0．001）；（2）两组用药前血浆OX-LDL及MCP-1水平相当，无显著性差异（p〉0．05）。治疗180天后，两组水平均明显下降，但对照组下降程度较试验组更明显，组间差异具有显著性（p〈0．001）；（3）彩超示对照组血管IMT有所增加，试验组IMT有轻微增加，但无显著性差异（p〉0．05）。结论两组干预对颈动脉粥样硬化的发展均有一定影响，其作用程度相近。病人对通心络胶囊的耐受良好，有高度依从性。

Objective To investigate the intervention effect on the patients with carotid atherosclerosis. Methods 30 patients with carotid atherosclerosis complicated by cerebral blood supply unsatisfaction , 30 of whom, as the test group, were treated with Tongxinluo （dose ：4# tid ） and the rest, as the control group,were given Simvastatin （dose： 20mg qd ） and aspirin （dose：75mg qd ） for treatment 6 months. Before and after the treatment , determine the IMT of carotid artery, measure OX - LDL and MCP - 1 in serum. Compare the changes between the dif- ferent treat groups after 6 - month treatment. Results （ 1 ） The levels of serum OX - LDL and MCP - 1, either in the patients of the test group, or of the control group were decreased significantly （ p 〈0.001 ）. （2） The levels of serum OX - LDL and MCP - 1 of the two groups had no difference at the first （ p 〉 0.05 ） . After 6 months treating , levels of serum OX - LDL and MCP - 1 of the control group were lower sig- nificantly than those of the test group（ p 〈 0.001 ）. （3） The carotid artery IMT of the test group and the control group began to become a little thicker after having been given treating in 6 months, but the changes were not significant （ p 〉 0.05 ）. Conclusion This study revealed that the therapies both of the test group and the control group were effective in treating carotid atherosclerosis. The efficiency of the two therapies were nearly equal.