通心络治疗颈动脉粥样硬化临床分析

Clinical Study of Tongxinluo capsule in the treatment of carotid atheronecerosis

目的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60例诊断脑供血不足的门诊患者,经Hpsonos5500型超声仪,证实颈动脉内膜有硬化改变或硬化斑块,随机分为治疗组和对照组,各30例。治疗组给予通心络胶囊4粒,每天3次,对照组给予阿司匹林每天75mg,辛伐他汀(舒降之)每天20mg,均连服180d。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,彩色多普勒超声检查颈动脉粥样硬化情况,观察内-中膜厚度(IMT)、内外表面情况及硬化斑的变化。结果2组用药前血浆OX-LDL及MCP-1水平相当,差异无统计学意义(P>0.05)。治疗180d后,2组平均水平明显下降,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<0.01);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2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。患者对通心络胶囊的耐受性良好,有高度依从性。

Objective To investigate the depressant effect on the patients with carotid atheroselerosis. Methods 60 patients with carotid atheroselerosis complicated by cerebral blood supply unsatisfaetion , 30 of whom, as the test group, were treated with Tongxinlao （dose：4 pias tid ） and the rest, as the control group, were given Simvastatin （dose： 20rag 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 different treat groups after 6-month treatment . Results The levels of serum OX-LDL and MCP-1 of the two groups had no difference before treatments （ P 〉 0.05 ）. After 6 months treating , the levels of serum OX-LDL and MCP-1 of the control group were lower significantly than those of the test group （ P 〈 0.01 ）. （ 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 of the test group and the control group were effective in the treatment of carotid atheroselerosis. The efficiency of the two therapies were nearly equal.