复方芪参降脂饮对不同证型颈动脉粥样硬化患者易损斑块稳定性的影响

The Influence of Compound Qishen Jiangzhi Decoction on Stability of Carotid Atherosclerotic Vulnerable Plaque

目的观察复方芪参降脂饮对颈动脉粥样硬化(AS)患者易损斑块稳定性的影响。方法 258例颈AS斑块患者,按中医辨证分为痰湿阻滞证、瘀阻脉络证、浊毒内蕴证和肝肾亏虚证、气虚证5型。给予复方芪参降脂饮口服,疗程为6个月。检查各证型患者治疗前后颈动脉斑块内膜中层厚度(IMT)、斑块面积、斑块积分及血脂、高敏C-反应蛋白(hs-CRP)变化。结果颈AS患者易损斑块分布以瘀阻脉络证和浊毒内蕴证组远大于其他证组(P<0.05)。治疗后瘀阻脉络证、浊毒内蕴证、气虚证组颈动脉易损斑块IMT、斑块面积、斑块积分及血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、hs-CRP水平较治疗前显著降低(P<0.05)。结论复方芪参降脂饮对稳定瘀血、浊毒、气虚证易损斑块效果明显。其作用机制可能是通过调脂及抗炎作用实现的。

Objective To observe the effects of compound Qishen Jiangzhi decoction（CQJD） on the stability of carotid atherosclerotic vulnerable plaque.Methods Two hundred and fifty-eight patients（pts） with carotid atherosclerosis were assigned to five groups according to the syndrome differentiation of traditional Chinese medicine（TCM）：Phlegm-damp syndrome group,blood stasis syndrome group,turbid toxins syndrome group,deficiency syndrome of liver and kidney group,and qi-deficiency syndrome group.The intima-media thickness（IMT）,area of atherosclerotic clots and plaque score were examined,serum lipids and high sensitivity C-reactive protein（hs-CRP） were measured before and after treatment for 6 months.Results IMT,area of atherosclerotic clots,the plaque score,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C） and hs-CRP in blood stasis syndrome group,turbid toxins syndrome group and qi-deficiency syndrome group were lower significantly compared with other groups（P0.05）.Conclusion CQJD could stabilize the vulnerable plaque of carotid atherosclerosis in pts with blood stasis syndrome,turbid toxins syndrome,and qi-deficiency syndrome.