加味五虫散治疗老年高血压颈动脉粥样硬化病变80例

Clinical efficacy of modified Wuchong powder in elderly hypertensive patients with carotid atherosclerosis: a report of 80 cases

目的:观察加味五虫散对老年高血压颈动脉粥样硬化病变患者的临床疗效及血脂、血管活性物质、肝肾功能、心肌安全性的影响。方法:将160例该病患者随机分为两组各80例,对照组予西医常规治疗,治疗组在对照组治疗基础上加服加味五虫散治疗,两组均以1个月为1个疗程,共治疗6个疗程。观察两组治疗前后临床症状、血脂、血管活性物质、肝肾功能及心肌酶指标水平的变化。结果:证候疗效总有效率治疗组为95.0%,对照组为82.5%,两组比较,差异有统计学意义(P<0.05);治疗组治疗后TC、TG、LDLC、ET下降,HDLC、NO升高,与治疗前比较,差异有统计学意义(P<0.05),对照组治疗后TC、TG下降,较治疗前差异有统计学意义(P<0.05),HDLC、LDLC、ET、NO水平变化较治疗前差异无统计学意义(P>0.05),但治疗组上述指标变化程度与对照组比较,差异均有统计学意义(P<0.05);两组治疗后肝肾功能及心肌酶指标水平较治疗前差异均无统计学意义(P>0.05),组间比较差异均无统计学意义(P>0.05)。结论:加味五虫散可明显改善患者临床症状,有效延缓老年高血压颈动脉粥样硬化病变的进程,并在调节血脂、血管活性物质等方面疗效确切,且安全可靠,值得推广。

Objective：To observe the clinical efficacy of modified Wuchong powder in elderly hypertensive pa tients with carotid atherosclerosis and its effects on blood lipids, vasoactive substances, hepatic and renal function, and myocardial safety. Methods：A total of 160 elderly hypertensive patients with carotid atherosclerosis were ran domly divided into treatment group （ n = 80 ） and control group （ n = 80 ）. The control group received conventional Western medicine treatment,while the treatment group received modified Wuchong powder in addition to the con ventional Western medicine treatment. Six courses of treatment were performed in both groups, with each course last ing for one month. The clinical symptoms, blood lipids, vasoactive substances, hepatic and renal function, and myo cardial enzymes were evaluated and measured before and after treatment. Results：According to the improvements in syndromes,the treatment group had a significantly higher overall response rate than the control group （95.0% vs 82.5 %, P 〈 0. 05 ）. After treatment, the treatment group showed significant decreases in total cholesterol （ TC ）, tri glyceride （ TG）, low - density lipoprotein cholesterol （ LDLC ）, and endothelin （ P 〈 0. 05 ） and significant increases in high - density lipoprotein cholesterol（ HDLC ） and nitric oxide （ NO ） （ P 〈 0. 05 ） ; the control group showed signifi cant decreases in TC and TG （ P 〈 0.05 ）, but without significant changes in HDLC, LDLC, ET, and NO （ P 〉 0. 05）,but the treatment group the index changes compared with the control group had a significant differences （ P 〈 0. 05 ）. In addition, neither group showed significant changes in hepatic and renal function and myocardial en- zymes after treatment（P 〉 0. 05 ）, and there were no significant differences between the two groups （P 〉 0.05 ）. Conclusion：Modified Wuchong powder can significantly relieve clinical symptoms, effectively delay disease progres sion, and regulate blood lipids and vasoactive substances in elderly hypertensive patients with carotid atherosclerosis. It is safe and reliable and holds promise for clinical application.