补肾活血化痰法干预颈动脉粥样硬化斑块的临床研究

Clinical research of nourishing kidney resolving blood and phlegm medicine in treating with carotid atherosclerotic plaque

目的:观察补肾活血化痰法干预颈动脉粥样硬化斑块患者的临床疗效。方法:收集207例颈动脉粥样硬化斑块患者,按随机数字表法分为治疗组与对照组:治疗组101例,对照组106例。治疗组予西药基础治疗+补肾活血化痰中药,对照组予单纯西药治疗,两组均观察用药12周。进行中医证候疗效评定、颈动脉斑块及血流检测,评价治疗的效果。结果:治疗组的中医证候疗效显著好于对照组(P<0.01);与本组治疗前及对照组比较,治疗组治疗后颈动脉内膜-中层厚度、颈动脉不稳定斑块的数目、斑块Crouse积分均显著降低(P<0.05);治疗后治疗组颈总动脉收缩期最大血流速度、舒张期最小血流速度、搏动指数与治疗前水平及对照组比较,均有显著改善(P<0.05);两组治疗后总胆固醇和低密度脂蛋白均较治疗前水平显著改善(P<0.05)。结论:补肾活血化痰中药在改善颈动脉粥样硬化斑块患者的中医证候、颈动脉斑块和血流方面具有较好的疗效,值得进一步研究和运用。

Objective： To research the clinical effect of nourishing kidney resolving blood and phlegm medicine in treating with carotid atherosclerotic plaque patients. Methods： 207 patients were randomly divided into control group （n=106） and treatment group （n=101）. Control group was treated with only western medicine and treatment group was treated with both Chinese medicine and western medicine. The two groups were observed 12 weeks. The clinical effect was evaluated by Chinese medicine syndromes assessment standards and ultrasound. Results： Chinese medicine syndrome clinical effect of treatment group was better than control group （P〈0.01）. After the treatment of Chinese medicine, the IMT, number of plaques, score of Crouse, were significantly reduced than control group and pre-treatment of the same group （P〈0.05）. Vmax, Vmin PI and lipids were better than control group and pre-treatment of the same group （P〈0.05）. Conclusion： Nourishing kidney resolving blood and phlegm medicine have good clinical effect in treating with carotid atherosclerotic plaque.