颈动脉斑块与中医体质相关性临床观察

Study of Relationship between Carotid Artery Plaque and Constitution of TCM

目的:研究颈动脉斑块与中医体质的相关性。方法:在本科室门诊及住院病人中,经颈动脉超声检查,筛选出100例颈动脉粥样硬化斑块形成的病例作为观察对象(试验组1),另随机选出100例无颈动脉粥样硬化斑块的病例作为对照组1。对两组病人分别进行中医体质辨识,得出结论,并进行统计分析,得出颈动脉斑块与中医体质的相关性。然后把100例有斑块的病例再次分为试验组2和对照组2各50例,试验组服用瑞舒伐他汀每次10 mg,每晚1次,另服用本科室经验方—软脉化斑汤,对照组仅服用瑞舒伐他汀每次10 mg,每晚1次,两组病人均低脂饮食及适当锻炼。观察12周,重新测定斑块的大小及性质,并重新进行体质辨识,通过分析软件进行分析。结果:与无颈动脉斑块的病例比较,有颈动脉斑块的病例体质辨识中首先以痰湿质、瘀血质,其次以阳虚质为多见。有颈动脉斑块的病例,经过12周的治疗,试验组斑块的大小及性质变化优于对照组,经缩小及稳定斑块治疗,患者的原体质评价得分已有明显降低。结论:与无颈动脉斑块的病例比较,有颈动脉斑块的病例体质辨识中首先以痰湿质、瘀血质,其次以阳虚质为多见。软脉化斑汤与瑞舒伐他汀协同使用,有助于缩小颈动脉斑块,并增强其稳定性。缩小及稳定斑块有助于体质的改善。

Objective ：To investigate the relationship between carotid artery plaque and constitution of TCM. Methods：In the outpatient and inpatient,by carotid artery ultrasound screening, 100 cases of carotid atherosclerotie plaque formation were as ob- served objects （test group 1 ） ,another randomly selected 100 cases without carotid atherosclerosis were as control group 1The patients in the two groups were determined the TCM constitutions, drawing the conclusion and making the statistical analysis on cor- relation between the carotid artery plaque and TCM constitution. Then the 100 cases with plaque again were divided into the test group 2 and the control group 2 with 50 cases in each group, rosuvastatin 10mg each time, once every night, taking the experienced prescription of our departments -Ruanmai Huaban Decoction, the control group 2 only took rosuvastatin 10mg every time, once every night ,patients in both the two groups were asked a low- fat diet and exercise. After 12 weeks observation, determination of the size and nature of plaque was carried out again to determine their TCM constitution again, and then the data was analyzed through the analysis of software. Results ： Compared with cases without carotid plaque, a physical identification of cases of carotid plaque in first was phlegm dampness ,blood stasis ,followed by Yang deficiency. After 12 weeks treatment, the size and nature of plaque of carotid artery in the test group were better than that of control group. After reduced and plaque stabilization treatment, original constitution evaluation score of patients was decreased significantly. Conclusion： Compared with cases without carotid plaque, TCM constitution of cases of carotid plaque in first was phlegm dampness, blood stasis, followed by Yang deficiency. Ruan- mai Huaban Decoction and rosuvastatin cooperative application can help narrow the carotid artery plaque, and enhance its stability and narrowing and improving the stability of plaque contribute to the constitution.