益气化痰活血法治疗颈动脉粥样硬化斑块的临床研究

Clinical Observation of Qi-replenishing,Blood-activating and Phlegm-removing Therapy in the Treatment of 60 Cases of Carotid Atherosclerotic Plaques

目的:观察益气化痰活血法治疗颈动脉粥样硬化斑块的临床疗效。方法:将120例颈动脉粥样硬化斑块患者随机分为治疗组60例与对照组60例,对照组予以拜阿斯匹林肠溶片100mg加瑞舒伐他汀片10mg,睡前服,治疗组在对照组治疗的基础上加服益气化痰活血中药汤剂,每日1剂;两组均治疗6个月后观察临床疗效,治疗前后分别测定两组患者颈动脉内径(CAD)、颈动脉粥样硬化斑块面积、颈动脉内膜中层厚度(IMT)、血脂及中医临床症状等指标。结果:治疗后两组颈动脉CAD增宽、IMT变薄、颈动脉粥样硬化斑块面积缩小,并且血清TC、TG、HDL-C、LDL-C、中医临床症状较治疗前有明显好转,两组治疗前后比较差异有统计学意义(P<0.05)。治疗组在治疗后颈动脉CAD较对照组增宽、IMT较对照组变薄、颈动脉粥样硬化斑块面积较对照组缩小,血清TC、TG、LDL-C、中医临床症状均较对照组改善明显,两组比较差异有统计学意义(P<0.05)。结论:益气化痰活血法治疗颈动脉粥样硬化斑块时,在使颈动脉内径(CAD)增宽、颈动脉IMT变薄、颈动脉粥样硬化斑块面积缩小、改善血脂代谢异常方面起到协同作用,对中医临床症状有明显改善,值得临床推广。

Objectives： To discuss the clinical curative effect of Qi-replenishing, Blood-activating and Phlegm-removing Therapy in treatment of carotid atherosclerotic plaques. Methods： 120 patients with carotid atherosclerotic plaques were chosen as the research objects, and they were randomly divided into the controlled group and the treatment group, with 60 cases in each group. The controlled group was given by Bayaspirin plus rosuvastatin, and the treatment group was given Traditional Chinese Medicine medicinal broth of Qi-replenishing, Blood-activating and Phlegm-removing on the basis of the controlled group. The intima-media-thickness （IMT）, carotid artery CAD, carotid plaque area, TC, TG, HDL-C, LDL-C and clinical syndrome of the patients of two groups before and after treatment were measured. Results： After treatment, carotid artery CAD of the two groups was broadening, IMT was thinning, carotid plaque area was reduced, and the serum TC, TG, HDL-C, LDL-C and clinical syndrome were better than that before the treatment, the effect of the two groups before and after treatment had significant difference （P 〈 0. 05）. Comparing the two groups after treatment, carotid CAD of the treatment group was wider than that of the controlled group, IMT of the treatment group was thinner than that of the controlled group, and the carotid plaque area of the treatment was smaller than that of the controlled group, and the serum TC, TG, LDL-C and clinical syndrome of the treatment group were better than those of the controlled group, there were significant differences between the two groups （ P 〈 0. 05 ）. Conclusion ： In the treatment of carotid atherosclerotic plaques, Qi-replenishing, Blood-activating and Phlegm-removing thera- py play a synergistic effect in broadening the carotid artery diameter, thinning the carotid artery IMT, reducing the carotid plaque area, improving blood lipid metabolism abnormalities and clinical syndrome, and they are worthy of clinical application.