黄连素联合阿托伐他汀对高血压动脉粥样硬化患者血脂异常的疗效

Effect of berberine combined with atorvastatin on dyslipidemia in patients with hypertension and atherosclerosis

目的观察黄连素联合阿托伐他汀治疗高血压动脉粥样硬化患者血脂异常的临床效果,以寻求更好的血脂调控方案。方法 120例高血压病合并动脉粥样硬化且血脂异常患者随机分成对照组、低剂量组、高剂量组各40例,均治疗8周。高剂量组脱落2例。对照组,给予常规治疗(生活方式干预+规范化、个体化降压药物治疗+阿托伐他汀钙片20 mg/次,1次/d);低剂量组,给予常规治疗+黄连素片0. 3 g/次,3次/d;高剂量组,给予常规治疗+黄连素片0. 6 g/次,3次/d。测定3组患者治疗前、治疗8周后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及肌酸激酶、肝肾功能等。结果治疗后3组患者TC、TG、LDL-C均低于治疗前,HDL-C均高于治疗前,组内比较差异有统计学意义(P <0. 05);治疗后低、高剂量组TC、TG、LDL-C又低于对照组,且高剂量组又低于低剂量组,组间比较差异有统计学意义(P <0. 05);但治疗后3组间HDL-C差异无统计学意义(P> 0. 05)。结论黄连素联合阿托伐他汀能够进一步降低高血压动脉粥样硬化患者TC、TG、LDL-C水平,且黄连素剂量加大时降低TC、TG、LDL-C作用更明显,有助于TC、TG、LDL-C控制达标。

Objective To observe the effect of berberine combined with atorvastatin on dyslipidemia in hypertensive patients with atherosclerosis,thus to seek better control of dyslipidemia. Methods A total of 120 patients with hypertension and atherosclerosis were randomly divided into three groups: control group,low-dose group and high-dose group( n = 40),all of whom were treated for eight weeks. Two cases in the high-dose group dropped out. Patients in the control group were given with routine treatment( life style intervention + standardized and individualized antihypertensive medication + atorvastatin calcium tablets 20 mg Qd),while the low-dose group were given with routine treatment and berberine tablets( 0. 3 g Tid),and the high-dose group were given with routine treatment and berberine tablets( 0. 6 g Tid). The indexes of total cholesterol( TC),triglyceride( TG),low-density lipoprotein cholesterol( LDL-C),high-density lipoprotein cholesterol( HDL-C),creatine kinase,and liver and kidney function were tested before and after treatment. Results After treatment,the TC,TG and LDL-C in three groups were significantly lower than before treatment,while HDL-C was significantly higher( P < 0. 05). The TC,TG and LDL-C in the low-dose and high-dose groups were significantly lower than the control group,which were significantly lower in the high-dose group than the low-dose group( P < 0. 05). But there was no significant difference in HDL-C among three groups after treatment( P >0. 05). Conclusion Berberine combined with atorvastatin can reduce the level of TC,TG and LDL-C in patients with hypertension and atherosclerosis in dose-pendent manner.