红曲改善老老年冠心病患者颈动脉粥样斑块及血脂的疗效和安全性评价

Efficacy and safety of red rice in improvement of carotid atherosclerotic plaques and blood lipid in old patients with coronary heart disease

目的探讨红曲改善老老年冠心病颈动脉粥样斑块及血脂的疗效及安全性。方法老老年冠心病合并颈动脉粥样硬化患者43例,按随机数字表法分为治疗组(21例)与对照组(22例),分别给予红曲口服及予辛伐他汀治疗,疗程均为6个月。分别于治疗前、治疗6月行颈部血管彩超测定颈动脉内膜-中层厚度(IMT)及斑块积分,同时测定血脂、一氧化氮(NO)、内皮素-1(ET-1)水平,治疗3月、6月查肝肾功能、肌酶、血常规,并记录有无肌无力、肌痛、肌溶解等临床不良反应。结果治疗6月后,两组IMT较治疗前明显改善,斑块积分、ET-1、TG、TC、LDL-C均降低,NO及HDL-C升高,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗组不良反应发生率(9.5%)明显低于对照组(42.8%),差异有统计学意义(P<0.05)。结论红曲可能通过调控血脂,改善血管内皮功能,稳定老老年冠心病颈动脉粥样硬化斑块,促进斑块逆转,疗效确切且安全无副作用。

Objective To explore the efficacy and safety of red rice in improvement of carotid atherosclerotic plaques and blood lipid in old patients with coronary heart disease .Methods Forty-three elderly patients with coronary heart disease complicated with carotid atherosclerosis were divided into treatment group （ n=22 ） and control group （ n =21 ） .The treatment group was treated with oral red rice while the control group with oral simvastatin .Treatment cause was 6 months.Before and after treatment , carotid artery intima-media thickness （ IMT） and plaque score were measured by color Doppler ultrasound .Meanwhile, serum lipids, nitric oxide （NO） and endothelin-1 （ET-1） were detected.During the treatment of 3 and 6 months, hepatic and renal functions as well as blood routine were examined .Clinical adverse reactions such as weakness , myalgia and muscle dissolution were also recorded .Results After 6 months of treatment , IMT was significantly improved;plaque integral and serum levels of ET-1, TG, TC and LDL-C were reduced while NO and HDL-C were increased in the both groups when compared to before treatment .The differences were all significant （ P 〈0.05 ） .However , no significant differences in those indexes were found between the two groups .Nevertheless , the incidence of adverse reaction in the treatment group was significantly lower than that in the control group （ P〈0.05 ） .Conclusion Red rice could regulate blood lipid , improve endothelial function , stable carotid atherosclerotic plaques and promote plaque reversal in the old patients with coronary heart disease .It has definite curative effect and safe without side effects .