活血化瘀中药对冠状动脉粥样硬化斑块稳定性的影响

Effect of Chinese Drugs for Activating Blood Circulation and Removing Blood Stasis on Coronary Atherosclerotic Plaque Stability

目的:观察在常规用他汀类药物治疗基础上加用活血化瘀中药对冠状动脉粥样硬化斑块稳定性的影响。方法:将64例稳定性冠心病患者随机分为两组,每组32例。对照组常规给予洛伐他汀片治疗;治疗组在对照组治疗基础上加用复方丹参片口服,疗程12个月。使用64排螺旋CT观察患者冠状动脉狭窄率、冠状动脉钙化(CAC)积分及斑块数目的变化,并检测患者血脂水平及血瘀证记分的改变。结果:两组患者治疗后病情均有明显的改善,治疗组患者冠状动脉狭窄率变化值相比对照组明显减小(P<0.05),治疗组冠状动脉斑块数目及CAC积分均明显减少,较对照组有显著差异(P<0.05)。活血化瘀中药还可明显降低患者血清总胆固醇(TC)并可升高血清高密度脂蛋白胆固醇(HDL-C)浓度,从而降低动脉粥样硬化指数(AI),较对照组有显著差异(P<0.05)。治疗后治疗组及对照组血瘀证计分较治疗前均明显降低(P<0.05),两组患者血瘀证的改善情况无显著差异。结论:他汀药联合活血化瘀中药治疗稳定性冠心病可达到更好地抗动脉粥样硬化(AS)及稳定斑块的作用,体现了中西医结合治疗的优势。

Objective： To observe the additional effect of Chinese drugs for activating blood circulation and removing blood stasis （CDABCRBS） on the stability of coronary atherosclerotic plaque based on the standardized treatment with statins. Method： Totally 64 patients with stable coronary heart disease （CHD） were randomly divided into two groups （32 in each group） , the control group treated with statins, and the CDABCRBS group treated with compound tablet of red sage root based on statins treatment. After the 12-month treatment, the change of coronary artery stenosis rate, coronary artery calcium （CAC） scores and plaque number were observed by 64 row spiral CT. The serum lipid level and blood stasis syndrome （BSS） scores of the patients were also tested. Result： All patients had good improvment after treatment. Compared with the control group, the change of coronary artery stenosis rate decreased significantly （P 〈 0.05 ）, CAC scores and plaque number decreased obviously in CDABCRBS group （P 〈 0.05）. In addition, the CDABCRBS group had superior effects in reducing the concentration of total cholesterol, increasing the concentration of high density lipoprotein cholesterol, and decreasing the atheroselerosis index, as compared to the control group （P 〈0. 05 ）. BSS scores in both groups decreased significantly after treatment （P 〈 0.05） , while the improvement in the BSS scores showed no significant difference between two groups. Conclusion： Standardized statins combined with CDABCRBS therapy show better effect in atherosclerosis treatment and plaque stability in stable CHD patients, which reflect the advantage of integrated traditional Chinese and western medicines.