针药并举联合西药治疗高血压颈动脉粥样硬化80例临床观察

Clinical Observation on 80 Cases of Hypertension with Carotid Atherosclerosis Treated with Acupuncture and Chinese Medicine Combined with Western Medicine

目的观察针药并举联合西药治疗高血压颈动脉粥样硬化的临床疗效。方法将高血压颈动脉粥样硬化火热证患者162例随机分为治疗组82例和对照组80例,对照组给予西药常规治疗,治疗组在对照组基础上服用葛根芩连汤加减并配合针刺。3周为1个疗程,两组均连续治疗4个疗程。比较两组治疗前后颈动脉内膜中层厚度(IMT)值、斑块面积、血压、血脂[包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]水平及中医症状积分的变化。结果与本组治疗前比较,治疗后两组双侧IMT均下降,斑块面积均缩小,中医症状积分均明显降低(P<0.01);收缩压、舒张压及TC、TG、LDL-C水平均明显下降(P<0.01)。与对照组治疗后比较,治疗组双侧斑块面积明显缩小,中医症状积分、收缩压、舒张压及TC、LDL-C水平较对照组明显降低(P<0.05或P<0.01)。结论针药并举联合西药治疗高血压颈动脉粥样硬化能有效改善患者临床症状,缩小颈动脉IMT及斑块面积,降低血脂,延缓颈动脉粥样硬化进程。

Objective To observe the clinical effect of acupuncture and Chinese medicine combined with western medicine in treating hypertension with carotid atherosclerosis. Methods Totally 162 cases of carotid atherosclerosis in hypertension were randomly divided into treatment group of 82 cases and control group of 80 cases. The control group was given regular western medicine,while the treatment group was given Gegen Qinlian Decoction and Acupuncture in addition. Three weeks were taken as one treatment course. Both groups were given treatment for 4 courses continuously. Before and after the treatment,carotid artery intima-media thickness（ IMT） and plaque area were tested,and changes of the blood pressure,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterol（ LDL-C） levels and scores of Chinese medicine symptoms were observed. Results Bilateral IMT,carotid artery plaque area,scores of symptoms,blood pressure,levels of TC,TG and LDL-C decreased significantly after treatment（ P〈 0. 01）. The improvement of bilateral plaque area,scores of symptoms,blood pressure,TC and LDL-C in the treatment group was greater than in the control group（ P〈 0. 05 or P 〈0. 01）. Conclusion Acupuncture and Chinese medicine combined with western medicine can effectively improve clinical symptoms,reduce carotid artery atherosclerosis,reduce blood fat,and delay carotid atherosclerosis process.