散结祛瘀复方联合阿托伐他汀对颈动脉易损斑块的干预作用

Intervention effect of Sanjie Quyu Compound combined with Atorvastatin for the vulnerable plaques of carotid artery

目的观察散结祛瘀复方联合阿托伐他汀对颈动脉粥样硬化易损斑块的干预作用。方法将广州市中西医结合医院2013年12月~2015年12月经颈动脉彩超确认为颈动脉粥样硬化易损斑块的患者112例按简单随机数字表法将其随机分为治疗组和对照组,其中对照组给予阿托伐他汀钙片,治疗组加用散结祛瘀复方口服,共治疗3个月。比较两组治疗前后颈动脉超声结果(颈动脉内膜中层厚度、斑块积分、斑块面积)以及血脂(总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)水平,并随访1年,记录脑血管事件发生情况。结果两组治疗后颈动脉内膜中层厚度、斑块面积、斑块积分、血脂水平均较治疗前有所改善(P<0.05),且治疗组治疗后颈动脉内膜中层厚度、斑块面积、斑块积分和血脂水平均优于对照组,差异均有统计学意义(P<0.05)。治疗组脑卒中发生率低于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀单用或与散结祛瘀复方联用对颈动脉易损斑块均有一定的临床疗效,散结祛瘀复方联合阿托伐他汀较单用阿托伐他汀可更有效地缩小颈动脉内膜中层厚度、斑块面积和斑块积分,改善血脂水平,并最终降低脑卒中的发生率,值得在临床上进一步推广。

Objective To observe the intervention effect of Sanjie Quyu Compound combined with Atorvastatin for the vulnerable plaques of carotid artery atherosclerosis. Methods One hundred and twelve patients with vulnerable plaques of carotid artery atherosclerosis diagnosed by carotid uhrasonography in Guangzhou Hospital of Integrated Chinese and Western Medicine from December 2013 to December 2015 were randomly divided into treatment group and control group by simple random number table method. The control group was treated with Atorvastatin, the treatment group was added with Sanjie Quyu Compound, orally, the course was 3 months. The carotid uhrasonography results （carotid inti- ma-media thickness, plaque score, plaque area） and the levels of blood lipid （total cholesterol, triacylglycerol, low den- sity lipoprotein cholesterin, high density lipoprotein cholesterol） before and after treatment between the two groups were compared, followed-up for 1 year, the occurrence of cerebrovascular events was recorded. Results After treatment, the carotid intima-media thickness, plaque score, plaque area and the levels of blood lipid in the two groups were all sig- nificantly improved compared with those before treatment （P 〈 0.05）, and the carotid intima-media thickness, plaque score, plaque area and the levels of blood lipid in the treatment group after treatment were better than those of control group, the differences were all statistically significant （P 〈 0.05）. The incidence of stroke events in the treatment group was lower than that of the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Both appli- cation of Atorvastatin alone and combined with Sanjie Quyu Compound have certain clinical effects for the vulnerable plaques of carotid artery. Compared with Atorvastatin alone, Sanjie Quyu Compound combined with Atorvastatin has better effects in reducing carotid intima-media thickness, plaque score and plaque area, improving the levels of blood lipid and decreasing the incidence of stroke, which is worthy of promotion in clinic.