消斑汤对颈动脉粥样硬化斑块形态的影响

Analysis of Morphology Effects of Xiaoban Decoction on Carotid Atherosclerosis Plaque and Part of Mechanism

目的:观察消斑汤对颈动脉粥样硬化斑块形态和机体骨桥蛋白(Osteopontin,OPN)的影响。方法:选取2016年1月至2017年6月恩施土家族苗族自治州中心医院收治的颈动脉粥样硬化患者100例,随机分为对照组和观察组,每组50例。其中对照组降脂稳斑、抗血小板等内科常规治疗,观察组在对照组治疗措施基础上加用消斑汤,2组均治疗3个月,治疗结束后比较2组临床疗效、颈总动脉内中膜厚度(IMT)、斑块总积分、OPN的变化。结果:观察组总有效率94%,明显高于对照组82%,差异有统计学意义(χ~2=3.25P<0.05)。2组治疗后IMT、斑块总积分较治疗前明显下降,差异有统计学意义(P<0.05),且治疗后观察组改善程度明显优于对照组(P<0.05)。3)治疗后2组OPN表达下降,与治疗前比较,差异有统计学意义(P<0.05),观察组下调的趋势较对照组明显,差异有统计学意义(P<0.05)。结论:消斑汤有明显抑制及预防颈动脉粥样硬化的作用,其作用机制可能与下调机体OPN有关。

Objective： To observe the morphology effect of Xiaoban decoction on carotid atherosclerosis plaque and the impact on the osteopontin（ OPN）.Methods： A total of 100 patients with carotid atherosclerosis admitted in our hospital from January 2016 to June 2017 were included in the study and randomly divided into the control group and the observation group,with 50 cases in each group.The control group was treated with conventional medical treatment such as lipid-reducing,plaque-stabilizing and antiplatelet,and the observation group had the Xiaoban decoction on the basis of treatment of the control group.Both groups had 3 months as a treatment course.After the treatment courses,the clinical curative effect,common carotid artery IMT and plaques total integral,and the changes of OPN of two groups were compared.Results： 1） The total effectiveness of the observation group was 94%,which was significantly higher than 82% of the control group.The differences were with statistical significance（ chi-square = 3.25,P〈0.05）.2） The IMT and plaques total scores of the two groups significantly decreased after treatment,and the differences were statistically significant（ P〈0.05）.The improvement of the observation group was significantly than the control group after treatment（ P〈0.05）.3） OPN expression levels decreased in both groups after treatment,with statistically significant differences compared before treatment（ P〈0.05）.The down-trend of the observation group was lower than the control group,and the differences were statistically significant（ P〈0.05）.Conclusion： Xiaoban decoction has significant effects on inhibiting and preventing carotid atherosclerosis,and the mechanism may be related to the down-regulation of OPN in the body.