温和灸联合西医治疗颈动脉粥样斑块患者有效性研究

Study on the effectiveness of mild-warm moxibustion combined with western medicine in treating patients with carotid atherosclerotic plaque

目的探讨温和灸联合西医治疗颈动脉粥样斑块患者有效性。方法选取92例颈动脉粥样斑块患者,根据随机数字表达法分为西药组(阿司匹林肠溶片+阿托伐他汀钙片治疗)、中西医结合组(阿司匹林肠溶片+阿托伐他汀钙片+温和灸),各46例。比较2组中医证候疗效、血脂、炎性因子及颈动脉粥样斑块情况等指标。结果中西医结合组中医证候疗效结果(95.65%,44/46)明显高于西药组(80.43%,37/46)(P<0.05);2组治疗后动脉硬化指数(AI)、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、白介素-8(IL-8)、基质金属蛋白酶-9(MMP-9)、血管紧张素II(AngII)、单核细胞趋化蛋白(MCP-1)水平均较治疗前明显降低(P<0.05),HDL-C较治疗前明显升高(P<0.05);中西医结合组治疗后LDL-C、TC、TG、AI、hs-CRP、IL-8、AngII、MCP-1、MMP-9明显低于西药组(P<0.05),HDL-C明显高于西药组(P<0.05);2组治疗后颈动脉斑块面积、IMT明显缩小(P<0.05);且中西医结合组治疗后颈动脉斑块面积、IMT缩小更显著(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论温和灸联合西医治疗颈动脉粥样斑块中医证候疗效显著,能有效抑制动脉粥样斑块炎性因子表达,改善血脂代谢异常,促进斑块消退,具有良好的药物安全性。

Objective To explore the effectiveness of mild-warm moxibustion combined with western medicine in the treatment of carotid atherosclerotic plaque. Methods 92 patients with carotid atherosclerotic plaque were randomly divided into western medicine group(aspirin enteric-coated tablets + atorvastatin calcium tablets) and integrated traditional Chinese and western medicine group(aspirin enteric-coated tablets + atorvastatin calcium tablets + mild-warm moxibustion), 46 cases each. The curative effect of TCM syndrome, blood lipid, inflammatory factors and carotid atherosclerotic plaque were compared between the two groups. Results The curative e ect of TCM syndrome in the integrated traditional Chinese and western medicine group was significantly higher than that in the western medicine group(95.65% vs 80.43%)(P <0.05). After treatment, the levels of arteriosclerosis index(AI), cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high sensitivity C-reactive protein(hs-CRP), interleukin-8(IL-8), matrix metalloproteinase-9(MMP-9), angiotensin Ⅱ(AngⅡ), monocyte chemotactic protein(MCP-1) were all significantly lower(P <0.05), yet HDL-C significantly higher than before treatment(P <0.05). After treatment, in the integrated traditional Chinese and western medicine group, LDL-C, TC, TG, AI, hs-CRP, IL-8, Ang Ⅱ,MCP-1 and MMP-9 were significantly lower(P<0.05) and HDL-C was significantly higher than those of western medicine group(P <0.05). The carotid plaque area and IMT were significantly reduced after treatment in both groups(P <0.05) and the integrated traditional Chinese and western medicine group was much more significantly reduced(P <0.05). There was no statistically significant di erence in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Mild-warm moxibustion combined with western medicine, in the treatment of carotid atherosclerotic plaque, has a significant effect on TCM syndromes. It can effectively inhibit the expression of inflammatory factors in carotid atherosclerotic plaques, improve metabolism of blood lipids, and promote plaque regression. It has good drug safety and is worth clinical recommending.