通络降浊汤治疗颈动脉粥样硬化临床研究

Clinical Study on Collateral-Unblocking and Turbidity-Removing Decoction in the Treatment of Carotid Atherosclerosis

目的:观察通络降浊汤治疗颈动脉粥样硬化的临床疗效。方法:将178例颈动脉粥样硬化患者按照随机数字表法分为对照组86例和治疗组92例。两组患者均给予基础治疗,对照组在基础治疗的基础上口服瑞舒伐他汀,治疗组在对照组的基础上口服通络降浊汤。比较两组患者治疗前后超声影像学指标[低回声斑块个数、颈动脉内膜-中层厚度(intirna.media thickness,IMT)、斑块面积、高回声斑块个数]、血脂水平[低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)]、炎症因子水平[单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、可溶性细胞间黏附分子-1(soluble iIntercellular adhesion molecule-1,sICAM-1)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)]及神经功能评分。结果:两组患者治疗后低回声斑块个数、IMT、斑块面积、高回声斑块个数均小于本组治疗前,且治疗组治疗后小于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后HDL-C高于本组治疗前,TC、LDL-C、TG低于本组治疗前,治疗组治疗后HDL-C高于对照组治疗后,TC、LDL-C、TG低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后hs-CRP、MCP-1、TNF-α、sICAM-1、MMP-9低于本组治疗前,且治疗组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后NIHSS评分低于本组治疗前,且治疗组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。结论:通络降浊汤治疗颈动脉粥样硬化,能够改善患者神经功能,促进超声影像学指标恢复,且可调节患者血脂水平。

Objective:To observe the clinical curative effect of Collateral-Unblocking and Turbidity-Removing Decoction on carotid atherosclerosis.Methods:A total of 178 patients with carotid atherosclerosis were randomly divided into the control group with 86 cases and the treatment group with 92 cases.Both groups were given basic treatment,then the control group was additionally given Rosuvastatin,and the treatment group was additionally given Collateral-Unblocking and Turbidity-Removing Decoction on the basis of control group.The ultrasound imaging indexes[including the number of low echo plaques,intima-media thickness(IMT),plaque area,the number of high echo plaques],blood lipid levels[including low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)],inflammatory factors[including monocyte chemotactic protein-1(MCP-1),tumor necrosis factor-α(TNF-α),soluble intercellular adhesion molecule-1(sICAM-1),matrix metalloproteinase-9(MMP-9)]and neurological function score were compared between the two groups before and after treatment.Results:After treatment,the number of low echo plaques,IMT,plaque area and the number of high echo plaques in the two groups were less than those of the same group before treatment,and all the differences were statistically significant(P<0.05).After treatment,HDL-C of the two groups was higher than those of the same group before treatment,while TC,LDL-C,TG were lower than those of the same group before treatment;HDL-C of the treatment group was higher than that of the control group,while TC,LDL-C,TG of the treatment group were lower than that of the control group,and all the differences were statistically significant(P<0.05).After treatment,the levels of hs-CRP,MCP-1 and TNFα,sICAM-1 and MMP-9 in the two groups were lower than those of the same group before treatment,and the above indexes of the treatment group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The NIHSS score of the two groups after treatment was lower than that of the same group before treatment,and the NIHSS score of the treatment group was lower than that of the control group after treatment,and the difference was statistically significant(P<0.05).Conclusion:In terms of carotid atherosclerosis,Collateral-Unblocking and Turbidity-Removing Decoction can improve the neurological function of patients,promote the recovery of ultrasound imaging indexes,and regulate their blood lipid levels.