疏肝温胆汤治疗动脉粥样硬化疗效分析

Analysis of curative effect of Shugan Wendan Decoction in the treatment of atherosclerosis

目的评价疏肝温胆汤治疗动脉粥样硬化的临床疗效。方法纳入2016年11月—2017年5月于广州中医药大学第二附属医院心内科门诊就诊的颈动脉粥样硬化患者共84例,采用随机对照的方法分为试验组和对照组各42例,2组各40例完成研究。对照组给予阿托伐他汀治疗,试验组给予阿托伐他汀联合疏肝温胆汤治疗,2组疗程均为12周。观察2组患者治疗前后颈动脉内-中膜厚度(IMT)、血管内皮功能、血脂、高敏C反应蛋白(hs-CRP)、纤维蛋白原及中医症状评分的变化,评估2组临床疗效。结果2组治疗后IMT均较治疗前明显减少(P均<0.05),但2组间治疗前后IMT差值比较差异无统计学意义(P>0.05);2组治疗后总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP、纤维蛋白原水平均较治疗前明显降低(P均<0.05),试验组治疗后TC、LDL-C、hs-CRP、纤维蛋白原水平均明显低于对照组(P均<0.05)。2组治疗后一氧化氮(NO)水平均明显高于治疗前(P均<0.05),内皮素-1(ET-1)水平均明显低于治疗前(P均<0.05),且试验组治疗后NO水平明显高于对照组(P<0.05),ET-1水平明显低于对照组(P<0.05)。2组治疗后中医症状总积分均较治疗前明显降低(P均<0.05),试验组治疗后中医症状总积分明显低于对照组(P<0.05)。试验组的总有效率为87.5%(35/40),对照组为65.0%(26/40),试验组明显高于对照组(P<0.05)。2组患者治疗前后血常规、尿常规、肝功、肾功、肌酸激酶等无明显改变,治疗期间患者未出现药物不良反应。结论疏肝温胆汤可以降低颈动脉粥样硬化患者的血脂、炎症指标水平,保护内皮功能,改善中医症状。

Objective It is to evaluate the clinical efficacy of Shugan Wendan Decoction in the treatment of atherosclerosis.Methods A total of 84 patients with carotid atherosclerosis who were treated in the cardiology department of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from November 2016 to May 2017 were enrolled.They were divide into the experimental group and the control group by a randomized control method,with 42 cases in each group,40 cases in each groups completed the study.The control group was treated with atorvastatin,and the experiment group was treated with atorvastatin combined with Shugan Wendan Decoction.The treatment course of both groups was 12 weeks.The changes in carotid artery-media thickness(IMT),vascular endothelial function,blood lipids,high-sensitivity C-reactive protein(hs-CRP),fibrinogen and TCM symptom scores were observed before and after treatment in the two groups,and the clinical efficacy of the two groups was evaluated.Results After treatment,the IMT was significantly reduced in both groups(P<0.05),but there was no significant difference in the IMT difference between the two groups before and after treatment(P>0.05);the levels of total cholesterol(TC),total cholesterol(TC),Low-density lipoprotein cholesterol(LDL-C),hs-CRP,and fibrinogen were significantly lower than those before treatment(all P<0.05),and the levels of TC,LDL-C,hs-CRP,and fibrinogen in the experiment group were significantly lower than those in the control group after treatment(P<0.05).The levels of nitric oxide(NO)after treatment were significantly higher while the levels of endothelin-1(ET-1)were significantly lower than those before treatment in the two groups(both P<0.05),and the level of NO was significantly higher while the level of ET-1 was significantly lower in the experiment group than those in the control group(P<0.05).After treatment,the total scores of TCM symptoms in the two groups were significantly decreased compared with before treatment(P<0.05),and the total scores of TCM symptoms in the experimental group were significantly lower than those in the control group(P<0.05).The total effective rate of the experimental group was 87.5%(35/40),and the control group was 65.0%(26/40),the experimental group was significantly higher than the control group(P<0.05).There was no obvious change in blood routine,urine routine,liver function,renal function,creatine kinase,etc.In the patients of the two groups before and after treatment,and no adverse drug reactions occurred during the treatment.Conclusion Shugan Wendan Decoction can reduce the levels of blood lipids and inflammation index,protect endothelial function,and improve TCM symptoms in patients with carotid atherosclerosis.