加味越鞠丸对高血压患者颈动脉粥样硬化、血脂及炎性因子的影响

Effect of modified Yueju pill on carotid atherosclerosis,lipid and inflammatory factors in hypertensive patients

目的:评价加味越鞠丸对痰瘀互结证高血压患者颈动脉粥样硬化(CAS)、血脂及炎性因子的影响,为中西医结合防治高血压靶器官损害提供一定的依据。方法:筛选痰瘀互结证高血压伴CAS患者,选用随机、对照、双盲、单模拟剂的研究方法,在原有降压药物及辛伐他汀的基础上,治疗组给予加味越鞠丸颗粒剂,对照组给予加味越鞠丸安慰剂,疗程24周,治疗前后检测颈动脉超声、空腹血糖、血脂及炎性因子,并对结果进行统计分析。结果:①治疗组颈动脉内膜中层厚度及斑块厚度均较治疗前减少(P<0.01),对照组患者治疗前后比较,差异无统计学意义(P>0.05)。②治疗组总胆固醇较治疗前降低(P<0.05),高密度脂蛋白较治疗前升高(P<0.05),且组间比较差异有统计学意义(P<0.01),与对照组比较,差异均无统计学意义(P>0.05);两组患者空腹血糖较治疗前均有升高(P<0.05),组间比较差异无统计学意义(P>0.05)。③两组超敏C反应蛋白较治疗前均减少(P<0.05)。结论:加味越鞠丸能有效改善高血压患者CAS,改善脂代谢,并有一定的抗炎作用。

Objective:To evaluate the effect of modified Yueju pill on carotid atherosclerosis,lipid and inflammatory factors in hypertensive patients with phlegm and blood stasis syndrome.Then a certain basis for the prevention and treatment of hypertension with integrated Chinese and western medicine will be provided.Methods:Hypertensive patients with phlegm and stasis syndrome were screened,and randomized,controlled,double-blind,single-simulant methods were used.The antihypertensive drugs,simvastatin and granules of modified Yueju pill were given to the patients in treatment group,while antihypertensive drugs,simvastatin and placebo of modified Yueju pill were given to the patients in control group for a total treatment period of 24 weeks.Carotid artery ultrasound,fasting plasma glucose,blood lipids and inflammatory factors were detected at the beginning and end of the study.The results were collected for statistical analysis.Results:①The carotid artery intima-media thickness and plaque thickness in the treatment group were significantly reduced compared with before treatment(P<0.01),and there was no difference in the control group(P>0.05).②Total cholesterol in the treatment group was lower than before treatment(P<0.05),high density lipoprotein was higher than before treatment and there were significant differences between the groups(P<0.01),and there was no difference in the control group(P>0.05).The fasting plasma glucose of both groups was higher than before treatment(P<0.05),there was no difference between groups(P>0.05).③The hypersensitive C-reactive protein in the both group were reduced compared with that before treatment(P<0.05).Conclusion:Modified Yueju pill can effectively improve the CAS in hypertensive patients,improve lipid metabolism,and has a certain anti-inflammatory effect.