祛痰通络中药复方联合二级预防治疗对症状性颈动脉狭窄患者干预作用研究

An intervention study of TCM compound prescriptions for eliminating phlegm and tongluo combined with secondary preventive treatment on patients with symptomatic carotid artery stenosis

目的观察祛痰通络中药复方联合二级预防治疗对症状性颈动脉狭窄(SCAS)患者的干预效果。方法将我院收治的105例SCAS患者随机分为对照组53例与观察组52例。观察组采用祛痰通络中药复方联合二级预防治疗,对照组采用二级预防治疗,比较两组临床疗效,治疗前后患者斑块数量、内中膜厚度(MIT)、斑块指数(Crouse积分)、美国国立卫生研究院卒中量表(NIHSS)、血脂、胱抑素-C(Cys-C)、高敏C反应蛋白(hs-CRP)、内皮素-1(ET-1)水平。结果治疗后,观察组总有效率显著高于对照组(P<0.05);两组患者斑块数量、MIT、Crouse积分、NIHSS均下降,且观察组斑块数量、IMT、Crouse积分、NIHSS均低于对照组(P<0.05);两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均下降,高密度脂蛋白胆固醇(HDL-C)水平均升高,且观察组TC、TG、LDL-C水平均低于对照组,HDL-C水平高于对照组(P<0.05);两组Cys-C、hs-CRP、ET-1水平均下降,且观察组Cys-C、hs-CRP、EF-1水平均低于对照组(P<0.05)。结论祛痰通络中药复方联合二级预防治疗对SCAS患者干预效果较好,能改善神经功能,调节血脂水平,提高内皮功能,降低炎症状态。

Objective To observe the intervention effect of TCM compound prescriptions for eliminating phlegm and dredging collaterals combined with secondary preventive treatment on patients with symptomatic carotid artery stenosis(SCAS).Methods A total of 105 SCAS patients were randomly divided into control group(53 cases)and observation group(52 cases).Observation group was treated with expectorant and dredging TCM compound combined with secondary prevention treatment,and control group was treated with secondary prevention treatment. The clinical effects,the number of plaques,media-intima thickness(MIT),Crouse points,and National Health Institute of Stroke Scale(NIHSS),blood lipids,cystatin C(Cys-C),highsensitivity C-reactive protein(hs-CRP),endothelin-1(ET-1)levels of the two groups were compared. Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);the number of plaques,MIT,Crouse score,and NIHSS of both groups decreased;the number of plaques,MIT,Crouse score,and NIHSS of observation group were lower than those of control group(P<0.05);the total cholesterol(TC),triglycerides(TG),low-density lipoprotein-cholesterol(LDL-C),and the levels of high-density lipoprotein cholesterol(HDL-C)decreased in both groups;the levels of TC,TG,LDLC in observation group were lower than those in control group,and the levels of HDL-C were higher than those in control group(P<0.05);the levels of Cys-C,hs-CRP and ET-1 decreased,and the decrease in observation group were more obvious than control group(P<0.05). Conclusion TCM compound for removing phlegm and dredging collaterals combined with secondary preventive treatment has a better intervention effect on SCAS patients,which can improve nerve function,regulate blood lipid levels,improve endothelial function,and reduce inflammation.