降脂膏联合瑞舒伐他汀钙片治疗颈动脉易损斑块痰瘀互结证

Clinical study on the combination of lipid-lowering cream and rosuvastatin calcium tablets in the treatment of vulnerable carotid artery plaques with the syndrome of intermingled phlegm and blood stasis

目的探讨降脂膏联合瑞舒伐他汀钙片治疗颈动脉易损斑块痰瘀互结证临床疗效。方法按照随机数字表法将120例颈动脉易损斑块痰瘀互结证患者分成对照组与观察组,各60例。对照组采用瑞舒伐他汀钙片治疗,观察组在对照组基础上联合降脂膏治疗。观察2组治疗前后眩晕、头痛、耳鸣、肢体疼痛或麻木、胸胀中医证候积分、颈动脉超声相关指标IMT值、颈动脉斑块面积、颈总动脉收缩期Vmax、舒张期Vmin、颈总动脉RI、血清学指标肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、hs-CRP、血脂水平、凝血指标凝血酶原时间(PT)、D-二聚体、凝血酶原国际标准化比(INR)水平变化,比较2组治疗总有效率及安全性。结果观察组治疗后各项中医证候积分、IMT值、颈动脉斑块面积、颈总动脉RI、TNF-α、IL-6、hs-CRP、TG、TC、LDL-C、PT、D-二聚体、INR水平均低于对照组(P<0.05),颈总动脉收缩期Vmax、舒张期Vmin、HDL-C水平及治疗总有效率均高于对照组(P<0.05);2组治疗期间均无明显不良反应发生。结论降脂膏联合瑞舒伐他汀钙片能够显著缓解颈动脉易损斑块痰瘀互结证症状,降低血脂指标、血液高凝态、炎症因子,改善颈动脉血流速度。

Objective To explore the clinical efficacy of lipid-lowering cream combined with rosuvastatin calcium tablets in the treatment of vulnerable carotid artery plaques with the syndrome of intermingled phlegm and blood stasis.Methods According to the method of random number table,120 patients with carotid artery vulnerable plaques of the syndrome of intermingled phlegm and blood stasis were divided into a control group and an observation group.The control group was treated with rosuvastatin calcium tablets,while the observation group was additionally treated with lipid-lowering cream.The changes in the TCM syndrome scores(dizziness,headache,tinnitus,limb pain or numbness,chest distension),carotid artery ultrasound related indicators(IMT value,carotid plaque area,common carotid artery systolic Vmax,diastolic Vmin,common carotid artery RI),serological related indicators tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hs-CRP,blood lipid levels,coagulation indicators prothrombin time(PT),D-dimer,prothrombin international standardized ratio(INR)were observed in the two groups before and after treatment,and the total effective rate and safety were compared between the two groups.Results After treatment,the scores of TCM syndromes,IMT values,carotid plaque area,common carotid artery RI,the levels of TNF-α,IL-6,hs-CRP,TG,TC,LDL-C,PT,D-dimer,and INR were lower in the observation group than those in the control group(P<0.05).The levels of systolic Vmax,diastolic Vmin,HDL-C,and total effective rate of treatment were higher in the observation group than those in the control group(P<0.05).There were no significant adverse reactions in both groups.Conclusion The combination of lipid-lowering cream and rosuvastatin calcium tablets can significantly alleviate the clinical symptoms of patients with vulnerable carotid plaques of the syndrome of intermingled phlegm and blood stasis,regulate blood lipid and coagulation indicators,reduce serum inflammatory factor levels,improve carotid ultrasound related indicators,and play a role in stabilizing vulnerable carotid plaques.