中医药从肾论治与安妥明或脉通医治高脂血症的疗效对比分析(附30例报告)

Hyperlipemia in 30 Inpatients:A Comparative Study of Therapeutic Effects of Composite TCM Prescriptions According to“Shenhing”with That of Clofibrate/Maitong

现今的降血脂西药多只能扭转高血脂症的血脂过多,尚不能满意地控制由本症引起的一些全身多种器官(系统)的并发症。作者在一次临床实践中,对30例住院高脂血症患者进行了中医药从“肾”论治的试验性治疗。治疗方案为,将患者分为(甲)肝肾阴虚气滞血瘀型,和(乙)肾阴阳俱虚气滞血瘀型,然后对甲、乙两型分别给予相应的复方汤剂治疗;一个月后,将疗效与先服用西药安妥明(或脉通)阶段的疗效进行对比分析。服用安妥明阶段(15例)或服用脉通阶段(15例)属自身对照性质,先于从“肾”论治时日一个月。供对比分析的具体监测指标为:TG、T-CH、ApoB 共三个指标之降低,HDL-Ch、ApoA(?)等共四个指标之升高,以及心律失常、传导阻滞共5种心电图异常患者数之减少。前、后两种疗程结束后的两种结果显示:(1)血生化的改变,从“肾”论治阶段所有7个指标之降低(升高)均非常显著(P 均<0.001);(2)就安妥明组与脉通组之间的对比来说,仅那3个应降指标各各的对比非常显著(P 均<0.001);(3)5种心电图异常患者数的减少程度方面,从“肾”论治阶段者似明显地大于安妥明(脉通)组者,特别是各种传导阻滞患者数的减少程度〔4→2vs2→2(2→2)〕。

The current antilipe- mic agents usually can only lower the blood lipids level at most,yet control & ameliorate rather unsatisfactorily the systemie complications of hyper- lipemia.In a Clinical trial,30 inpat- ients with hyperlipemia were divided into[A]the liver-Kidney Yin defic- (?)ency & Qi depression to blood stasis (QDBS)type,and[B] the kidney Yin -Yang deficiency & QDBS type,tre- ated respectively by two kinds of co- mposite TCM decoction-prescriptions for one mo;their therapeutic effects were then compared with those of con- trast self-controls——in groups of 5 cases each,by clofibrate/Maitong 〔脉通〕,whose treatments were order- ed one mo before the ensuing of the above TCM decoctions in the same pa- tieats.The monitoring criteria for ef- fects-comparison were:(1)the lower- ing of criterium TG,T-Ch or Apo B in blood;(2)the rising of one of the following four criteria,i.e.ApoA(?), HDL-Ch,et al in blood;and(3)the less- ening of criteria no.of pt(s)with one of the following five abnormal ECGs, i.e.arrhythmia,heart block,et al.Fo- llowing completion of the TCM trea- tment course according to“Shenbing”, the resultant data showed that,as to blood concentration,lowering/rising of all of the above seven criteria were of very marked statistical signlf- icance(P all<0.001);and,as to crite- ria the degree of lessening of no.of pt(s)with one of the above five kin- ds of abnormal ECG,it seemed as if obviously larger than the correspon- ding criterium degree observed follo- wing completion of the contrast trea- tment course by clofibrate/Maitong, very markedly revealed in the degree of lessening of no.of pt(s)with heart block,i.e.[4→23]vs[2→2/(2→2)].