清热祛瘀颗粒对稳定性冠心病患者颈动脉易损斑块的影响

作者	单位
程文立	卫生部中日友好医院心血管病中心
王勇	卫生部中日友好医院心血管病中心
蔡哲	卫生部中日友好医院心血管病中心
柯元南	卫生部中日友好医院心血管病中心
刘晓飞	卫生部中日友好医院心血管病中心
范书英	卫生部中日友好医院心血管病中心
陈馨	卫生部中日友好医院心血管病中心
李鸿	卫生部中日友好医院临床医学研究所
安容姝	卫生部中日友好医院临床医学研究所
郭健	卫生部中日友好医院临床医学研究所

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中文摘要:

目的观察清热祛瘀颗粒对冠心病伴颈动脉易损斑块患者的治疗作用。方法82例稳定性劳力型心绞痛伴颈动脉易损斑块患者中医辨证属痰热血瘀型者,随机分为清热祛瘀颗粒加西医常规治疗的试验组(41例)和采用西医常规治疗加安慰剂治疗的对照组(41例),共观察25周。采用高频超声检测颈动脉复杂斑块的数目、简单斑块的数目、斑块的Crouse积分及颈动脉内中膜的厚度,观察清热祛瘀颗粒对颈动脉斑块及血浆高敏C反应蛋白(hs-CRP)、CD40L变化及肝肾功能。结果试验组治疗后颈动脉复杂斑块的数目、斑块的Crouse积分、颈动脉内中膜的厚度较治疗前为低,差异均有统计学意义(P<0.05);颈动脉斑块的Crouse积分、颈动脉内中膜的厚度也较对照组治疗后为低,差异亦有统计学意义(P<0.05),试验组治疗后hs-CRP及CD40L与治疗前及对照组治疗后比较,差异均有统计学意义(P<0.05,P<0.01)。治疗过程中未见明显不良反应。结论清热祛瘀颗粒对冠心病伴颈动脉易损斑块患者的颈动脉斑块具有一定的稳定作用。

英文摘要:

Objective To investigate the effect of Qingre Quyu Granule(QQG) for treatment of carotid vulnerable atherosclerotic plaque(CVAP) in patients with coronary heart disease(CHD).Methods Eighty-two CHD patients with stable exertional angina,complicated with CVAP and differentiated to phlegm-heat and blood-stasis syndrome type were randomly assigned to two groups equally,the test group treated by Western medical routine therapy combined with QQG,and the control group treated with Western medical routine therapy with placebo.Using high frequency ultrasonography,the number(complex and simple) and Crouse integral of CVAP and the intima-media membranous thickness of carotid artery were measured,and changes in serum levels of CD40L and high-sensitivity C-reactive protein(hs-CRP),liver and renal functions were observed.Results After treatment,significant improvement were shown in the test group in terms of complex plaques′ number,Crouse integral,intima-media thickness and serum levels of CD40L and hs-CRP as compared with that before treatment,also with those in the control group after treatment(P<0.05 or P<0.01).No adverse reaction was found in the treatment course.Conclusion QQG has certain stabilizing action on CVAP in patients with CHD.

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