胡瑞　张晓云　苏玉杰等

摘要：目的观察中药益气活血散对颈动脉硬化患者斑块的影响及生化指标变化。方法将70例颈动脉硬化斑块伴高脂血症患者随机分为治疗组和对照组各35例，治疗组给予益气活血散，对照组给予阿托伐他汀口服治疗8周，于服药前、后抽取清晨空腹静脉血，检测血脂、血清一氧化氮（NO）、血浆内皮素（ET）的水平，用彩色多普勒检测服药前后颈动脉IMT及斑块积分。结果治疗8周后2组患者的总胆固醇（TC）、LDL、ET均明显下降，NO及HDL明显升高，与治疗前相比有明显差异（P<0.01），其中对照组优于治疗组（P<0.05）；2组IMT、斑块积分较治疗前明显降低，有显著性差异（P<0.01），2组间无明显差异（P>0.05）。结论益气活血散能有效降低颈动脉硬化患者颈动脉内膜厚度、缩小斑块体积从而防治颈动脉硬化的进一步发展。

关键词：颈动脉粥样硬化；中药干预；临床研究

中图分类号：R54文献标志码：A文章编号：1007-2349（2015）05-0033-03

【Abstract】Objective： To observe the effect of Yiqihuoxue Powder on the plaques of carotid atherosclerosis patients and their biochemical indicator changes. Methods： 70 carotid atherosclerosis patients with hyperlipidemia were randomly divided into a treatment group and a control group， 35 cases per group. The treatment group was treated with Yiqihuoxue Powder while the control group was given atorvastatin oral treatment for eight weeks. The morning fasting venous blood before and after medication was drawn to detect the serum lipids， serum nitric oxide （NO） and endothelin （ET） of the patients and color Doppler was used to measure their carotid IMT and plaque scores before and after the medication. Results： After a 8-week treatment， the TC， LDL and ET of the patients of the two groups significantly decreased， but their NO and HDL significantly increased. There were significant differences （P<0.01） when compared with pre-treatment. The treatment group was better than the control group （P<0.05）. The IMT and plaque scores of the two groups were significantly lower than that of the pre-treatment， the difference was significant （P<0.01）， but no significant difference （P>0.05） between the two groups. Conclusion： Yiqihuoxue Powder can effectively reduce the carotid intima-media thickness of carotid atherosclerosis patients and plaque volume， thus prevent the further development of carotid atherosclerosis.

【Key words】carotid atherosclerosis， traditional Chinese medicine intervention， clinical study

动脉粥样硬化是心脑血管疾病的主要发病机制[1]，阻止及延缓动脉粥样硬化的发生发展是防治心脑血管的重点。颈动脉粥样硬化（carotid atherosclerotic disease，CAD）与心脑血管疾病有明确相关性[2]，可早期提示心脑血管疾病的易患性。因此阻止及延缓颈动脉粥样斑块的形成成为防治心脑血管疾病的热点。益气活血散由成都中医药大学附属医院陈绍宏教授独创，具有益气固本、活血化瘀之功。笔者就该药对颈动脉粥样硬化斑块的影响，现报道如下。

1临床资料

1.1病例选择符合颈动脉粥样硬化标准：颈动脉彩超示IMT≥1.0 mm即为增厚、IMT≥1.5 mm即定义为斑块、满足其一即可诊断，同时满足2007年《中国成人血脂异常防治指南》原发性混合型高脂血症诊断标准[3]，并知情同意者。……