吴宝 李树斌 吴欣芳 许国磊 王吉元

摘要 目的：觀察分析活血降脂汤加减联合辛伐他汀对气滞血瘀型高脂血症的治疗效果。方法：选取2018年6月至2019年2月中国中医科学院广安门医院南区收治的气滞血瘀型高脂血症患者112例患者作为研究对象，随机分为对照组与观察组，每组56例。对照组给予常规西药辛伐他汀治疗，观察组在对照组治疗的基础上加用活血降脂汤加减治疗，持续治疗3个月。比较治疗前后2组患者中医症状评分，血浆三酰甘油（TG）、血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平、临床疗效及不良反应。结果：治疗后2组患者主症、次症和总症状评分均下降，差异有统计学意义（P<0.05），且观察组各项评分均低于对照组，差异有统计学意义（P<0.05）;治疗后2组患者TC、TG和LDL-C水平均下降，HDL-C水平均升高，观察组TG、TC和LDL-C水平低于对照组，HDL-C水平高于对照组，2组比较差异均有统计学意义（P<0.05）;观察组临床总有效率高于对照组，差异有统计学意义（P<0.05）;且观察组不良反应发生率（10.71%）与对照组（14.29%）相近，2组比较差异无统计学意义（P>0.05）。结论：活血降脂汤加减联合常规西药辛伐他汀能够更好的降低中医症状评分，改善血脂水平，增强疗效，且未增加患者不良发应，安全性好。

关键词  活血降脂汤;辛伐他汀;高脂血症;临床研究;三酰甘油;胆固醇;低密度脂蛋白;高密度脂蛋白

Observation on the Clinical Effects of Huoxue Jiangzhi Decoction Combined With Routine Western Medicine In Treating Hyperlipidemia of Qi Stagnation and Blood Stasis Type

WU Bao，LI Shubin，WU Xinfang，XU Guolei，WANG Jiyuan

（Guanganmen Hospital Southern District，China Academy of Chinese Medical Science，Beijing 102600，China）

Abstract Objective：To observe and analyze the therapeutic effects of Huoxue Jiangzhi Decoction combined with routine Western medicine on hyperlipidemia of qi stagnation and blood stasis type.Methods：A total of 112 patients admitted to Guanganmen Hospital Southern District，China Academy of Chinese Medical Science，were randomly divided into a Western medicine group and a combined group，with 56 cases each.The Western medicine group was treated with simvastatin，a kind of routine Western medicine，while the combined group was treated with modified Huoxue Jiangzhi Decoction for 3 months.The TCM symptom scores，plasma triglyceride （TG），serum total cholesterol （TC），low density lipoprotein cholesterol （LDL-C），high density lipoprotein cholesterol （HDL-C） before and after treatment，clinical efficacy and adverse reactions were compared between the 2 groups.Results：After treatment，the scores of main symptoms，secondary symptoms and total symptoms of the 2 groups decreased （P<0.05），and the scores of the combined group were lower than those of the Western medicine group （P<0.05）.After treatment，the levels of TC，TG and LDL-C of the 2 groups decreased，while the levels of HDL-C increased，and the levels of TG，TC and LDL-C of the combined group were lower than those of the Western medicine group （P<0.05），and the level of HDL-C was higher than that of the Western medicine group （P<0.05）.The total effective rate of the combined group was higher than that of the Western medicine group （P<0.05），and the incidence of adverse reactions in the combined group was similar to that in the Western medicine group （P>0.05）.Conclusion：Huoxue Jiangzhi Decoction combined with routine Western medicine can better reduce the TCM symptom scores，improve blood lipid level，enhance the curative effects.And it dose not significantly increase adverse reactions of patients，with good safety.

Keywords Huoxue Jiangzhi Decoction; Simvastatin; Hyperlipidemia; Clinical study; Triacylglycerol; Cholesterol; Low density lipoprotein cholesterol （LDL-C）; High density lipoprotein cholesterol （HDL-C）

中图分类号：R256.4 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.019

高脂血症是我国常见的中老年人慢性疾病，且发病率逐年升高[1]，主要表现为血脂代谢异常。研究发现[2]，高脂血症与脑出血、脑梗死、高血压、糖尿病等心血管疾病的发生密切相关，严重影响人们的身心健康及生命质量，因此血脂控制对心血管类疾病的防治具有重要意义。西医主要施以他汀类降脂药降低LDL-C水平，降低高脂血症引起的心血管疾病的发病率，但药物的个体差异性大，部分患者不能理想降脂，在临床应用具有一定的局限性[3]。……