蛭龙活血通瘀胶囊对冠状动脉粥样斑块的干预性研究

发布时间：2018-05-01 09:07

本文选题：易损斑块 + 炎症因子　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:探讨蛭龙活血胶囊对冠状动脉轻中度狭窄患者的临床疗效及对斑块稳定性的影响。方法:(1)从西南医科大学附属中医医院心脑病科2016年1月到2016年9月的门诊及住院病人中筛选符合本实验纳入标准的患者40例。(2)将40例患者按随机数字表随机分为对照组20例和治疗组20例,两组都给予基础治疗,治疗组加用蛭龙活血通瘀胶囊1.2g tid服用三个月。分别于治疗前及治疗后3个月,使用中医证候评分表计算患者中医证候积分,采用免疫荧光法检测患者血清超敏C反应蛋白(hs-CRP)水平、ELISA法检测患者血清5脂氧化酶(5-LO)、脂蛋白相关磷脂酶A2(LP-PLA2)水平,采用SOMATOM Definition 128双源螺旋CT测量患者冠状动脉粥样硬化性狭窄的管腔狭窄程度及粥样斑块CT值,评估两组患者临床疗效及斑块稳定性的变化情况。(3)统计软件SPSS 20.0用于相关数据的统计描述与分析。结果:(1)治疗组与对照组一般资料比较:两组患者在年龄,性别,高血压病史,糖尿病病史,高脂血症、高同型半胱氨酸血症患病率及个人生活史(吸烟、饮酒、女性患者绝经史)的比较上差异无统计学意义(P0.05);(2)治疗组与对照组治疗前各指标比较:治疗前两组患者hs-CRP、5-LO、LP-PLA2水平、斑块CT值、病变处血管狭窄程度,中医证候积分的比较差异均无统计学意义(P0.05));(3)治疗组与对照组治疗后各指标比较:治疗后治疗组患者hs-CRP、5-LO、LP-PLA2、中医证候积分较对照组低,差异有统计学意义(P0.05);治疗后治疗组患者斑块CT值较对照组高,差异具有统计学意义(P0.05);治疗后治疗组患者病变处血管狭窄程度与对照组比较差异无统计学意义(P0.05)。(4)治疗组与对照组治疗前后各观察指标比较:治疗后两组患者hs-CRP、5-LO、LP-PLA2、中医证候积分均较治疗前降低,斑块CT值均较治疗前升高,差异有统计学意义(P0.001)。两组治疗前后病变处血管狭窄程度无明显变化,差异无统计学意义(P0.05)。(5)治疗组与对照组疗效差值的比较:治疗组hs-CRP、5-LO、LP-PLA2、中医证候积分、斑块CT值的疗效差值(绝对值)均较对照组大,差异具有统计学意义(P0.05)。结论:经过治疗后治疗组、对照组患者hs-CRP、5-LO、LP-PLA2、中医证候积分、斑块CT值较治疗前均有变化。治疗后治疗组患者hs-CRP、5-LO、LP-PLA2、中医证候积分、斑块CT值疗效差值差异更大,这说明加用了蛭龙活血通瘀胶囊的患者比单纯使用基础治疗方案的疗效更显著,斑块的稳定性增加。
[Abstract]:Objective: to investigate the clinical effect of Zhilong Huoxue capsule on the stability of plaque in patients with mild to moderate coronary artery stenosis. Methods from January 2016 to September 2016, 40 outpatients and inpatients in the Department of Cardio-encephalopathy, affiliated traditional Chinese Medicine Hospital of Southwest Medical University, were selected from 40 patients who met the criteria for inclusion of the experiment. 40 patients were randomly divided into two groups according to the random digital table. There were 20 cases in the control group and 20 cases in the treatment group. Both groups were given basic treatment. The treatment group was treated with Zhilong Huoxue Tongyu capsule 1.2 g tid for 3 months. Before treatment and 3 months after treatment, TCM syndrome score was calculated by using TCM syndrome score table. The levels of serum hypersensitive C-reactive protein hs-CRP were detected by immunofluorescence assay and the serum levels of 5-lipoxygenase 5-LOX and lipoprotein associated phospholipase A2LP-PLA2 were detected by Elisa. The degree of coronary artery stenosis and the CT value of atherosclerotic plaque were measured by SOMATOM Definition 128 double source spiral CT. To evaluate the changes of clinical efficacy and plaque stability in two groups. The statistical software SPSS 20.0 was used to describe and analyze the related data. Results the general data of the treatment group and the control group were compared: age, sex, history of hypertension, history of diabetes, hyperlipidemia, prevalence of hyperhomocysteinemia and personal life history (smoking, drinking), There was no significant difference in menopausal history of female patients (P 0.05). The indexes of treatment group and control group before treatment were as follows: before treatment, hs-CRPU 5-LOLOLP-PLA2 level, plaque CT value, degree of vascular stenosis in lesion, and so on. There were no significant differences in TCM syndromes between the treatment group and the control group (P 0.05). The indexes of the treatment group were compared with those of the control group: after treatment, the hs-CRPn5-LOLP-PLA2 of the patients in the treatment group was lower than that of the control group, and the score of TCM syndromes was lower than that of the control group. After treatment, the CT value of plaque in the treatment group was higher than that in the control group. After treatment, there was no significant difference in the degree of vascular stenosis between the treatment group and the control group (P 0.05). Comparison of the observed indexes before and after treatment between the treatment group and the control group: after treatment, hs-CRPn5-LOLP-PLA2 in the treatment group was compared with that in the control group, and in the middle of the treatment group, there was no significant difference between the treatment group and the control group before and after treatment. The score of medical syndrome was lower than that before treatment. The CT value of plaque was higher than that before treatment, and the difference was statistically significant (P 0.001). Before and after treatment, there was no significant change in the degree of vascular stenosis in the two groups, but there was no significant difference between the treatment group and the control group. The difference of therapeutic effect between the treatment group and the control group: the difference of therapeutic effect between the treatment group and the control group was greater than that of the control group: the score of TCM syndromes and the absolute value of CT value of plaque were larger than those of the control group. The difference was statistically significant (P 0.05). Conclusion: after treatment, hs-CRPU 5-LOLP-PLA2, TCM syndromes integral and plaque CT value were all changed in the control group. After treatment, the difference of curative effect between the patients with hs-CRPU 5-LOP LP-PLA2, TCM syndrome score and plaque CT value was greater, which indicated that the curative effect of the patients treated with Zhilong Huoxue Tongyu capsule was more significant than that of the basic treatment alone, and the plaque stability was increased.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】