CAJ | 학술논문

目的观察山楂消脂胶囊对非急性期冠心病痰瘀证患者颈动脉内-中膜厚度（IMT）和斑块积分的影响。方法本研究采用前瞻性研究方法，将符合诊断标准的102例非急性期冠心病痰瘀症患者按随机数字表法分为两组。对照组（50例）给予西药常规治疗；观察组（52例）在对照组基础上加用山楂消脂胶囊（主要成分为山楂、大黄）0.7 g，每日3次，疗程均为6个月。观察两组急性心脑血管事件的发生率，同时比较治疗前后两组患者颈动脉IMT和斑块积分，以及痰浊证和血瘀证积分的变化和不良反应。结果观察组急性心脑血管事件发生率较对照组明显降低（5.77%比20.00%，P＜0.05）；两组治疗后颈动脉IMT、斑块积分及痰浊证积分和血瘀证积分均较本组治疗前明显降低，且以观察组降低更显著〔颈动脉IMT（mm）：0.80±0.13比0.95±0.12，斑块积分（分）：1.35±0.65比1.75±0.88，痰浊证积分（分）：20.98±6.42比35.55±9.22，血瘀证积分（分）：23.23±5.12比28.95±6.38，P＜0.05或P＜0.01〕。观察组有2例出现腹痛，无其他明显不良反应。结论山楂消脂胶囊可能通过祛痰、化瘀作用，减轻颈动脉内中膜的厚度，降低斑块积分，从而稳定斑块，减少急性心脑血管事件的发生。
목적관찰산사소지효낭대비급성기관심병담어증환자경동맥내-중막후도（IMT）화반괴적분적영향。방법본연구채용전첨성연구방법，장부합진단표준적102례비급성기관심병담어증환자안수궤수자표법분위량조。대조조（50례）급여서약상규치료；관찰조（52례）재대조조기출상가용산사소지효낭（주요성분위산사、대황）0.7 g，매일3차，료정균위6개월。관찰량조급성심뇌혈관사건적발생솔，동시비교치료전후량조환자경동맥IMT화반괴적분，이급담탁증화혈어증적분적변화화불량반응。결과관찰조급성심뇌혈관사건발생솔교대조조명현강저（5.77%비20.00%，P＜0.05）；량조치료후경동맥IMT、반괴적분급담탁증적분화혈어증적분균교본조치료전명현강저，차이관찰조강저경현저〔경동맥IMT（mm）：0.80±0.13비0.95±0.12，반괴적분（분）：1.35±0.65비1.75±0.88，담탁증적분（분）：20.98±6.42비35.55±9.22，혈어증적분（분）：23.23±5.12비28.95±6.38，P＜0.05혹P＜0.01〕。관찰조유2례출현복통，무기타명현불량반응。결론산사소지효낭가능통과거담、화어작용，감경경동맥내중막적후도，강저반괴적분，종이은정반괴，감소급성심뇌혈관사건적발생。
Objective To investigate the effect of Shanzha Xiaozhi capslue on intima-media thickness(IMT) and plaques score of carotid artery in patients with non-acute phase coronary heart disease and traditional Chinese medicine(TCM)syndrome of phlegm and blood stasis. Methods A prospective study was conducted to carry out a research on 102 patients with non-acute phase coronary heart disease and TCM syndrome of phlegm and blood stasis. They were randomly divided into two groups:a control group(50 cases)treated with conventional western medicine alone and a observation group(52 cases)which was treated by both conventional western medicine and Shanzha Xiaozhi capslue(the main TCM ingredients:Shanzha,Dahuang)0.7 g,3 times a day,the therapeutic course being 6 months in both groups. The cardiocerebral vascular incidences of the two groups were observed,in the mean time,the carotid artery IMT and plagues score were registered,the scores of phlegm stagnation syndrome and blood-stasis syndrome were measured,adverse reaction was observed and compared in both groups before and after treatment. Results After treatment,the occurrence of major adverse acute cardiovascular and cerebrovascular events in observation group were reduced significantly compared with those in the control group(5.77%vs. 20.00%,P<0.05). The IMT and plaques score of carotid artery and the scores of phlegm stagnation syndrome and blood-stasis syndrome were all decreased obviously compared to those before treatment,and the effect was more remarkable in the treatment group〔IMT of carotid artery(mm):0.80±0.13 vs. 0.95±0.12,the plaques score:1.35±0.65 vs. 1.75±0.88, phlegm syndrome score:20.98±6.42 vs. 35.55±9.22,blood-stasis syndrome score:23.23±5.12 vs. 28.95±6.38, P<0.05 or P<0.01〕. Abdominal pain appeared in 2 patients of observation group without other adverse reactions. Conclusion Shanzha Xiaozhi capsule can stabilize atherosclerotic plaque and reduce the occurrence of acute adverse cardiocerebral vascular events in patients with non-acute phase coronary heart disease and phlegm and blood stasis syndrome possibly by removing phlegm and blood stasis to decrease the IMT and plaques score of carotid artery.