CAJ | 학술논문

目的：探讨联合使用脂康颗粒和阿托伐他汀治疗高脂血症的疗效及安全性。方法将80例高脂血症患者按照就诊先后顺序随机分为对照组和治疗组各40例，对照组给予阿托伐他汀20 mg，每日1次口服；治疗组在服用阿托伐他汀的基础上加服脂康颗粒，每次8．0 g（1袋），每日2次冲服。疗程均为8周，并于治疗前、治疗后第4周、治疗后第8周，检测血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的变化，同时监测血常规、尿常规、肝肾功能及药物不良反应。结果治疗结束，治疗组总有效率在治疗第4周（97．5％，39／40）、第8周（100％，40／40）均高于对照组（P＜0．05）；其中治疗组4周后临床控制率达40．0％（16／40）高于对照组的17．5％（7／40），治疗8周后临床控制率达到52．5％（21／40）高于对照组的27．5％（11／40）（P ＜0．05）。两组治疗后TC、TG、LDL-C与治疗前比较均明显下降，HDL-C则明显上升（P ＜0．05）。治疗组治疗4周、8周后与对照组比较TC、TG、LDL-C亦有明显下降，而 HDL-C则明显升高（P＜0．05）。两组患者治疗后与治疗前比较各种自觉不适症状均有明显的改善，其中治疗组在治疗8周后与对照组比较头胀、耳鸣眼花、腰膝酸软、胸闷胸痛等症状的发生有显著下降（P＜0．05）。治疗后4周、8周复查血常规、尿常规、肝功能、肾功能相关指标，除对照组出现血清转氨酶轻度升高外（正常上限3倍以内），其余指标均未出现异常。结论降脂中成药脂康颗粒联合阿托伐他汀能有效调节血脂异常，治疗高脂血症总体疗效好于单用阿托伐他汀，且较单纯使用阿托伐他汀安全性高，值得临床推广使用。
목적：탐토연합사용지강과립화아탁벌타정치료고지혈증적료효급안전성。방법장80례고지혈증환자안조취진선후순서수궤분위대조조화치료조각40례，대조조급여아탁벌타정20 mg，매일1차구복；치료조재복용아탁벌타정적기출상가복지강과립，매차8．0 g（1대），매일2차충복。료정균위8주，병우치료전、치료후제4주、치료후제8주，검측혈청총담고순（TC）、감유삼지（TG）、고밀도지단백담고순（HDL-C）화저밀도지단백담고순（LDL-C）적변화，동시감측혈상규、뇨상규、간신공능급약물불량반응。결과치료결속，치료조총유효솔재치료제4주（97．5％，39／40）、제8주（100％，40／40）균고우대조조（P＜0．05）；기중치료조4주후림상공제솔체40．0％（16／40）고우대조조적17．5％（7／40），치료8주후림상공제솔체도52．5％（21／40）고우대조조적27．5％（11／40）（P ＜0．05）。량조치료후TC、TG、LDL-C여치료전비교균명현하강，HDL-C칙명현상승（P ＜0．05）。치료조치료4주、8주후여대조조비교TC、TG、LDL-C역유명현하강，이 HDL-C칙명현승고（P＜0．05）。량조환자치료후여치료전비교각충자각불괄증상균유명현적개선，기중치료조재치료8주후여대조조비교두창、이명안화、요슬산연、흉민흉통등증상적발생유현저하강（P＜0．05）。치료후4주、8주복사혈상규、뇨상규、간공능、신공능상관지표，제대조조출현혈청전안매경도승고외（정상상한3배이내），기여지표균미출현이상。결론강지중성약지강과립연합아탁벌타정능유효조절혈지이상，치료고지혈증총체료효호우단용아탁벌타정，차교단순사용아탁벌타정안전성고，치득림상추엄사용。
ABSTRACT:Objective To evaluate the efficacy and safety of combined use of Zhikang granule (ZKG)and atorvastatin in the treatment of hyperlipidemia.Methods Eighty out-patients with hyperlipemia who met the inclusion criteria were enrolled and randomly divided into two groups:treatment group (ZKG-atorvastatin,n=40)and control group (atorvastatin alone,n=40).Patients in both groups received oral administration of atorvastatin 20 mg once daily,while patients in the treatment group also took ZKG 8 g after mixing with water twice daily.The treatment course was eight weeks.Serum total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesferol (HDL-C)and low density lipoprotein cholesterol (LDL-C)were determined before the treatment,4 and 8 weeks after the treatment.Routine blood and urine examination,liver and kidney function and adverse drug reactions of the patients were also monitored.Results The total response rates at 4 and 8 weeks after the treatment showed increase trend in the treatment group as compared with those in the control group(P <0.05).The clinical control rates at 4 and 8 weeks after the treatment were 40.0%(16/40)and 52.5% (21/40)in the treatment group,significantly higher than those in the control group,respectively (17.5%,7/40 and 27.5%,11/40,P<0.05).After the treatment,the levels of TC,TG and LDL-C in both groups decreased significantly,but HDL-C increased markedly as compared with those before the treatment (P<0.05).A variety of discomfort symptoms were improved obviously in both groups after the treatment.At 8 weeks after the treatment,the incidence of tinnitus,vertigo,headache and chest tightness/pain in the treatment group decreased markedly as compared with those in the control group (P <0.05).No significant side effect was observed during the treatment except one case in the control group having mild elevation of serum transaminase.Conclusion ZKG combined with atorvastatin is effective in the treatment of hyperlipidemia.Its overall therapeutic effects are better than atorvastatin alone.Thus,it can be widely used in clinic.