摘要
目的探讨中药强化调脂联合低剂量他汀用于老年缺血性脑卒中患者二级预防的临床效果。方法选取2015年医院脑病科收治的老年缺血性脑卒中患者90例,随机分为治疗组47例和对照组43例。两组均给予缺血性脑卒中的常规治疗,对照组予阿托伐他汀20 mg,治疗组在对照组基础上给予荷丹片及血塞通软胶囊。比较治疗前和治疗后3,12个月两组患者低密度脂蛋白胆固醇(LDL-C)水平、总胆固醇(TC)、三酰甘油(TG)、血脂达标百分率、颈动脉斑块面积、颈动脉内膜中层厚度(CIMT)、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin评级(mRS)及治疗期间新发生卒中百分率与因新发生卒中而死亡的百分率。结果治疗后3,12个月,治疗组患者LDL-C,TC,TG,颈动脉斑块面积,CIMT,NIHSS评分均低于对照组,血脂达标百分率高于对照组,组间差异均有统计学意义(P<0.05);治疗后3,12个月,两组mRS评级差异均无统计学意义(P>0.05);两组治疗后3个月的新发生卒中百分率无统计学差异(P>0.05);治疗后12个月的新发生卒中百分率,治疗组低于对照组(P<0.05);卒中性死亡例数较少。结论中药强化调脂能进一步降低LDL-C水平,提高血脂达标率,缓解颈动脉粥样硬化,改善神经功能缺损程度,降低脑卒中再发率,提高对老年缺血性脑卒中患者二级预防的效果。
Objective To investigate the clinical effect of intensive lipid regulation with traditional Chinese medicine（ TCM） combined with atorvastatin for secondary prevention of elderly patients with ischemic stroke. Methods A total of 90 elderly patients with ischemic stroke admitted to the hospital in 2015 were selected and divided into in the treatment group（ 47 cases） and the control group（ 43 cases）. The two groups were given routine treatment of ischemic stroke. The control group was treated with 20 mg atorvastatin,the treatment group was given Hedan Tablets and Xuesaitong Soft Capsules on the basis of the control group. The levels of low density lipoprotein cholesterol（ LDL-C）, total cholesterol（ TC）, triglyceride（ TG）, the standard-reaching rate of blood lipid, carotid plaque area, carotid intima-media thickness（ CIMT）, NIHSS score and modified Rankin score（ mRS）, the incidence rate of new strokes and the deaths due to new strokes in the treatment in the two groups were compared before treatment, 3 months and 12 months after treatment. Results After treatment for 3 months and 12 months, the levels of LDL, TC, TG, the carotid plaque area,CIMT,and NIHSS score of the treatment group were lower than those of the control group, the standard-reaching rate of blood lipid was higher than that of the control group, and the difference between the two groups was statistically significant（ P〈0. 05）. There was no significant difference in mRS scores between the two groups（ P〈0. 05）. No statistically significant differences of incedence rate of new stroke was found between the two groups after treatment for 3 months（ P〈0. 05）,while the incidence rate of new stroke in the treatment group was statistically significantly lower than that in the control group after treatment for 12 months（ P〈0. 05）.Fewer deaths were caused by stroke. Conclusion Intensive lipid regulation with TCM can further reduce the level of LDL-C,improve the standard-reaching rate of blood lipid, alleviate carotid atherosclerosis, improve the degree of neurological impairment and reduce the recurrence rate of stroke,in order to improve the effect of secondary prevention of elderly patients with ischemic stroke.
作者
史菲
朱丹
王春燕
陈军
Shi Fei Zhu Dan Wang Chunyan Chen Jun(Yangpu Hospital of TCM, Shanghai, China 20009)
出处
《中国药业》
CAS
2017年第17期40-42,共3页
China Pharmaceuticals
关键词
缺血性脑卒中
老年
二级预防
中药
低密度脂蛋白
颈动脉粥样硬化
ischemic stroke
elderly
secondery preventation
traditional Chinese medicine
low densith lipoprotein
carotid atherosclerosis
