摘要
目的探讨应用超微血管成像(SMI)技术评价半夏白术天麻汤改善高血压痰湿壅盛型颈动脉硬化斑块稳定性的临床应用价值。方法选取2018年9月至2020年9月在黑龙江中医药大学附属第一医院就诊的120例高血压痰湿壅盛型颈动脉硬化斑块患者作为研究对象,按完全随机法将患者分对照组和治疗组,每组60例。对照组患者采用阿托伐他汀钙片治疗,每天1次、每次20 mg,早饭后口服;治疗组患者在对照组治疗的基础上加用半夏白术天麻汤水丸,每次50丸、每天2次,饭后口服;两组疗程均为6个月。检测治疗前后两组患者血清低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)水平,并行常规超声及SMI检查,记录两组患者治疗前后颈动脉内-中膜厚度(IMT)、颈动脉斑块Crouse积分及颈动脉斑块SMI分级。结果治疗前,两组高血压痰湿壅盛型颈动脉硬化斑块患者血清LDL-C、TC、TG水平差异均无统计学意义(P均>0.05);治疗后,两组患者的LDL-C、TC、TG水平均较治疗前降低(P均<0.05),且治疗组患者的血清LDL-C、TC、TG水平均低于对照组(P均<0.05)。治疗前,两组患者颈动脉IMT、斑块Crouse积分比较差异均无统计学意义(P均>0.05);治疗后,两组患者的颈动脉IMT、斑块Crouse积分均较治疗前降低但差异无统计学意义(P均>0.05),治疗组患者的颈动脉IMT及斑块Crouse积分与对照组比较差异也无统计学意义(P均>0.05)。治疗前,两组患者颈动脉斑块SMI分级比较差异无统计学意义(P>0.05);治疗后,两组患者颈动脉斑块SMI分级为2级的患者比例与治疗前比较均降低(P均<0.01),SMI分级为0级的患者比例与治疗前比较均增高(P均<0.01),且治疗组患者颈动脉斑块SMI分级为2级的患者比例低于对照组(P<0.05)。结论SMI技术能用于评估半夏白术天麻汤改善高血压痰湿壅盛型颈动脉硬化斑块稳定性的疗效,可为临床用药效果评价提供依据。
Objective To explore the clinical application of superb micro-vascular imaging(SMI)in evaluating the role of Banxia Baizhu Tianma decoction in improving the stability of carotid atherosclerotic plaque of hypertension with phlegm dampness obstruction.Methods A total of 120 patients with carotid atherosclerotic plaque of hypertension with phlegm dampness obstruction were enrolled,they visited the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from Sep.2018 to Sep.2020.The patients were randomly divided into control group and treatment group(60 cases in each group).The control group was treated with atorvastatin calcium tablets,20 mg once a day,orally after breakfast;the treatment group was also treated with Banxia Baizhu Tianma decoction,50 watered pills each time,twice a day,orally after meals.Both groups were treated for 6 months.The serum levels of low-density lipoproteincholesterol(LDL-C),total cholesterol(TC)and triglyceride(TG)were recorded before and after treatment.Routine ultrasound and SMI were performed.Carotid intima-media thickness(IMT),carotid plaque Crouse score and carotid plaque SMI grade were observed before and after treatment.Results There were no significant differences in serum levels of LDL-C,TC or TG between the 2 groups before treatment(all P>0.05);the serum levels of LDL-C,TC and TG in the 2 groups were significantly lower after treatment than those before treatment(all P<0.05);and the serum levels of LDL-C,TC and TG in the treatment group were significantly lower than those in the control group after treatment(all P<0.05).There were no significant differences in carotid IMT or plaque Crouse score between the 2 groups before treatment(both P>0.05);the carotid IMT and plaque Crouse scores of the 2 groups were decreased after treatment,with no significant difference(both P>0.05);there were no significant differences in carotid IMT or plaque Crouse score between the 2 groups after treatment(both P>0.05).There was no significant difference in carotid plaque SMI grade between the 2 groups before treatment(P>0.05);after treatment,the proportions of patients with carotid plaque SMI grade 2 were decreased and those with SMI grade 0 were increased in both groups compared with those before treatment(both P<0.01),and the proportion of patients with carotid plaque SMI grade 2 in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion SMI can be used to evaluate the role of Banxia Baizhu Tianma decoction in improving the stability of carotid atherosclerotic plaque of hypertension with phlegm dampness obstruction,which can help to evaluate the clinical effect of medication.
作者
张雪松
李晶
石光煜
赵丽娜
ZHANG Xue-song;LI Jing;SHI Guang-yu;ZHAO Li-na(Department of Ultrasound,the First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2021年第7期823-829,共7页
Academic Journal of Second Military Medical University
基金
黑龙江省自然科学基金面上项目(H2016055)
黑龙江省中医药管理局科研项目(ZHY2020-110,ZHY2020-114).
关键词
超微血管成像技术
半夏白术天麻汤
动脉粥样硬化
斑块
痰湿壅盛
superb micro-vascular imaging
Banxia Baizhu Tianma decoction
atherosclerosis
plaque
phlegm dampness obstruction
