星蛭软脉颗粒改变脑梗死患者颈动脉粥样硬化作用及机制探讨
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摘要
目的:观察星蛭软脉颗粒(XZRMKL)治疗脑梗死患者颈动脉粥样硬化斑块形态、性质、内-中膜厚度等变化,评价其对颈动脉粥样硬化的影响。方法:62例脑梗死合并颈动脉粥样硬化患者按序随机分为治疗组和对照组2组,对照组给予拜阿司匹林100mg,1次/d,口服;辛伐他汀10mg,每晚1次口服。治疗组(星蛭软脉颗粒组)在对照组基础上加星蛭软脉颗粒,冲服,2次/d,疗程为6个月。观察2组患者治疗前后颈动脉斑块Crouse积分、IMT、斑块的稳定性、斑块横切面最大面积。结果:与同组治疗前相比,2组治疗后Crouse积分、斑块最大横切面积(Smax)均降低、斑块稳定性改善;与对照组治疗后比较,治疗组改善更为明显,差异有统计学意义。与同组治疗前比较,2组治疗后IMT均稍微改善,但因样本量太小,需扩大样本量,进一步研究。结论:XZRMKL能降低脑梗死患者颈动脉粥样硬化的Crouse积分,降低斑块最大面积,减少不稳定斑块数量,但对IMT的作用需扩大样本,进一步研究。
Objective: To observe the changes of carotid atherosclerotic plaque morphology,properties and endomedia thickness in patients with cerebral infarction treated with Xingjing Soft Vein Granules(XZRMKL).The effect on carotid atherosclerosis was evaluated.Methods: 62 patients with cerebral infarction and carotid atherosclerosis were randomly divided into treatment group and control group.The control group was given aspirin 100 mg once daily for oral administration.Simvastatin 10 mg,taken orally once a night.The treatment group(Xingyi Ruanmai Granules group) was treated with Xingfu Ruanmai Granules on the basis of the control group,and was given 2 times/d for 6 months.Carrouse scores,IMT,plaque stability,and maximum area of plaque cross-section were observed before and after treatment in 2 groups.Results: Compared with the same group before treatment,the Crouse score and the maximum cross-sectional area(Smax) of the plaques were decreased and the plaque stability was improved.Compared with the control group after treatment,the improvement of the treatment group was more obvious,and the difference was statistically significant.Compared with the same group before treatment,the IMT of the two groups improved slightly after treatment,but because the sample size is too small,the sample size needs to be expanded to further study.Conclusion: XZRMKL can reduce the Crouse score of carotid atherosclerosis in patients with cerebral infarction,reduce the maximum area of plaque and reduce the number of unstable plaques,but the effect on IMT needs to be expanded to further study.
Objective: To observe the changes of carotid atherosclerotic plaque morphology,properties and endomedia thickness in patients with cerebral infarction treated with Xingjing Soft Vein Granules(XZRMKL).The effect on carotid atherosclerosis was evaluated.Methods: 62 patients with cerebral infarction and carotid atherosclerosis were randomly divided into treatment group and control group.The control group was given aspirin 100 mg once daily for oral administration.Simvastatin 10 mg,taken orally once a night.The treatment group(Xingyi Ruanmai Granules group) was treated with Xingfu Ruanmai Granules on the basis of the control group,and was given 2 times/d for 6 months.Carrouse scores,IMT,plaque stability,and maximum area of plaque cross-section were observed before and after treatment in 2 groups.Results: Compared with the same group before treatment,the Crouse score and the maximum cross-sectional area(Smax) of the plaques were decreased and the plaque stability was improved.Compared with the control group after treatment,the improvement of the treatment group was more obvious,and the difference was statistically significant.Compared with the same group before treatment,the IMT of the two groups improved slightly after treatment,but because the sample size is too small,the sample size needs to be expanded to further study.Conclusion: XZRMKL can reduce the Crouse score of carotid atherosclerosis in patients with cerebral infarction,reduce the maximum area of plaque and reduce the number of unstable plaques,but the effect on IMT needs to be expanded to further study.
引文
[1]党卫红.颈动脉粥样硬化与脑梗死的相关性探讨[J].中国实用医药,2011,6(6):124-125.
[2]洪震.脑卒中的流行病学及其危险因素[J],中国卒中杂志,2006,8(1):559-563.
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[4]郭万学.超声医学[M].6版.北京:人民军医出版社,2011:689-691.
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[7]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2014,43:146-153.
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[9]中国中西医结合学会神经科专业委员会.脑梗死和脑出血中西医结合诊断标准(试行)[J].中国中西医结合杂志,2006,26(10):948-949.
[10]赵新民,江凤荣,刘永杰.彩超对颈动脉粥样硬化与缺血性脑血管疾病的研究[J].中国超声医学杂志,2003,5(19):337-340.
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[12]Wang Peng,Xiu Chunhong,Wang Lanfeng.the relationship between carotid atherosclerosis and cardiovascular and cerebrovascular diseases[J].Chinese Journal of arteriosclerosis,2014,11:1175-1178.
[13]中华人民共和国卫生部.中药新药临床研究指导原则[S].2辑.北京:卫生部,1995,17l-174.
[14]王亚萍.彩超对颈动脉粥样硬化斑块与脑梗死关系的价值分析[J].中国实用医药,2011.6(17):123-124.
[15]刘臻洁,关正,吴海琴,等.脑梗死患者颈动脉粥样硬化的特点及其对血流动力学的影响[J].中国血流变学杂志,2008,18(4):497-499.
[16]张红.B超对颈部动脉粥样硬化斑块发生部位的探讨[J].中华现代影像学杂志,2007,4(6):535-536.
[17]Bond MG,Strickland HL,Wilmoth SK,et al.Interwentional clinical trials using noni vasive ultrasound end points:them ulticenter is radipine/diuretic atherosclerosis study[J].JCardiovasc Pharmacol,1990,15(suppl 1):30.
[18]李洁,王静.超声对动脉粥样斑块稳定性的评价进展[J].临床超声医学杂志,2014,8:546-548.
[19]赵步长,伍勤.动脉粥样硬化中医浅析[J].光明中医,2012,27(12):2518-2522.
[20]于云华,苏建春,塔衣尔江,等.118例颈动脉粥样硬化中医辨证分型特点分析[J].中华中医药杂志,2010,25(5):798-800.
[21]陈文强,黄小波,李宗信,等.颈动脉粥样硬化中医证候转化的定量分析[J].中国老年医学杂志,2010,30(15):2089-2090.
[2]洪震.脑卒中的流行病学及其危险因素[J],中国卒中杂志,2006,8(1):559-563.
[3]Touboul PJ,Hennerici MG,Meairs S,et al.Mannheim carotid intima-media thickness and plaque consensus(2004-2006-2011).An opdate on behalf of the advisory board of the 3th,15th and 5th watching the risksymposia,at the 13th,15th and20th European Stroke conferences,Mannheim,Germany,2004,Brussels,Belgium,2006,and Hamburg,Germany,2011[J].Cerebrovase Dis,2012,34(4):290-296.
[4]郭万学.超声医学[M].6版.北京:人民军医出版社,2011:689-691.
[5]Crouse JR,Harpold GH,Kahl FR,et al.Evaluation of ascoring system for extracranial carotid atherosclerosis extent with B-mode ultrasound[J].Stroke,1986,17:270.
[6]彭化生,孙翠云,吕红霞.辛伐他汀与阿司匹林联合用药对高血压病患者颈动脉粥样硬化的干预作用[J].中国脑血管病杂志,2006,3(1):15-18.
[7]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2014,43:146-153.
[8]北京市脑卒中诊疗质量控制与改进中心.脑动脉粥样硬化筛查与诊断规范(2014版)[J].中华医学杂志,2014,94(47):3705-3711.
[9]中国中西医结合学会神经科专业委员会.脑梗死和脑出血中西医结合诊断标准(试行)[J].中国中西医结合杂志,2006,26(10):948-949.
[10]赵新民,江凤荣,刘永杰.彩超对颈动脉粥样硬化与缺血性脑血管疾病的研究[J].中国超声医学杂志,2003,5(19):337-340.
[11]Bond MG,Strickland HL,Wilmoth SK,et al.Interwentional clinical trials using noni vasive ultrasound end points:them ulticenter is radipine/diuretic atherosclerosis study[J].JCardiovasc Pharmacol,1990,15(suppl 1):30.
[12]Wang Peng,Xiu Chunhong,Wang Lanfeng.the relationship between carotid atherosclerosis and cardiovascular and cerebrovascular diseases[J].Chinese Journal of arteriosclerosis,2014,11:1175-1178.
[13]中华人民共和国卫生部.中药新药临床研究指导原则[S].2辑.北京:卫生部,1995,17l-174.
[14]王亚萍.彩超对颈动脉粥样硬化斑块与脑梗死关系的价值分析[J].中国实用医药,2011.6(17):123-124.
[15]刘臻洁,关正,吴海琴,等.脑梗死患者颈动脉粥样硬化的特点及其对血流动力学的影响[J].中国血流变学杂志,2008,18(4):497-499.
[16]张红.B超对颈部动脉粥样硬化斑块发生部位的探讨[J].中华现代影像学杂志,2007,4(6):535-536.
[17]Bond MG,Strickland HL,Wilmoth SK,et al.Interwentional clinical trials using noni vasive ultrasound end points:them ulticenter is radipine/diuretic atherosclerosis study[J].JCardiovasc Pharmacol,1990,15(suppl 1):30.
[18]李洁,王静.超声对动脉粥样斑块稳定性的评价进展[J].临床超声医学杂志,2014,8:546-548.
[19]赵步长,伍勤.动脉粥样硬化中医浅析[J].光明中医,2012,27(12):2518-2522.
[20]于云华,苏建春,塔衣尔江,等.118例颈动脉粥样硬化中医辨证分型特点分析[J].中华中医药杂志,2010,25(5):798-800.
[21]陈文强,黄小波,李宗信,等.颈动脉粥样硬化中医证候转化的定量分析[J].中国老年医学杂志,2010,30(15):2089-2090.