清热泻火法干预高血压颈动脉粥样硬化临床探究.pdfVIP

提 要 目的：观察清热泻火法对高血压颈动脉粥样硬化的临床疗效，并探讨相关病机理 论，为抗动脉粥样硬化、稳定斑块及卒中的一二级预防提供有益的中医防治思路。方 法：选择高血压颈动脉粥样硬化火热证患者67例，随机分为两组。对照组34例，常 规服用氨氯地平和（或）氯沙坦氢氯噻嗪片，阿司匹林片及辛伐他汀；治疗组33例， 在对照组相同基础上加服清热泻火方，观察随访6个月。颈部血管超声检测治疗前后 两组患者颈动脉内膜厚度（IMT）值、斑块面积、厚度及超声评分，同时观察血压、 总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）水平的变化及中医证候疗效。 结果：治疗后治疗组中医证候改善率明显优于对照组（P＜0.05）。两组血压均有明显 下降（P＜0.01），治疗组在血压下降幅度及显效率方面优于对照组。颈动脉IMT、斑 块面积及 Crouse 积分同治疗前比较均显著减少（P＜0.01）。TC、TG、LDL-C 均下降 显著（P＜0.01），且 TC 治疗组较对照组差异有统计学意义（P＜0.05）。结论：清热 泻火法联合基础西药治疗具有稳定和缩减颈动脉粥样硬化斑块作用，能有效改善患者 临床症状，延缓颈动脉粥样硬化进程。 关键词 高血压；颈动脉粥样硬化；火热；血脉病 Clinical study on heat-clearing fire-purging method usage forcarotid atherosclerosis in hypertension Speciality: the clinical study of neuro-medical disease of TCM Author:Hao Miao Tutor: Prof. Ding Yuanqing Abstract Objective: To observe the clinical effect of using heat-clearing fire- purging method in Hypertension carotid atherosclerosis and explore the pathogenesis to provide effective secondary prevention for stroke and treatment ideas for anti-atherosclerosis and plaque stability. Methods: 67 cases of carotid atherosclerosis in hypertensive with fire heat syndrome were randomly divided into two groups. The control group, 34 patients taking amlodipine and conventional (or) losartan hydrochlorothiazide tablets, aspirin tablets, and simvastatin;the treatment group, 33 patients treated with control group treatment based and additional using heat-clearing fire-purging method.Followed up for 6 months. Correspondence neck vascular ultrasound before and after treatment in carotid artery IMT, plaque area, thickness, and ultrasound score, and compare the blood pressure ，total cholesterol