医学论文-彩色多普勒超声评价益气活血化痰通络方治疗下肢动脉硬化的疗效- 随机对照试验.docVIP

医学论文-彩色多普勒超声评价益气活血化痰通络方治疗下肢动脉硬化的疗效: 随机对照试验 ????????????????????作者：童仙君, 项晓宇, 程遵华, 陈励, 陈咸川, 陈敬贤 【摘要】? 目的：观察益气活血化痰通络方对下肢动脉硬化的治疗作用。方法：将上海岳阳中西医结合医院老年科门诊和住院患者中经彩色多普勒超声检查发现有下肢动脉硬化者随机分为治疗组和对照组，每组各30例。治疗组予以辛伐他汀及益气活血化痰通络方，对照组仅用辛伐他汀，6个月后复查下肢动脉彩色多普勒超声，测量股动脉及腘动脉内径、内中膜厚度和斑块面积，并比较血清总胆固醇（total cholesterol, TC）和低密度脂蛋白（lowdensity lipoprotein, LDL）含量。结果：治疗后，治疗组股动脉和腘动脉内中膜厚度较对照组明显变薄，动脉斑块面积较对照组明显缩小，两组比较，差异均有统计学意义（P0.05）。彩色多普勒超声显示治疗组下肢动脉单相波的出现比例由治疗前的26.67% （8/30）降至治疗后的6.67%（2/30），对照组则由治疗前的26.67%（8/30）降至治疗后的16.67%（5/30），两组治疗前后出现下肢动脉单相波的患者数比较，差异有统计学意义（P0.05），且治疗组治疗后出现单相波的患者数较对照组明显减少（P0.05）。辛伐他汀联合益气活血化痰通络方可有效降低TC、LDL浓度，与单用辛伐他汀比较，差异有统计学意义（P0.05）。结论：彩色多普勒超声显示益气活血化痰通络方能在一定程度上改善下肢动脉硬化。 【关键词】? 动脉硬化; 下肢; 多普勒超声; 中药; 补气; 活血; 祛痰; 通络; 随机对照试验 ??? Methods: The outpatients and inpatients with lower limb arteriosclerosis from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine were randomly divided into control group and treatment group after color Doppler ultrasound inspection, and there were 30 cases in each group. The patients in the treatment group were treated with simvastatin and a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals, and the patients in the control group were treated only with simvastatin. The color Doppler ultrasound imaging of lower limb arteries including inside diameter, intimamedia thickness, and plaque area in all the patients were examined after 6month treatment. The levels of serum total cholesterol (TC) and lowdensity lipoprotein (LDL) were detected too. ??? Results: After the treatment, the lower limb artery intimamedia thickness and artery plaque area in the treatment group decreased obviously as compared with those in the control group (P0.05). Color Doppler flow imaging showed that the percentage of patients with uniphase wave decreased from 26.67% (8/30) to 6.67% (2/30) in the treatment group (P0.05), and from 26.67% (8/30) to 16.67% (5/30) in the control group