世界中医药

目的：探讨阿托伐他汀和通心络对颈动脉粥样硬化斑块和血脂的影响。方法：选择67例颈动脉硬化斑块患者，随机分成3组，阿托伐他汀组、通心络组、联合治疗组（阿托伐他汀+通心络），观察12周。观察治疗前后患者颈动脉内膜-中层厚度，斑块面积，斑块积分和血脂的变化。结果：3组治疗前后颈动脉IMT和斑块面积均缩小，斑块总积分减少，治疗后与治疗前相比差异有统计学意义，组间比较，联合治疗组颈动脉IMT和斑块面积和斑块总积分优于单药治疗组，差异有统计学意义（P<0.05，P<0.01），阿托伐他汀组与通心络组比较，治疗后颈动脉IMT和斑块面积，差异有统计学意义（P<0.05），斑块总积分差异无统计学意义（P>0.05）。联合治疗组TC、LDL-C、TG下降幅度均高于单独用药组，差异有统计学意义（P<0.05），通心络组治疗前后TG差异有统计学意义（P<0.05）。阿托伐他汀组与通心络组治疗后比较，TC、LDL-C、TG差异有统计学意义（P<0.05）,通心络组降TG效果优于阿托伐他汀组（P<0.05），差异有统计学意义。结论：阿托伐他汀和通心络联合治疗作用互补，对颈动脉内膜-中层厚度，斑块面积，斑块积分和血脂的影响大于单药治疗。

English Summary:

To explore the effect of Tongxinluo and Atorvastatin on carotid atherosclerotic plaque and blood lipid. Methods: Selected 67 patients with carotid atherosclerotic plaques, randomly divided into 3 groups, i.e. Atorvastatin group, Tongxinluo group and combination group (Atorvastatin + Tongxinluo), observed 12 weeks. Carotid artery intima - middle thickness, plaque area, plaque integral and changes in blood lipids were observed. Results: Each treatment group’s carotid artery IMT and plaques area was decreased and total plaque score lowered after treatment (P <0.01). Comparison between groups regarding carotid IMT and plaque area and the total score: Atorvastatin + Tongxinluo group was better than the single drug groups with statistical difference. Atorvastatin group was significantly better (P<0.05) than Tongxinluo group except for plaques total score (P>0.05). Combination group TC TG, LDL - C declined greater than other groups (P<0.05). Tongxinluo group TG declined significantly after treatment (P<0.05). TAtorvastatin group showed better effect on TC TG, LDL - C difference (P<0.05), and Tongxinluo group was better to reduce TG (P<0.05). Conclusion:Atorvastatin in combination with Tongxinluo has better curative effect on carotid intima - middle thickness, plaque area, plaque score and blood lipids than monotherapy.

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