Objective To observe the effects of compound Qishen Jiangzhi decoction (CQJD) on the stability of carotid atherosclerotic vulnerable plaque. Methods Two hundred and fifty - eight patients (pts) with carotid atherosclerosis were assigned to five groups according to the syndrome differentiation of traditional Chinese medicine(TCM) :Phlegm-damp syndrome group,blood stasis syndrome group,turbid toxins syndrome group,deficiency syndrome of liver and kidney group,and qi - deficiency syndrome group. The intima - media thickness(IMT) , area of atherosclerotic clots and plaque score were examined, serum lipids and high sensitivity C - reactive proteinC hs - CRP) were measured before and after treatment for 6 months. Results IMT, area of atherosclerotic clots, the plaque score, total cholesterol(TC) ,low density lipbprotein cholesterol (LDL-C) and hs - CRP in blood stasis syndrome group,turbid toxins syndrome group and qi - deficiency, syndrome group were lower significantly compared with other groups(P<0. 05). Conclusion CQJD could stabilize the vulnerable plaque of carotid atherosclerosis in pts with blood stasis syndrome, turbid toxins syndrome, and qi - deficiency syndrome.%目的 观察复方芪参降脂饮对颈动脉粥样硬化(AS)患者易损斑块稳定性的影响.方法 258例颈AS斑块患者,按中医辨证分为痰湿阻滞证、瘀阻脉络证、浊毒内蕴证和肝肾亏虚证、气虚证5型.给予复方芪参降脂饮口服,疗程为6个月.检查各证型患者治疗前后颈动脉斑块内膜中层厚度(IMT)、斑块面积、斑决积分及血脂、高敏C-反应蛋白(hs - CRP)变化.结果 颈AS患者易损斑块分布以瘀阻脉络证和浊毒内蕴证组远大于其他证组(P＜0.05).治疗后瘀阻脉络证、浊毒内蕴证、气虚证组颈动脉易损斑块IMT、斑块面积、斑块积分及血清总胆固醇(TC)、低密度脂蛋白(LDL - C)、hs - CRP水平较治疗前显著降低(P＜0.05).结论 复方芪参降脂饮对稳定瘀血、浊毒、气虚证易损斑块效果明显.其作用机制可能是通过调脂及抗炎作用实现的.
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