调脂增寿汤调整血脂异常的效果观察

背景血脂异常是动脉粥样硬化和冠心病等心脑血管疾病发生的重要危险因素.目的观察调脂增寿汤干预血脂异常患者的临床疗效.设计随机分组对照观察.单位解放军总医院肿瘤科、中医科和心内科.对象2002-02/2004-01解放军总医院心内科和中医科血脂异常住院患者及血脂门诊患者120例.方法120例血脂异常患者随机分为3组,中药组43例,给予调脂增寿汤,1剂/d,早晚饭前分服;西药组40例,给予普伐他汀钠,10 mg/片,1片/d,每晚睡前口服;中西药组37例,给予普伐他汀钠和调脂增寿汤,其药物剂量、组成及服用法均同前.各治疗8周,观察其疗效、血脂变化及不良反应情况.主要观察指标各组患者的疗效及不良反应情况的比较.结果共纳入患者120例,因是外地患者失去联络及未能及时复诊共失访27例,其余的93例患者全部完成数据采集.①各组疗效比较中药组和西药组有效率相似(81%,80%,P＞0.05),且均小于中西药组(97%,P＜0.05).②各组治疗前后血脂系列变化的比较中药组三酰甘油由(2.59±1.64)mmol/L降至(1.56±0.72)mmol/L,血清总胆固醇由(5.30±1.71)mmol/L降至(4.35±0.85)mmol/L(P＜0.01);高密度脂蛋白胆固醇由(1.32±0.37)mmol/L升至(1.50±0.22)mmol/L(P＜0.05);西药组三酰甘油由(2.84±1.50)mmol/L降至(2.04±0.98)mmol/L,血清总胆固醇由(5.50±1.22)mmol/L降至(4.71±0.89)mmol/L(P＜0.05,P＜0.01);载脂蛋白A1由(1.24±0.21)g/L升至(1.49±0.15)g/L(P＜0.01);中西药组对降低三酰甘油、总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B、升高载脂蛋白A1和高密度脂蛋白胆固醇均疗效显著(P＜0.01,P＜0.05).③不良事件和副反应中药组不良反应例数低于西药组(1例,7例).结论调脂增寿汤治疗血脂异常临床疗效确切,且不良反应发生率低.

Observation of effects of tiaozhi zengshou tang on regulation of dyslipidemia

BACKGROUND: Dyslipidemia is the important risk of cardiac cerebral vascular diseases, such as arthrosclerosis and coronary heart disease, etc.OBJECTIVE: To observe the clinical therapeutic effects of tiaozhi zengshou tang (herbal decoction) on intervention of dyslipidemia.DESIGN: Randomized, group controlled observation.SETTING: Department of Oncology, Department of Chinese Medicine and Department of Cardiology of General Hospital of Chinese PLA.PARTICIPANTS: Totally 120 cases from inpatients with dyslipidemia in Department of Chinese Medicine and Department of Cardiology of General Hospital of Chinese PLA and outpatients in Clinic of Blood lipid from February 2002 to January 2004.METHODS: Totally 120 cases of dyslipidemia were randomized into 3 groups. In Chinese herb group (43 cases), tiaozhi zengshou tang (herbal decoction) was prescribed, one dose/d, taking separately before breakfast and dinner. In western drug group (40 cases), pravastatin sodium was prescribed, 10 mg/tablet, 1 tablet/d, taking orally before sleep at night. Integrative group (37 cases) both pravastatin sodium and herbal decoction were prescribed, the dosage, composition and administration were same as previous. The treatment lasted 8 weeks, and then, the therapeutic effects on changes of blood lipid and harmful effects were observed.MAIN OUTCOME MEASURES: Comparisons of therapeutic effects and harmful effects among groups.RESULTS: 120 cases were employed in the experiment, but 27 of those were dropped out due to loss of contact and absent re-visiting in time. Total parison of therapeutic effects among groups: The effective rates in Chinese herb group and western drug group were similar (81%, 80%, P ＞ 0.05),changes of blood lipid series before and after treatment in each group: In Chinese herb group, triglyceride (TG) (2.59t1.64) mmol/L was reduced to (1.56±0.72) mmol/L, serum total cholesterol (TC) (5.30±1.71) mmol/L was reduced to (4.35±0.85) mmol/L (P ＜ 0.01) and HDL-Cholesterol (HDL-Ch)(1.32±0.37) mmol/L was increased to (1.50±0.22) mmol/L (P ＜ 0.05). In western drug group, TG (2.84±1.50) mmol/L was reduced to (2.04±0.98) mmol/L,serum TC (5.50±1.22) mmol/L was reduced to (4.71±0.89) mmol/L (P ＜ 0.05,P ＜ 0.01) and APoA1 (1.24±0.21) g/L was increased to (1.49±0.15) g/L (P ＜ 0.01). In integrative group, the therapeutic effects were significant in re ducing TG, TC, LDL-Ch and APoB and increasing APoA1 and HDL-Ch harmful effects in Chinese herb group were less than western drug group (1 case, 7 cases).CONCLUSION: Tiaozhi zengshou tang provides definitely clinical therapeutic effects in dyslipidemia and presents low incident of harmful effects.