加味柴胡温胆汤对老年高血压患者血小板活化状态及颈动脉内膜厚度的影响

目的:探讨加味柴胡温胆汤抗动脉硬化的作用及其机制。方法:将入选老年高血压患者随机分成3组:阿托伐他汀组(A组)、加味柴胡温胆汤组(C组)、阿托伐他汀组+加味柴胡温胆汤组(A+C组)。在常规降压药物基础上,A组予以阿托伐他汀20 mg.d-1口服,C组予以加味柴胡温胆汤20 g/次,全天3次随三餐前或后口服,A+C组同时口服阿托伐他汀和加味柴胡温胆汤,剂量和方法与A,C组相同。患者入选时(记为0点)和服药满12个月(记为12点)、18个月时(记为18点)均分别用放射免疫法检测血浆血小板α颗粒膜蛋白(GMP)-140,超声检测左侧颈总动脉内膜-中层厚度(IMT)。结果:关于GMP-140值:C组、A+C组在12点和18点显著低于0点和A组(P<0.01);C组和A+C组在12点、18点无明显统计学差别。A组在18点方显示低于0点(P<0.05)。关于IMT值:在12点,C组和A+C组明显低于0点和A组(P<0.01);C组和A+C组无统计学差别;而A组较0点无降低。在18点,C组和A+C组仍明显比A组低(P<0.01);C组和A+C组仍无统计学差别;3组IMT均明显低于0点和12点(P<0.01)。结论:加味柴胡温胆汤可以抑制血小板活化,并抑制老年高血压患者动脉硬化进程。

Effects of Modified Chaihu Wendan Decoction on Platelet Activation and Intima-media Thickness of Carotid in Elder Hypertensive Patients

Objective: The purpose of this study was to investigate the effects of modified Chaihu Wendan decoction (mCWD) on atherosclerosis and its possible mechanisms. Method: Selected elder hypertensive patients were divided into three groups at random, i. e. Atrovastatin group, mCWD group andAtrovastatin plus mCWD group. These three groups were referred to as A group, C group and A+C group hereafter, respectively. Based on regular lowering-pressure treatments, specifically, A group was treated with Atrovastatin of 20 mg per day further, C group with mCWD in dose of 20 g per time, around each meal and three times a day, and A+C group with both Atrovastatin and mCWD in the same way and the dose for each medicine above mentioned. At selected time points, the effects of above treatments were examined by testing the changes of platelet alpha-granule membrane protein (GMP)-140(Radioimmunoassay, RIA) and intima-media thickness (IMT) of left common carotid(ultrasonic waves). Result: Firstly, at the end of 12 and 18 month treatments, the plasma concentrations of GMP-140 of both C and A+C groups decreased significantly compared with those in A group and the initial values (P<0. 01), and there was no difference between C group and A+C group; But until the end of 18 months the value of A group was lower than the initial one (P<0. 05). Secondly, at the end of 12 moths, compared with A group and the values prior to treatments, the change values of IMT in C group and A+C group were apparently lower (P<0. 01), there was no appreciable difference between C group and A+C group. At the end of 18 moths, the IMT values of both C group and A+C group were lower than those in A group as well (P<0. 01), there was no difference between C group and A+C group yet; and the IMT values in all groups were lower obviously than those at the end of 12 moths and those prror to treatment, too(P<0. 01). Conclusion: MCWD can attenuate the activity of platelet alpha-granule membrane protein and is an effective medicine for the treatment of anti-atherosclerosis.