精灵颗粒对动脉粥样硬化患者血管弹性功能影响的临床研究

  目的  观察精灵颗粒对气阴两虚、痰瘀互结型动脉粥样硬化患者中医证候积分、动脉弹性及形态功能、血脂、血液流变学及血清炎症因子的影响。  方法  符合纳入标准的100例动脉粥样硬化患者随机分为对照组及试验组, 每组50例; 对照组采用阿托伐他汀干预, 实验组在阿托伐他汀的基础上加用精灵颗粒进行干预, 观察时间为24周, 比较2组中医证候积分、颈动脉内膜中层厚度(Intima-media thickness, IMT)、极速脉搏波传导速度(Ultrafast pulse wave velocity, UFPWV)指标[收缩期起始脉搏波速度(Pulse wave velocity-beginning of systole, PWV-BS)、收缩期末脉搏波速度(Pulse wave velocity-end of systole, PWV-ES)]、血脂水平、血液流变学指标、血清炎症因子C-反应蛋白(C-reactive protein, CRP)、白细胞介素-6(Interleukin-6, IL-6)、白细胞介素-8(Interleukin-8, IL-8)及肝肾功能的变化。  结果  治疗后, 2组中医证候积分均明显降低(P < 0.01), 试验组优于对照组(P < 0.01);试验组双侧颈动脉PWV-BS、PWV-ES均有降低(P < 0.01), 对照组双侧颈动脉PWV-ES及左侧颈动脉PWV-BS降低(P < 0.05), 试验组右侧颈动脉PWV-ES变化优于对照组(P < 0.05);2组TC、TG、LDL-C水平均有所改善(P < 0.01), 试验组TC水平改善优于对照组(P < 0.01);2组全血中、低切及血浆黏度值均降低(P < 0.05), 试验组低切变化优于对照组(P < 0.05);试验组血清CRP、IL-6、IL-8水平均降低(P < 0.05);对照组IL-6、IL-8水平降低(P < 0.05), 试验组CRP水平变化优于对照组(P < 0.05)。治疗期间2组患者均未出现明显不良反应。  结论  精灵颗粒在阿托伐他汀治疗基础上能改善气阴两虚、痰瘀互结型动脉粥样硬化患者的中医证候积分, 血管弹性功能, TC、TG、LDL-C水平, 炎症因子CRP、IL-6、IL-8水平, 全血中低切黏度、血浆黏度值等指标, 且具有良好的安全性。 

Clinical Study on the Effect of Jingling Granules on Vascular Elasticity in Patients with Atherosclerosis

  OBJECTIVE  To observe the effects of Jingling granules on the traditional Chinese medicine (TCM) syndrome score, arterial elasticity and morphological function, blood lipids, blood rheology, as well as serum inflammatory factors in patients with atherosclerosis of qi-yin deficiency and phlegm-blood stasis.  METHODS  A total of 100 patients with atherosclerosis who met the inclusion criteria were randomly divided into control group and experimental group, 50 patients in each group. The control group was treated with atorvastatin, while the experimental group was administered with Jingling granules based on the treatment of the control group. The changes in the two groups were compared in terms of the TCM syndrome score, carotid intima-media thickness (IMT), ultrafast pulse wave velocity (UFPWV) indexes [pulse wave velocity-beginning of systole (PWV-BS), pulse wave velocity-end of systole (PWV-BS), pulse wave velocity-end of systole (PWV-ES)], blood lipids, blood rheological indexes (whole blood high shear viscosity, whole blood medium shear viscosity, whole blood low shear viscosity, plasma viscosity), serum inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), as well as the liver and kidney function.  RESULTS  After treatment, the TCM syndrome scores of the two groups were significantly reduced (P < 0. 01), but the result of the experiment group was better than that of the control group (P < 0.01). The bilateral carotid PWV-BS and PWV-ES of the experiment group were reduced (P < 0.01), and the bilateral carotid PWV-ES and left carotid PWV-BS of the control group were reduced (P < 0.05), but the change of the right carotid PWV-ES of the experiment group was better than that of the control group (P < 0.05). The levels of TC, TG and LDL-C showed better results in both groups (P < 0.01), while the change of TC level was better in the experiment group than in the control group (P < 0.01). Besides, the levels of whole blood medium shear viscosity and whole blood low shear viscosity, as well as plasma viscosity were reduced in both groups (P < 0.05), but the change of whole blood low shear viscosity showed better result in the experiment group than in the control group (P < 0.05). In addition, the levels of serum CRP, IL-6 and IL-8 were reduced in the experiment group (P < 0.05), and the levels of IL-6 and IL-8 were reduced in the control group (P < 0.05). However, the changes of CRP levels in the experiment group were better than those in the control group (P < 0.05). No significant adverse reactions were observed in both groups during the treatment.  CONCLUSIONS  Jingling granules, combined with atorvastatin, can achieve the better clinical efficacy in treating patients with atherosclerosis of qi-yin deficiency and phlegm-blood stasis, in terms of the TCM syndrome scores, vascular elasticity, TC, TG, LDL-C levels, inflammatory factors CRP, IL-6, IL-8 levels, the levels of whole blood medium shear viscosity, whole blood low shear viscosity, and plasma viscosity.