益气化痰活血法治疗高血压合并颈动脉粥样硬化临床研究

杨自如

摘 要 目的：探討益气化痰活血法治疗高血压合并颈动脉粥样硬化临床疗效。方法：选择2019年1月—2020年1月收治的高血压合并颈动脉粥样硬化患者50例，随机分为对照组和观察组各25例。对照组口服辛伐他汀20 mg/次，1次/d，口服肠溶阿司匹林100 mg/次，1次/d。观察组口服辛伐他汀和益气化痰活血中药1剂/d，水煎至400 ml，分早晚服用。两组均治疗6个月。观察患者治疗前后的症状积分、颈动脉斑块、颈内动脉血流动力学和血脂水平变化情况。结果：观察组干预后症状积分为（12.25±3.11）分，低于对照组的（16.44±3.68）分（P<0.05）。干预后，观察组斑块数量为（1.07±0.31）个，易损斑块数量为（0.47±0.03）个，分别低于对照组的（1.35±0.42）个和（0.62±0.06）个（P<0.05）；斑块面积为（64.46±5.21）mm2，小于对照组的（72.79±5.99）mm2（P<0.05）。干预后，观察组的血流动力学指标均低于对照组（P<0.05），血脂水平改善较好，优于对照组（P<0.05）。结论：益气化痰活血法治疗高血压合并颈动脉粥样硬化效果较好，可以改善患者的症状积分，减少斑块数量和易损斑块数量，缩小斑块面积，改善血流动力学和血脂水平，应用价值较高。

关键词 高血压；颈动脉粥样硬化；益气化痰活血法

中图分类号：R544.1 文献标志码：A 文章编号：1006-1533（2021）06-0022-03

Clinical study of Yiqi huatan huoxue therapy in the treatment of hypertension complicated with carotid atherosclerosis

YANG Ziru

（Internal Medicine of Traditional Chinese Medicine of Second Peoples Hospital of Zhangshu， Jiangxi 331211， China）

ABSTRACT Objective： To investigate the clinical effect of Yiqi huatan huoxue therapy in the treatment of hypertension complicated with carotid atherosclerosis. Methods： From January 2019 to January 2020， 50 patients with hypertension complicated with carotid atherosclerosis treated in the hospital were selected， and randomly divided into a control group and an observation group with 25 cases each. The control group received oral simvastatin 20 mg/time， once daily， and oral entericcoated aspirin 100 mg/time， once daily. The observation group was treated with simvastatin and Yiqi huatan huoxue Chinese medicine 1 dose/d， which was decocted in water to 400 ml， and took them in the morning and evening. Both groups were treated for 6 months. The changes of symptom score， carotid plaque， internal carotid artery hemodynamics and blood lipid levels of the patients were observed before and after treatment. Results： The symptom score in the observation group after intervention was（12.25±3.11） points， which was lower than that in the control group （16.44±3.68） points （P<0.05）. After intervention， the number of plaques in the observation group was （1.07±0.31） and the number of vulnerable plaques was （0.47±0.03）， which were lower than those in the control group （1.35±0.42） and （0.62±0.06）（P<0.05）； the plaque area was （64.46±5.21） mm2 in the observation group， which was smaller than that in the control group （72.79±5.99） mm2（P<0.05）. After the intervention， the hemodynamic indexes in the observation group were lower than those in the control group（P<0.05）， and the improvement of blood lipid level in the observation group was better than that in the control group（P<0.05）. Conclusion： Yiqi huatan huoxue therapy is effective in the treatment of hypertension complicated with carotid atherosclerosis， which can improve the symptom score of patients， reduce the number of plaques and the number of vulnerable plaques， reduce the area of plaques， and improve hemodynamics and blood lipid levels， which has high application value.

KEY WORD hypertension； carotid atherosclerosis； Yiqi huatan huoxue therapy

高血压发病率较高，随着患者病情进展，会逐步引起心脑、肾脏等器官损害，进一步引发心肌梗死和脑出血等症状[1-3]。已有研究显示，高血压靶器官病理损害的基础是血流动力学改变、颈动脉硬化斑块形成[4]。因此，研究有效的干预措施，改善患者的临床预后，对于提高患者的生活质量，具有重要意义。本文报道采用益气化痰活血法治疗高血压伴颈动脉粥样硬化效果。

1 资料与方法

1.1 一般资料

选择2019年1月—2020年1月收治的高血压伴颈动脉粥样硬化患者50例，均符合高血压诊断标准[5]和颈动脉粥样硬化诊断标准[6]。按照随机数字表对照法分为观察组和对照组各25例。观察组中男性20例，女性5例，年龄50～63岁，平均（54.16±7.66）岁，高血压病程5～20年，平均（11.01±2.13）年，合并冠心病10例，合并糖尿病10例，合并高脂血症5例。对照组中男性18例，女性7例，年龄49～53岁，平均（53.98±7.12）岁，高血压病程5～19年，平均（11.21±2.24）年，合并冠心病11例，合并糖尿病10例，合并高脂血症4例。……