【摘要】 目的:观察具有解毒作用的中药虎杖提取物配伍活血化瘀中药山楂提取物对颈动脉粥样硬化患者颈动脉内膜-中膜厚度(IMT)、斑块积分及其斑块稳定性相关血清学指标的干预作用,并观察其安全性,为具有解毒活血作用的中药提取物配伍应用于颈动脉粥样硬化及其相关疾病的防治提供依据。方法:按纳入病例标准,选择济南机床二厂社区颈动脉粥样硬化患者64例,随机分为解毒活血治疗组(简称治疗组)32例和对照组32例。治疗组给予虎杖提取物和山楂提取物胶囊(每粒含虎杖提取物160 mg,山楂提取物150 mg),每次1粒,每日2次(给药剂量为虎杖提取物5.33 mg·kg-1·d-1,山楂提取物5.0mg·kg-1·d-1);对照组给予洛伐他汀片口服,每次1片(20 mg/片),每日1次(给药剂量为0.33 mg·kg-1·d-1)。2组患者均连续治疗6个月,治疗期间避免服用影响血脂代谢和抗AS的其他药物。观察2组患者治疗前后颈动脉IMT、斑块积分及炎症因子超敏C反应蛋白(Hs-CRP)、血清基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶抑制物-1(TIMP-1)水平的变化。结果:治疗过程中,对照组1例患者出现肝功能异常退出试验、1例因为未遵循治疗方案予以剔除,治疗组未发生明显不良反应,最终纳入分析病例为治疗组32例,对照组30例。结果显示连续治疗6个月后,治疗组IMT、斑块积分均较治疗前显著减少(P<0.05,P<0.01),与对照组比较无统计学差异。治疗后2组血清Hs-CRP,MMP-9水平和MMP-1/TIMP-1显著降低(P<0.05,P<0.01),TIMP-1水平与治疗前比较无统计学差异,组间比较治疗后治疗组血清Hs-CRP低于对照组(P<0.05)。结论:具有解毒活血作用的虎杖提取物和山楂提取物配伍具有较好的抗动脉粥样硬化、稳定动脉粥样硬化斑块的作用,其机制可能与抗炎和抑制细胞外基质降解有关,值得进一步研究。更多还原

【Abstract】 Objective: To observe the effect of detoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn on carotid intima-media thickness( IMT),plaque integral and plaque stability related serum indexes of patients with carotid atherosclerosis. Method: Sixty and four cases of carotid artery atherosclerosis patients were assigned randomly to 2 groups: detoxifying and blood circulation activating treatment group( treatment group,32 cases) and control group( 32 cases). Patients in treatment group were treated with capsules of extraction of polygonum cuspidatum and hawthorn,1 pill po,bid( dosage of administration: polygonum cuspidatum extraction 5. 33 mg·kg- 1·d- 1,hawthorn extraction 5. 0 mg·kg- 1·d- 1); patients in control group were treated with lovastatin 20 mg po,qd( dosage of administration: 0. 33 mg·kg- 1·d- 1). The course of treatment was six months. To observe changes of IMT,plaque integral,and detect the level of plaque stability related serum indexes such as Hs-CRP, MMP-1 and TIMP-1. Result: After 6 months of treatment,in control group one patient quit the clinical trial because of liver dysfunction and one patient was rejected because of having not followed the therapeutic regimen. 32 cases in treatment group and 30 cases in control group were analyzed. The results showed that IMT and plaque integral of treatment group decreased significantly after the treatment( P < 0. 05,P < 0. 01),and there was no significant difference compared with control grope. Serum Hs-CRP,MMP-1 and MMP-1 / TIMP-1 decreased after the treatment( P < 0. 05,P < 0. 01),and the treatment group was superior to control group in decreasing serum Hs-CRP( P < 0. 05). Conclusion: Detoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn has good effect of anti-atherosclerosis and promoting plaque stability. Its mechanism might be related with anti-inflammation and inhibiting degradation of extracellular matrix,and deserves further studies.更多还原