發(fā)布時(shí)間：2018-05-01 09:07

  本文選題：易損斑塊 + 炎癥因子��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討蛭龍活血膠囊對(duì)冠狀動(dòng)脈輕中度狹窄患者的臨床療效及對(duì)斑塊穩(wěn)定性的影響。方法:(1)從西南醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院心腦病科2016年1月到2016年9月的門(mén)診及住院病人中篩選符合本實(shí)驗(yàn)納入標(biāo)準(zhǔn)的患者40例。(2)將40例患者按隨機(jī)數(shù)字表隨機(jī)分為對(duì)照組20例和治療組20例,兩組都給予基礎(chǔ)治療,治療組加用蛭龍活血通瘀膠囊1.2g tid服用三個(gè)月。分別于治療前及治療后3個(gè)月,使用中醫(yī)證候評(píng)分表計(jì)算患者中醫(yī)證候積分,采用免疫熒光法檢測(cè)患者血清超敏C反應(yīng)蛋白(hs-CRP)水平、ELISA法檢測(cè)患者血清5脂氧化酶(5-LO)、脂蛋白相關(guān)磷脂酶A2(LP-PLA2)水平,采用SOMATOM Definition 128雙源螺旋CT測(cè)量患者冠狀動(dòng)脈粥樣硬化性狹窄的管腔狹窄程度及粥樣斑塊CT值,評(píng)估兩組患者臨床療效及斑塊穩(wěn)定性的變化情況。(3)統(tǒng)計(jì)軟件SPSS 20.0用于相關(guān)數(shù)據(jù)的統(tǒng)計(jì)描述與分析。結(jié)果:(1)治療組與對(duì)照組一般資料比較:兩組患者在年齡,性別,高血壓病史,糖尿病病史,高脂血癥、高同型半胱氨酸血癥患病率及個(gè)人生活史(吸煙、飲酒、女性患者絕經(jīng)史)的比較上差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(2)治療組與對(duì)照組治療前各指標(biāo)比較:治療前兩組患者h(yuǎn)s-CRP、5-LO、LP-PLA2水平、斑塊CT值、病變處血管狹窄程度,中醫(yī)證候積分的比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05));(3)治療組與對(duì)照組治療后各指標(biāo)比較:治療后治療組患者h(yuǎn)s-CRP、5-LO、LP-PLA2、中醫(yī)證候積分較對(duì)照組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療后治療組患者斑塊CT值較對(duì)照組高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);治療后治療組患者病變處血管狹窄程度與對(duì)照組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(4)治療組與對(duì)照組治療前后各觀察指標(biāo)比較:治療后兩組患者h(yuǎn)s-CRP、5-LO、LP-PLA2、中醫(yī)證候積分均較治療前降低,斑塊CT值均較治療前升高,差異有統(tǒng)計(jì)學(xué)意義(P0.001)。兩組治療前后病變處血管狹窄程度無(wú)明顯變化,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(5)治療組與對(duì)照組療效差值的比較:治療組hs-CRP、5-LO、LP-PLA2、中醫(yī)證候積分、斑塊CT值的療效差值(絕對(duì)值)均較對(duì)照組大,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:經(jīng)過(guò)治療后治療組、對(duì)照組患者h(yuǎn)s-CRP、5-LO、LP-PLA2、中醫(yī)證候積分、斑塊CT值較治療前均有變化。治療后治療組患者h(yuǎn)s-CRP、5-LO、LP-PLA2、中醫(yī)證候積分、斑塊CT值療效差值差異更大,這說(shuō)明加用了蛭龍活血通瘀膠囊的患者比單純使用基礎(chǔ)治療方案的療效更顯著,斑塊的穩(wěn)定性增加。
[Abstract]:Objective: to investigate the clinical effect of Zhilong Huoxue capsule on the stability of plaque in patients with mild to moderate coronary artery stenosis. Methods from January 2016 to September 2016, 40 outpatients and inpatients in the Department of Cardio-encephalopathy, affiliated traditional Chinese Medicine Hospital of Southwest Medical University, were selected from 40 patients who met the criteria for inclusion of the experiment. 40 patients were randomly divided into two groups according to the random digital table. There were 20 cases in the control group and 20 cases in the treatment group. Both groups were given basic treatment. The treatment group was treated with Zhilong Huoxue Tongyu capsule 1.2 g tid for 3 months. Before treatment and 3 months after treatment, TCM syndrome score was calculated by using TCM syndrome score table. The levels of serum hypersensitive C-reactive protein hs-CRP were detected by immunofluorescence assay and the serum levels of 5-lipoxygenase 5-LOX and lipoprotein associated phospholipase A2LP-PLA2 were detected by Elisa. The degree of coronary artery stenosis and the CT value of atherosclerotic plaque were measured by SOMATOM Definition 128 double source spiral CT. To evaluate the changes of clinical efficacy and plaque stability in two groups. The statistical software SPSS 20.0 was used to describe and analyze the related data. Results the general data of the treatment group and the control group were compared: age, sex, history of hypertension, history of diabetes, hyperlipidemia, prevalence of hyperhomocysteinemia and personal life history (smoking, drinking), There was no significant difference in menopausal history of female patients (P 0.05). The indexes of treatment group and control group before treatment were as follows: before treatment, hs-CRPU 5-LOLOLP-PLA2 level, plaque CT value, degree of vascular stenosis in lesion, and so on. There were no significant differences in TCM syndromes between the treatment group and the control group (P 0.05). The indexes of the treatment group were compared with those of the control group: after treatment, the hs-CRPn5-LOLP-PLA2 of the patients in the treatment group was lower than that of the control group, and the score of TCM syndromes was lower than that of the control group. After treatment, the CT value of plaque in the treatment group was higher than that in the control group. After treatment, there was no significant difference in the degree of vascular stenosis between the treatment group and the control group (P 0.05). Comparison of the observed indexes before and after treatment between the treatment group and the control group: after treatment, hs-CRPn5-LOLP-PLA2 in the treatment group was compared with that in the control group, and in the middle of the treatment group, there was no significant difference between the treatment group and the control group before and after treatment. The score of medical syndrome was lower than that before treatment. The CT value of plaque was higher than that before treatment, and the difference was statistically significant (P 0.001). Before and after treatment, there was no significant change in the degree of vascular stenosis in the two groups, but there was no significant difference between the treatment group and the control group. The difference of therapeutic effect between the treatment group and the control group: the difference of therapeutic effect between the treatment group and the control group was greater than that of the control group: the score of TCM syndromes and the absolute value of CT value of plaque were larger than those of the control group. The difference was statistically significant (P 0.05). Conclusion: after treatment, hs-CRPU 5-LOLP-PLA2, TCM syndromes integral and plaque CT value were all changed in the control group. After treatment, the difference of curative effect between the patients with hs-CRPU 5-LOP LP-PLA2, TCM syndrome score and plaque CT value was greater, which indicated that the curative effect of the patients treated with Zhilong Huoxue Tongyu capsule was more significant than that of the basic treatment alone, and the plaque stability was increased.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

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