【摘要】：目的觀察化濁剔絡(luò)方治療老年高脂血癥屬痰瘀互結(jié)證在中醫(yī)癥狀積分、血脂指標(biāo)(TC、TG、LDL、HDL)、炎性因子(hs-CRP、IL-6、TNF-α)等方面的臨床療效,并評(píng)估其安全性,為中醫(yī)藥治療老年高脂血癥提供新的診治思路。方法本試驗(yàn)共納入60例確診符合老年高脂血癥西醫(yī)診斷標(biāo)準(zhǔn)及痰瘀互結(jié)證中醫(yī)診斷標(biāo)準(zhǔn)的患者,按隨機(jī)對(duì)照的方法分為觀察組和對(duì)照組,兩組各30人,對(duì)照組給予阿托伐他汀鈣片,觀察組予化濁剔絡(luò)方聯(lián)合阿托伐他汀鈣片,中藥煎劑口服,兩組觀察療程均為4周。觀察兩組治療前后中醫(yī)癥狀積分、TC、TG、LDL、HDL、hs-CRP、IL-6、TNF-α等指標(biāo)的變化,以及判定患者的不良反應(yīng)和安全性。最后全部數(shù)據(jù)以SPSS19.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果觀察組與對(duì)照組的年齡、性別、中醫(yī)癥狀積分、血脂指標(biāo)、炎癥因子等基線比較均無顯著統(tǒng)計(jì)學(xué)差異(P0.05),兩組具有可比性。中醫(yī)癥狀積分比較:兩組患者治療后中醫(yī)癥狀積分均有明顯下降(P0.05),觀察組較對(duì)照組有顯著差異(P0.05);癥候療效方面:觀察組總有效率為96.3%,對(duì)照組總有效率為73.3%,有明顯統(tǒng)計(jì)學(xué)差異(P0.05)。降脂效果及西醫(yī)臨床療效分析:觀察組及對(duì)照組患者治療后TC、TG、LDL、HDL均有明顯改善(P0.01),兩組間治療后比較,觀察組TC、LDL改善較對(duì)照組有顯著差異(P0.05),TG、HDL改善無明顯差異(P0.05);療效分析:觀察組總有效率為86.7%,對(duì)照組總有效率為80%,兩組降脂效果無明顯差異(P0.05)。炎癥因子比較:兩組患者治療后hs-CRP、IL-6水平較治療前明顯下降,hs-CRP、IL-6與治療前比較有顯著性差異(P0.05),TNF-α無明顯差異(P0.05);兩組治療后比較:hs-CRP、IL-6有差異(P0.05),TNF-α無統(tǒng)計(jì)學(xué)差異(P0.05)。整個(gè)研究過程中患者未出現(xiàn)不良反應(yīng)。結(jié)論1.化濁剔絡(luò)方能有效的改善老年高脂血癥中醫(yī)臨床癥狀。2.化濁剔絡(luò)方能改善老年高脂血癥痰瘀互結(jié)證患者TC、LDL的水平。3.化濁剔絡(luò)方能降低老年高脂血癥痰瘀互結(jié)證患者h(yuǎn)s-CRP、IL-6的水平。4.化濁剔絡(luò)方治療老年高脂血癥是安全及有效的。
[Abstract]:Objective to observe the clinical efficacy of Huazhuo Tiluo recipe in treating senile hyperlipidemia with phlegm and blood stasis syndromes in the aspects of TCM symptom score, blood lipid index (TCU TGG LDLX HDL), and inflammatory factor (hs-CRPU IL-6 TNF- 偽), and to evaluate its safety. To provide a new way of diagnosis and treatment for senile hyperlipidemia with traditional Chinese medicine. Methods A total of 60 patients with hyperlipidemia diagnosed by western medicine and TCM diagnostic criteria of phlegm and blood stasis syndromes were included in this study. The patients were divided into observation group and control group according to the method of random control, with 30 patients in each group. The control group was given Atto vastatin calcium tablet, the observation group was treated with Huazhuo Tiluo recipe combined with Atto vastatin calcium tablet, and the traditional Chinese medicine decoction was taken orally. The course of treatment was 4 weeks in both groups. Before and after treatment, the changes of TCM symptom scores and the changes of HDLHs-CRPPIL-6 TNF- 偽 were observed, and the adverse reactions and safety of the patients were evaluated. Finally, all the data are analyzed by SPSS19.0 statistical software. Results there was no significant difference between the two groups in age, sex, TCM symptom score, blood lipid index, inflammatory factors and other baseline (P0.05), the two groups were comparable. TCM symptom score comparison: two groups of patients after treatment of TCM symptom scores were significantly decreased (P0.05), the observation group than the control group has a significant difference (P0.05); symptom efficacy: the observation group total effective rate was 96.3G, the control group total effective rate was 73.3cm, there was significant statistical difference (P0.05). Analysis of the effect of lowering fat and clinical curative effect of western medicine: the patients in the observation group and the control group were significantly improved in HDL after treatment (P0.01), and the comparison was made between the two groups after treatment. Compared with the control group, the improvement of TCU LDL in the observation group was significantly different from that in the control group (P0.05). There was no significant difference in the improvement of TGG HDL (P0.05); the total effective rate of the observation group was 86.7%, the total effective rate of the control group was 80%, and there was no significant difference between the two groups (P0.05). Comparison of inflammatory factors: after treatment, the level of hs-CRPnil IL-6 in two groups was significantly lower than that before treatment (P0.05). There was no significant difference in TNF- 偽 between the two groups (P0.05), and there was no significant difference between the two groups after treatment (P0.05). No adverse reactions were observed throughout the study. Conclusion 1. Huazhuo Tiluo recipe can effectively improve the elderly hyperlipidemia clinical symptoms. 2. Huazhuo Tiluo recipe can improve the level of TCU LDL in senile hyperlipidemia patients with phlegm and blood stasis syndrome. Huazhuo Tiluo recipe can reduce the level of hs-CRPU IL-6 in senile hyperlipidemia patients with phlegm and blood stasis syndrome. 4. Huazhuo Tiluo recipe is safe and effective in the treatment of senile hyperlipidemia.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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