Clinical Effect Observation Of Di Dang Tong Mai Decoction In The Treatment Of Asymptomatic Carotid Atherosclerotic Stenosis

Objective:This study synthetically evaluates the clinical intervention and explores the unique advantage of combining traditional Chinese and western medicine in the treatment by observing the clinical efficacy of didangtongmai decoction in treating asymptomatic carotid atherosclerotic stenosis(ACASS).Methods: The researcher selected the 80 moderate or severe stenosis ACASS patients who were hospitalized in the encephalopathy department in the first affiliated hospital of Guangxi Traditional Chinese Medicine University during January 2014 to May 2015 and meet eligibility criteria and diagnosed phlegm and blood stasis type into the research.The patients were numbered according to the order of admission and divided into treatment group and control group 40 cases by using the method of random number table.The control group was given 100 mg aspirin enteric-coated tablets combined with clopidogrel bisulfate tablets 75 mg,taken after breakfast,atorvastatin calcium tablets 20 mg,taken at eight every night.The treatment group was treated in the control group in the foundation adding didangtongmai decoction(including Shuizhi 3g,Mangchong 0.6g,Taoren 10 g,Shoudahuang 12 g,Fufangteng 10 g,Dangshen 10 g,Huangqi 10 g,Zhifuzi 3g,Shengjiang 3g,Shichangpu 6g,Zhigancao 3g)avoid-fried-granules,daily 1 agent,blunt by 400 ml water,taken the medicine two times after morning and evening meal.Paitients were treated for 2courses with 3 months in a couse.The researcher detected symptom scores,CASS,carotid intima-film thickness(IMT)and CAS plaque type,lipid content and their changes before and after treatment in both groups.The study safe(including blood,urine and stool routine,liver and kidney function,coagulation function and ECG)was evaluated before and after one course of treatment and the end of the treatment,the adverse drug reactions were observed at the same time.SPSS19.0 software was used for statistical analysis and the effect of treatment was evaluated.Results:(1)TCM syndromes: The total effective rate was 89.5% in the treatment group and the total effective rate was 52.6% in the control group,total effective rate between the treatment group and control group compared with significant difference(P < 0.01).(2)ACASS clinical efficacy: The total effective rate was 89.5% in the treatment group and the total effective rate was 68.4% in the control group.There was statistically significant difference in the efficiency between the two groups(P<0.05).(3)TCM symptom score: Compared with before treatment,the treatment group was significantly lower symptom scores after treatment(P <0.01),the control group symptom score reduced after treatment(P <0.05).After treatment,the difference of the TCM syndrome scorew was statistically significant among the two groups(P <0.05).(4)carotid IMT: compared with before treatment,carotid artery IMT after the treatment was lower not only in the treatment groups(P < 0.05),but also in the control group(P < 0.05).There was a significant difference in carotid artery IMT between the two groups after the treatment(P < 0.05).(4)carotidplaque: compared with before treatment,number of carotid plaques after the treatment has been reducednot only in the treatment groups(P < 0.05),but also in the control group(P < 0.05).There was a significant difference in number of carotid plaques between the two groups after the treatment(P < 0.05).(6)blood lipid content(TC,TG,LDL-C,HDL-C): compared with before treatment,TC,TG,LDL-C in the treatment group decreased significantly after the end of treatment,HDL-C in the treatment group was significantly increased(P <0.05).TC,TG,LDL-C in the control group were decreased significantly after the end of treatment and HDL-C of the control group was significantly increased(P <0.05).The blood lipid content was compared significant difference in the two groups after the treatment(P <0.05).(7)safety evaluation: there were no significant changes of blood,urine and stool routine,liver and kidney function,coagulation function and ECG in two groups before and after treatment without significant difference(P>0.05).Conclusion:(1)Didangtongmai decoction has a significant effect on treating ACASS of phlegm and blood stasis type.(2)Didangtongmai decoction is good at improving the clinical symptoms,reducing carotid IMT,number of carotid plaques,regulating blood lipids,improving carotid stenosiswith no significant adverse reactions.(3)Didangtongmai decoction combined with western medicine treatment of ACASS curative effect is obviously superior to western medicine treatment alone.