| Objective To explore the theoretical basis of treating carotid atherosclerotic plaque from qi deficiency and blood stasis,and to evaluate the therapeutic effect of Yiqi Huoxue method(tonifying qi and promoting blood flow)on patients with carotid atherosclerotic plaque and to observe its effect on carotid artery ultrasonography,blood lipid,blood coagulation and other related laboratory indexes.Methods In the theoretical part,based on the review of the ancient and modern literature on the carotid atherosclerotic plaques,the recognition of the name,etiology,pathogenesis and treatment of the arteriosclerosis plaque in traditional Chinese medicine is discussed,The treatment of carotid atherosclerotic plaques with Western medicine was summarized and reviewed.According to the literature and previous clinical practice,Qi deficiency and blood stasis is the basic pathogenesis of carotid atherosclerotic plaques,Qi deficiency and blood stasis is the basic syndrome,and Yiqi Huoxue method is the basic therapy.In the clinical research part,87 patients with carotid atherosclerotic plaque were randomly divided into treatment group(n=43)and control group(n=44).The Control Group was given Atorvastatin calcium,one capsule per night,on the basis of routine control of blood pressure and blood sugar,antithrombotic therapy,smoking cessation and alcohol limitation,.In the treatment group,on the basic treatment of the control group,Yiqi Huoxue prescription(Shenlong capsule)was given orally,The course of treatment is 3 months.The score of TCM Syndrome,the indexes of carotid artery ultrasonography(IMT,the number,area and nature of plaque),blood lipid,blood coagulation and other related laboratory indexes were compared between the two groups before and after treatment.To evaluate the curative effect of Shenlong Capsule in improving clinical symptom of TCM,reducing intima-media thickness of carotid artery,reducing the number of plaque,reducing the area of plaque,improving the nature of plaque,reducing blood lipid and no coagulation dysfunction.Outcomes TCM Syndrome score:TCM Syndrome score in the two groups were significantly decreased after treatment(p<0.01),suggesting that symptoms were significantly improved,and in the treatment group was significantly lower than the control group(p<0.01),suggesting that the improvement degree of the treatment group is obviously better than that of the control group.TCM syndrome curative effect:in the treatment group,2 cases were cured,24 cases were obviously effective,16 cases were effective,1 case was ineffective,the obvious effective rate was 55.8%,the total effective rate was 97.7%;In the control group,0 cases were cured,9 cases were obviously effective,27 cases were effective,8 cases were ineffective,the obvious effective rate was 20.4%,and the total effective rate was 81.8%.(P<0.01,P<0.05).suggested that the therapeutic effect of the treatment group is superior to that of the control.The IMT of carotid artery,the number of carotid artery plaque and the area of carotid artery plaque in the two groups decreased significantly after treatment(p<0.01),and the treatment group were more significant than those in the Control Group(p<0.01).The results showed that the IMT,the number of plaque and the area of plaque were decreased better in the treatment group.The nature of Carotid Plaque:43 cases in the treatment group,before the treatment there were 16 cases of vulnerable plaque,18 cases of non-vulnerable plaque,9 cases of calcified plaque;after treatment were 6 cases,21 cases,16 cases.44 cases in the control group,before the treatment there were 11 cases of vulnerable plaque,23 cases of non-vulnerable Plaque,calcified plaque in 10 cases,after treatment were 8 cases,33 cases,3 cases.The distribution of carotid plaques in the treatment group was significantly better than that in the control group(P<0.01),mainly on the transformation of vulnerable plaques into non-vulnerable plaques and calcified plaques(P<0.01).The curative effect of the change of IMT for carotid artery ultrasound:In the treatment group,43 cases were obviously effective,41 cases were effective,1 case was ineffective,and the total effective rate was 97.7%,while in the control group 44 cases were obviously effective,28 cases were effective,5 cases were effective,11 cases were ineffective,and the total effective rate was 75.0%(P<0.01).Suggested that the therapeutic effect in treatment group was better than that in control group.Blood lipid index:the level of TC and LDL-ch were significantly decreased in both groups(p<0.01),and TG were significantly decreased in the treatment group(p<0.01).After treatment,the level of TC,TGQLDL-ch in the treatment group was significantly lower than that in the control group(P<0.05,P<0.01).Suggested that Yiqi Huoxue recipe has significant effect on reducing lipid.After treatment,the value of coagulation index INR increased(P<0.01),TT and FIB decreased(P<0.01,P<0.05),but they were still in the normal range.There was no significant difference in PT,TT,APTT,INR and FIB between the treatment group and the control group after treatment(P>0.05).Suggested that Yiqi Huoxue recipe has no obvious effect on coagulation index and does not cause coagulation dysfunction.Safety Test:The blood routine,liver and kidney function and electrolyte of the two groups were analyzed and compared before and after treatment.The results showed that there was no obvious abnormality in the laboratory indexes after taking shenlong Capsule,and suggested that Yiqi Huoxue prescription is safe.Conclusion On the basis of the conventional treatment in Western medicine,the therapy ofYiqi Huoxue can significantly improve the clinical symptoms,obviously increase the curative effect,reduce the number of plaques,reduce the area of plaques,and stabilize the nature of arteriosclerosis plaques.It can also improve the blood lipid index in the laboratory,and then delay the process of carotid atherosclerosis,and there is no obvious adverse reaction. |
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