[1]王如梦,王莲花,高琨,等.活血解毒优化方治疗高脂血症合并颈动脉粥样硬化临床研究[J].陕西中医,2025,46(6):761-765.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.008]
　WANG Rumeng,WANG Lianhua,GAO Kun,et al.Clinical study on the treatment of hyperlipidemia combined with carotid atherosclerosis with the Huoxue Jiedu optimized prescription[J].,2025,46(6):761-765.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.008]
点击复制

活血解毒优化方治疗高脂血症合并颈动脉粥样硬化临床研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年6期
页码:
761-765
栏目:
临床研究
出版日期:
2025-06-05

文章信息/Info

Title:
Clinical study on the treatment of hyperlipidemia combined with carotid atherosclerosis with the Huoxue Jiedu optimized prescription
作者:
王如梦1; 2; 王莲花1; 2; 高琨1; 2; 王曜昌1; 2; 3; 唐璇子1; 2; 3; 薛梅1; 2; 李立志1; 2
（1.中国中医科学院西苑医院心血管病中心，北京 100091;2.国家中医心血管病临床医学研究中心，北京 100091;3.北京中医药大学研究生院，北京 100029)
Author(s):
WANG Rumeng1; 2; WANG Lianhua1; 2; GAO Kun1; 2; WANG Yaochang1; 2; 3; TANG Xuanzi1; 2; 3; XUE Mei1; 2; LI Lizhi1; 2
（1.Department of Cardiology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091，China;2.National Clinical Research Center for Chinese Medicine Cardiology,Beijing 100091，China;3.Graduate School,Beijing University of Chinese Medicine,Beijing 100029，China）
关键词:
高脂血症; 颈动脉粥样硬化; 瘀毒; 活血解毒优化方; 炎症; 超敏C反应蛋白
Keywords:
Hyperlipidemia; Carotid atherosclerosis; Stasis; Huoxue Jiedu optimized prescription; Inflammation; Hypersensitive C-reactive protein
分类号:
R 589.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.06.008
文献标志码:
A
摘要:
目的：评价活血解毒优化方治疗高脂血症合并颈动脉粥样硬化的临床疗效和安全性。方法：采用随机、对照的研究方法，纳入高脂血症合并颈动脉粥样硬化患者60例，随机分为试验组和对照组，每组30例。对照组予以阿托伐他汀治疗，试验组予以阿托伐他汀联合活血解毒优化方，两组治疗周期均为12周。记录两组患者血脂水平、颈动脉内中膜厚度、中医症候积分、炎症相关指标[超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、一氧化氮合成酶(iNOS)、精氨酸酶-1(Arg-1)]以及安全性指标包括血尿常规、肝肾功能以及其他不良事件的发生。结果：与治疗前相比，两组患者的总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平、颈动脉内中膜厚度、中医症候积分、hs-CRP、TNF-α、iNOS均较治疗前降低（P<0.05），HDL-C、TGF-β1和Arg-1水平较治疗前升高（P<0.05）。组间比较，试验组能够进一步降低TC、TG和LDL-C、中医症候积分、iNOS水平（P<0.05），进一步升高Arg-1水平（P<0.05），而HDL-C、颈动脉内中膜厚度、hs-CRP、TNF-α、TGF-β1之间差异无统计学意义（P>0.05），试验组总有效率优于对照组（P<0.05）。在整个研究期间，未见肝肾功能损伤及其他不良事件。结论：活血解毒优化方能够提高瘀毒证高脂血症合并颈动脉粥样硬化患者的临床疗效，改善患者症状，其机制可能与调节脂质代谢和炎症反应有关。
Abstract:
Objective:To evaluate the clinical efficacy and safety of the optimized formula of Huoxue Jiedu optimized prescription in treating hyperlipidemia combined with carotid atherosclerosis.Methods:A total of 60 patients with hyperlipidemia combined with carotid atherosclerosis were included in the randomized,controlled study method and were randomly divided into the experimental group and the control group,with 30 cases in each group.The control group was treated with atorvastatin,and the experimental group was treated with atorvastatin combined with the optimized formula for Huoxue Jiedu optimized prescription.The treatment period for both groups was 12 weeks.Blood lipid level,carotid artery intima-media thickness,Chinese medicine syndrome score,inflammation-related indexes (hs-CRP,TNF-α,TGF-β1,iNOS,Arg-1),and safety indexes,including blood and urine routine,liver and kidney function,and the occurrence of other adverse events were recorded in both groups.Results:Compared with pretreatment,TC,TG,and LDL-C levels,carotid intima-media thickness,Chinese medicine evidence score,hs-CRP,TNF-α,and iNOS were lower (P<0.05),and HDL-C,TGF-β1,and Arg-1 levels were higher in both groups (P<0.05).Comparing between groups,the experimental group was able further to reduce the levels of TC,TG,and LDL-C,Chinese medicine evidence points,and iNOS (P<0.05),and further increase the levels of Arg-1 (P<0.05).In contrast,there was no statistically significant difference between HDL-C,carotid artery inner intima-media thickness,hs-CRP,TNF-α,and TGF-β1 (P>0.05).During the study period,there was no hepatic and renal function injury or other adverse events.Conclusion:The optimized formula for Huoxue Jiedu optimized prescription can improve the clinical efficacy and symptoms of patients with hyperlipidemia combined with carotid atherosclerosis with stasis and toxicity,and its mechanism may be related to the regulation of lipid metabolism and inflammatory response.

参考文献/References:

[1]HERRERO F B,GOMEZ B R,SOMOVILLA C B,et al.Immunobiology of atherosclerosis:A complex net of interactions[J].Int J Mol Sci,2019,20(21):5293.
[2]SONG P,FANG Z,WANG H,et al.Global and regional prevalence,burden,and risk factors for carotid atherosclerosis:A systematic review,meta-analysis,and modelling study[J].Lancet Glob Health,2020,8(5):e721-e729.
[3]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[4]乔翠峰,巩颖,赵红岩,等.系统化干预对老年冠心病合并高脂血症患者血脂水平、治疗依从性和生活质量的影响[J].河北医药,2022,44(24):3776-3778.
[5]PATEL J,MARTIN S S,BANACH M.Expert opinion:The therapeutic challenges faced by statin intolerance[J].Expert Opin Pharmacother,2016,17(11):1497-1507.
[6]国家卫生健康委员会脑卒中防治专家委员会血管超声专业委员会，中国超声医学工程学会浅表器官及外周血管超声专业委员会，中国超声医学工程学会颅脑及颈部血管超声专业委员会.头颈部血管超声若干问题的专家共识(颈动脉部分)[J].中国脑血管病杂志,2020,17(6):346-353.
[7]中国中西医结合学会活血化瘀专业委员会,陈可冀,徐浩,等.实用血瘀证诊断标准[J].中国中西医结合杂志,2016,36(10):1163.
[8]陈可冀,史大卓,徐浩,等.冠心病稳定期因毒致病的辨证诊断量化标准[J].中国中西医结合杂志,2011,31(3):313-314.
[9]中国康复医学会心血管病专业委员会，中国营养学会临床营养分会，中华预防医学会慢性病预防与控制分会，等.心血管疾病营养处方专家共识[J].中国循环杂志,2014，53(2):124-130.
[10]国家食品药品监督管理总局.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社,2002:356.
[11]吴丽敏,贺晓鸣,陈卫建,等.中西医结合治法对“脾虚血瘀”型患者颈动脉粥样硬化斑块的逆转作用研究[J].时珍国医国药,2022,33(5):1175-1177.
[12]陈姣,罗丹梅,孙承霞,等.扶正化浊法治疗动脉粥样硬化研究进展[J].陕西中医,2023,44(11):1653-1656.
[13]李青筱,苏文全,杜雅薇,等.从瘀毒互结论治颈动脉粥样硬化易损斑块[J].辽宁中医药大学学报,2024,26(2):125-130.
[14]史大卓,徐浩,殷惠军,等.“瘀”“毒”从化——心脑血管血栓性疾病病因病机[J].中西医结合学报,2008,6(11):1105-1108.
[15]HUYNH N X,梁硕,孟毅,等.益气活血清热解毒方治疗动脉粥样硬化临床研究[J].陕西中医,2023,44(6):746-750.
[16]苗佳勇,董馨,况媛媛,等.赤芍的研究进展及其质量标志物预测分析[J].中华中医药学刊,2024,42(10):236-242.
[17]GAO W Y,CHEN P Y,HSU H J,et al.Tanshinone ⅡA downregulates lipogenic gene expression and attenuates lipid accumulation through the modulation of LXRα/SREBP1 pathway in HepG2 cells[J].Biomedicines,2021,9(3):326.
[18]武鑫华,荀思佳,吴文轩,等.黄连的化学成分及药理作用研究进展[J].中医药学报,2024,52(7):110-116.
[19]蒋沅岐,董玉洁,周福军,等.红曲的化学成分、药理作用及临床应用研究进展[J].中草药,2021,52(23):7379-7388.
[20]黄明艳,陈可冀,龙霖梓,等.活血解毒方调控AKT/mTOR通路抑制心肌凋亡改善大鼠缺血再灌注损伤的作用机制[J].中西医结合心脑血管病杂志,2021,19(24):4260-4265.
[21]WILLEIT P,TSCHIDERER L,ALLARA E,et al.Carotid intima-media thickness progression as surrogate marker for cardiovascular risk:Meta-analysis of 119 clinical trials involving 100667 patients[J].Circulation,2020,142(7):621-642.
[22]冯克娜,张淼,陈雅静.2型糖尿病患者血清C1q肿瘤坏死因子相关蛋白5、脂联素水平与颈动脉粥样硬化关系研究[J].陕西医学杂志,2024,53(3):357-360.
[23]赵庚申.超声多参数成像在颈动脉粥样硬化诊断中的应用价值[J].实用医学影像杂志,2023,24(4):275-278.
[24]WEBER C,HUNDELSHAUSEN P.Cantos trial validates the inflammatory pathogenesis of atherosclerosis:Setting the stage for a new chapter in therapeutic targeting[J].Circ Res,2017,121(10):1119-1121.
[25]BADIMON L,PENA E,ARDERIU G,et al.C-reactive protein in atherothrombosis and angiogenesis[J].Front Immunol,2018,9:430.
[26]MOORE K J,SHEEDY F J,FISHER E A.Macrophages in atherosclerosis:A dynamic balance[J].Nat Rev Immunol,2013,13(10):709-721.
[27]MARTINET W,DE MEYER G R.Autophagy in atherosclerosis:A cell survival and death phenomenon with therapeutic potential [J].Circ Res,2009,104(3):304-317.
[28]南武娟,文申英.急性冠脉综合征大鼠外周血巨噬细胞中脂质稳态与动脉粥样硬化指数相关性研究[J].陕西医学杂志,2022,51(4):401-405.
[29]胡伊蕾,马至言,周曼丽,等.基于正邪理论探讨巨噬细胞极化在动脉粥样硬化过程中的作用[J].中国动脉硬化杂志,2023,31(12):1084-1090.
[30]路艳林,李方琴,周明,等.发育型内皮基因座-1作用下氧化型低密度脂蛋白对巨噬细胞分泌TNF-α、MIP-1α及MIP-2的影响[J].贵州医科大学学报,2023,48(8):888-894.
[31]荆晓朔,林轶,唐金保,等.中医药影响TGF-β/Smads信号通路防治冠心病研究进展[J].中国中医急症,2023,32(11):2056-2059.

相似文献/References:

[1]李向辉,卢文杰.葛黄降糖汤治疗2型糖尿病合并颈动脉硬化临床研究*[J].陕西中医,2019,(5):580.
　LI Xianghui,LU Wenjie..Effect of Gehuang Jiangtang decoction on mellitus complicated with carotid arteriosclerosis in type 2 diabetes patients[J].,2019,(6):580.
[2]胡汉楚,张 征,王赤华.芪独合剂改善缺血性脑卒中恢复期患者神经缺损程度、〖JZ〗颈动脉粥样硬化、血管内皮生长因子临床研究*[J].陕西中医,2020,(1):24.
　HU Hanchu,ZHANG Zheng,WANG Chihua..Clinical study on improving the degree of nerve defect,carotid atherosclerosis and vascular endothelial 〖JZ〗growth factor in patients with ischemic stroke during recovery period by Qidu mixture decoction[J].,2020,(6):24.
[3]丁 维,钟立仁,张海波,等.丹参酮ⅡA磺酸钠对高脂血症勃起功能障碍大鼠Nrf2/HO-1通路及勃起功能的影响*[J].陕西中医,2020,(11):1520.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.002]
　DING Wei,ZHONG Liren,ZHANG Haibo,et al.Sodium tanshinone ⅡA sulfonate ameliorates erectile function in hyperlipidemia ED rats by up-regulating Nrf2/HO-1[J].,2020,(6):1520.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.002]
[4]刘小微,李娟娥,姜小帆,等.丹蒌片对载脂蛋白E基因敲除小鼠血脂及AMPK/SREBP通路的影响[J].陕西中医,2021,(11):1531.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.008]
[5]孙帅玲,马晓北.基于网络药理学探讨茵陈蒿汤治疗高脂血症作用机制[J].陕西中医,2021,(12):1793.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.038]
[6]吴巧敏,刘金凤,汪艳丽,等.刘如秀教授论治血浊经验[J].陕西中医,2022,(5):624.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.019]
　WU Qiaomin,LIU Jinfeng,WANG Yanli,et al.Professor LIU Ruxiu's experience in treating hyperlipidemia[J].,2022,(6):624.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.019]
[7]周颖丽,罗 茜,尹紫薇,等.郭志华治疗高脂血症临床经验[J].陕西中医,2023,(6):781.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.023]
　ZHOU Yingli,LUO Xi,YIN Ziwei,et al.Guo Zhihua's clinical experience in the treatment of hyperlipidemia[J].,2023,(6):781.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.023]
[8]周 芳,陈文明,陈新宇,等.冬春谧阳方对高脂血症患者PPARγ/ANGPTL受体配体的影响[J].陕西中医,2023,(11):1537.[doi:DOI:10.3969/j.issn.1000-7369.2023.11.009]
　ZHOU Fang,CHEN Wenming,CHEN Xinyu,et al.Effect of Dongchun Miyang decoction on serum PPARγ/ANGPTL receptor ligand in patients with hyperlipidemia[J].,2023,(6):1537.[doi:DOI:10.3969/j.issn.1000-7369.2023.11.009]
[9]刘美之,王俊林,边爱忠,等.从中医痰湿体质论治高脂血症研究进展[J].陕西中医,2024,(5):719.[doi:DOI:10.3969/j.issn.1000-7369.2024.05.034]

备注/Memo

备注/Memo:
国家自然科学基金资助项目(81973686)；中国中医科学院科技创新工程重大攻关项目(CI2021A00913)
更新日期/Last Update: 2025-06-09