Intervention of Huoxue Tongmai Tablets on Carotid Vulnerable Plaques

HUANG Qun-lian; XIANG Shu-li; HU Yun-chun; CHEN Yong-jun

doi:10.13422/j.cnki.syfjx.2017080184

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Intervention of Huoxue Tongmai Tablets on Carotid Vulnerable Plaques

更新时间：2024-01-04

- Intervention of Huoxue Tongmai Tablets on Carotid Vulnerable Plaques
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 8, Pages: 184-189(2017)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2017080184
  CLC： R259
- Published：2017
- 稿件说明：
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HUANG Qun-lian, XIANG Shu-li, HU Yun-chun, et al. Intervention of Huoxue Tongmai Tablets on Carotid Vulnerable Plaques[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(8): 184-189.
DOI：

HUANG Qun-lian, XIANG Shu-li, HU Yun-chun, et al. Intervention of Huoxue Tongmai Tablets on Carotid Vulnerable Plaques[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(8): 184-189. DOI： 10.13422/j.cnki.syfjx.2017080184.

摘要

目的：探讨活血通脉片对颈动脉易损斑块硬化斑块厚度、稳定性的影响，并从抗血小板活化和抗炎反应方面探讨其作用机制。方法：将150例患者随机按数字表法分为对照组和观察组。对照组口服拜阿司匹林肠溶片，100 mg/次，1次/d；阿托伐他汀钙片，10 mg/次，1次/d。观察组在对照组治疗的基础上加服活血通脉片，5片/次，3次/d。两组疗程均为4个月。采用彩色多普勒超声测量治疗前后颈动脉内膜中层厚度（IMT），采用Crouse斑块积分法计算双侧颈动脉斑块积分、测量颈总动脉收缩期最大血流速度（Vmax），舒张期最小血流速度（Vmin），阻力指数（RI）和搏动指数（PI）；检测治疗前后甘油三酯（TG），总胆固醇（TC），高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平；检测治疗前后血小板表面活性标志蛋白CD62 p，CD63和糖蛋白（GP）Ⅱb/Ⅲa受体复合物水平；检测治疗前后高敏C-反应蛋白（hs-CRP），白细胞介素-6（IL-6），肿瘤坏死因子-α（TNF-α），基质金属蛋白酶-9（MMP-9）水平；进行两组患者治疗前后血瘀证评分和安全性评价。结果：治疗后观察组IMT厚度低于对照组，斑块个数少于对照组，Crouse评分低于对照组（P<0.01）；观察组Vmax，Vmin快于对照组，PI低于对照组（P<0.01）；观察组TG，TC，LDL-C水平均低于对照组，HDL-C高于对照组（P<0.01）；观察组CD62p，CD63和GP Ⅱb/Ⅲa受体复合物均低于对照组（P<0.01）；观察组血瘀证评分低于对照组（P<0.01）；观察组患者血清hs-CRP，IL-6，TNF-α和MMP-9水平均低于对照组（P<0.01）。结论：加服活血通脉片干预颈动脉易损斑块，能缩小斑块，使斑块厚度变薄，改善颈动脉血流，降低血小板活化程度和抗炎症反应，起到稳定斑块的作用，还能调节脂代谢，降低血瘀证积分，这些都有利于防止动脉粥样硬化性心血管疾病的发生。

Abstract

Objective: To discuss the effects of Huoxue Tongmai tablets on thickness and stability of vulnerable plaques in carotid artery

and investigate their action mechanism from anti-platelet activation and anti-inflammatory response. Method: One hundred and fifty patients were randomly divided into control group and observation group by random number table. Patients in control group received Bayaspirin enteric-coated tablets

100 mg/time

1 time/day

Atorvastatin calcium tablets

10 mg/time

1 time/day. Based on the treatment in control group

the patients in observation group added Huoxue Tongmai tablets

5 tablets/time

3 times/day. The treatment course was 4 months in both groups. Before and after treatment

thickness of carotid intima of the carotid artery (IMT) was detected by color Doppler ultrasound; bilateral carotid plaque score was calculated by Crouse plaque integration method.The maximum blood flow velocity (Vmax) of common carotid artery systolic stage

the minimum blood flow velocity (Vmin) of diastolic stage

resistance index (RI) and pulsatility index (PI) were detected. Levels of triglycerides (TG)

total cholesterol (TC)

high density lipoprotein-C (HDL-C) and low density lipoprotein-C (LDL-C) were detected. Levels of activity marker protein of platelet surface CD62 p

CD63 and receptor complex of glycoprotein (GP)Ⅱb/Ⅲa

high-sensitivity C-reactive protein (hs-CRP)

interleukin-6 (IL-6)

tumor necrosis factor-α (TNF-α)

and matrix metalloproteinases-9 (MMP-9) were detected. In addition

the scores of blood stasis syndrome were graded and safety evaluation was evaluated both before and after treatment. Result: After treatment

thickness of IMT

numbers of plaques and scores of Crouse in observation group were less than those in control group (P<0.01). Vmax and Vmin were faster than those in control group

and PI was lower than that in control group (P<0.01). Levels of TG

TC and LDL-C and CD62 p

CD63 and receptor complex of GP Ⅱb/Ⅲa and scores of blood stasis syndrome

as well as levels of hs-CRP

IL-6

TNF-α and MMP-9 were lower than those in control group

while the level of HDL-C was higher than that in control group (P<0.01). Conclusion: Huoxue Tongmai tablets can shrink the plaque

reduce plaque thickness

ameliorate carotid blood flow

decrease degree of platelet activation and anti-inflammatory response

make plaques stable

regulate lipid metabolism

decrease blood stasis syndrome

and all of those can prevent atherosclerotic cardiovascular diseases.

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