【作者】 吴同和；

【导师】 司晓晨；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2012， 博士

【摘要】 目的：通过观察(中药制剂)降脂胶囊对老年冠心病血脂异常患者的血脂及炎性因子的影响,探讨其调脂及改善血管内皮功能的作用与机制。方法：随机抽取200例老年冠心病合并血脂异常患者,按照随机平行对照法的原则分为4组,即辛伐他汀低剂量组(A组)、标准剂量辛伐他汀组(B组)、单纯降脂胶囊组(C组)、中西医结合组(D组),各50例。分别予以A组辛伐他汀10mg qd; B组辛伐他汀20mg qd; C组降脂胶囊4粒tid; D组辛伐他汀10mg qd+降脂胶囊4粒tid。4组连续用药8周,用药前后分别抽取静脉血留存血清备检。进行血常规,尿常规,大便常规,肝、肾功能,ECG等安全性检测以及治疗前后血清TC、TG、HDL-C、LDL-C和CRP、Hey、vWF、NO、ET的含量的测定。结果：与治疗前相比,降脂胶囊可以降低患者血清TG、TC、LDL-C、Hey、vWF、CRP、ET的含量,提高血清HDL-C、NO的含量(P<0.05)；改善患者血清TG、HDL-C、Hey、vWF的作用优于标准剂量辛伐他汀(P<0.05)；改善血清CRP、ET、NO的作用等同标准剂量辛伐他汀；降低患者血清TC、LDL-C作用等同小剂量辛伐他汀组。降脂胶囊联合小剂量辛伐他汀在改善TG、TC、HDL-C、LDL-C和CRP、Hey、vWF、NO、ET的方面,疗效优于其余三组(P<0.05)。此外,降脂胶囊联合小剂量辛伐他汀的安全性优于标准剂量辛伐他汀组,对大于60岁的老年患者有良好的耐受性。结论：降脂胶囊能够降低老年冠心病合并血脂异常患者的血清TC、TG、LDL-C和CRP、Hey、 vWF、ET的水平,提高HDL-C、NO的水平；降脂胶囊联合小剂量辛伐他汀调脂效果及改善血管内皮功能更显著,是临床老年冠心病患者安全有效的调脂治疗方案。更多还原

【Abstract】 Objective:. To explore the effect and mechanism of jiangzhi capsules in regulating blood lipids and improving vascular endothelial function by observing the impact of jiangzhi capsules on blood lipids and inflammatory cytokines in elderly patients with coronary heart disease and dyslipidemia.Methods:200elderly patients with coronary heart disease and dyslipidemia were randomly divided into four groups according to the principles of randomized controlled method which include low dose simvastatin group (group A, simvastatin10mg qd), conventional-dose simvastatin group (group B, simvastatin20mg qd), jiangzhi capsules alone group (group C, jiangzhi capsules4tid) and the integrative medicine group (group D, jiangzhi capsules4tid and simvastatin10mg qd),50cases in each group. Venous blood were extracted and retained before and after8weeks’treatment respectively for preparing to be tested.Levels of serum lipids profile such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) and levels of serum inflammatory cytokines such as c-reactive protein (CRP), homocysteine (Hey), Von Willebrand factor (vWF), nitric oxide (NO) and endothelin (ET)were measured and compared. Other security data such as blood routine, urine routine, stool routine, liver function,renal function and ECG were also been concerned. Results:Compared with before treatment, jiangzhi capsules can significantly reduce levels of serum TC, TG, LDL-C, Hey, vWF and ET, increase levels of serum HDL-C and NO(P <0.05). Jiangzhi capsule alone can significantly improve levels of serum TG, HDL-C、Hey、and vWF, which better than that of conventional-dose simvastatin group (P<0.05). The efficiency improvement of serum CRP, ET and NO in jiangzhi capsule alone group is equivalent to that of standard doses of simvastatin group.The effect of jiangzhi capsule alone on reducing levels of serum TC, LDL-C is also equivalent to that of low dose simvastatin group.Jiangzhi capsules combined with low dose simvastatin were more effective than the other three groups in the improvement of levels of serum TG, HDL-C, LDL-C,CRP, Hey, vWF, NO and ET(P<0.05). In addition, the safety of jiangzhi capsule combined with low dose simvastatin is better than that of conventional dose simvastatin group, which showed well tolerated by elderly patients more than60years of age.Conclusion:Jiangzhi capsules can reduce levels of serum TC, TG, LDL-C and levels of serum inflammatory cytokines such as CRP, Hcy, vWF and ET, increase levels of serum HDL-C and NO in elderly patients with coronary heart disease and dyslipidemia. The effect of jiangzhi capsules combined with low dose simvastatin in regulating blood lipids and in improving vascular endothelial function is so more significant that it may be a safe and effective clinical treatment programs in regulating blood lipids of elderly patients with coronary artery disease.更多还原