针灸干预痰湿体质患者对颈动脉斑块的影响

廖细芳 冯智君 刘美冰 郭秋燕

[摘要]目的 探讨针灸干预痰湿体质（PDC）颈动脉斑块治疗的临床效果。方法 选择2017年1月～2018年1月在我院就诊属于PDC颈动脉斑块80例患者作为研究对象，将其随机分为治疗组和对照组，每组各40例。治疗组给予拜阿司匹林+针灸治疗，对照组给予拜阿司匹林+阿托伐他汀治疗;比较两组治疗前后各三维超声参数变化情况。结果 ①两组颈动脉内膜中层厚度（IMT）及斑块面积治疗后均较治疗前显著降低，且治疗组的IMT及斑块面积明显低于对照组，差异有统计学意义（P<0.05）。②两组治疗后斑块灰阶中位数值（GSM）较治疗前明显升高，斑块体积（PV）明显降低，且治疗组治疗后GSM明显高于对照组，而PV明显低于对照组，差异有统计学意义（P<0.05）。结论 针灸干预PDC者颈动脉斑块具有可靠的临床效果，值得在临床推广应用。

[关键词]三维超声;针灸;痰湿体质;颈动脉斑块

[中图分类号] R246          [文献标识码] A          [文章编号] 1674-4721（2019）8（a）-0135-03

[Abstract] Objective To analyze the clinical effect of acupuncture and moxibustion in the treatment of carotid atherosclerosis in patients with phlegm-dampness constitution （PDC）. Methods Eighty patients with carotid atherosclerotic plaques identified as PDC were enrolled in our hospital from January 2017 to January 2018. They were randomly divided into treatment group and control group， 40 cases in each group. In the treatment group， Bayaspirin+acupuncture and moxibustion was adopted， and in the control group， Bayaspirin+Atorvastatin was used. The changes of three-dimensional ultrasound parameters before and after treatment were compared between the two groups. Results The carotid intima-media thickness （IMT） and plaque area in both the treatment group and the control group were significantly decreased than those before treatment. The IMT and plaque area of the treatment group were significantly lower than those of the control group （P<0.05）. The gray scale median （GSM） of the plaque in the treatment group and the control group was significantly higher than that before treatment. The plaque volume （PV） was significantly decreased. The GSM in the treatment group was significantly higher than that in the control group， while PV was lower compared with that in the control group （P<0.05）. Conclusion Intervention of acupuncture and moxibustion for carotid plaque in patients with PDC obtains a reliable clinical effect and is worthy of clinical application.

[Key words] Three-dimensional ultrasound; Acupuncture and moxibustion; Phlegm-dampness constitution; Carotid plaque

近年來，缺血性脑卒中（CIS）已经成为一种高致死率和致残率的老年性疾病，CIS的发生与颈动脉斑块形成相关[1-2]。颈动脉斑块以生活方式干预及药物调脂治疗为主。有学者发现，针灸对脂质代谢有明显的改善作用，可防止颈动脉斑块的形成与发展[3-4]，具有稳定和清除颈动脉斑块的作用[6-8]。目前实时三维超声成像在颈动脉斑块治疗效果评价方面有着较高的应用价值。本研究通过针灸干预痰湿体质（PDC）颈动脉斑块的治疗，并采用三维超声定量评价治疗效果，现报道如下。

1资料与方法

1.1一般资料

选择2017年1月～2018年1月在我院就诊的80例PDC颈动脉斑块患者作为研究对象，将其随机分为治疗组和对照组，每组各40例。治疗组中，男22例（55.00%），女18例（45.00%）;年龄45～82岁，平均（60.32±4.78）岁;体重指数（BMI）18.4～25.8 kg/m2，平均（23.86±3.75）kg/m2;糖尿病30例（75.00%），高血压23例（57.50%），吸烟史20例（50.00%）。对照组中，男23例（57.50%），女17例（43.50%）;年龄44～81岁，平均（61.15±4.88）岁;BMI 18.6～24.9 kg/m2，平均（23.62±3.51）kg/m2;糖尿病31例（77.50%），高血压22例（55.00%），吸烟史19例（47.50%）。两组的一般资料比较，差异无统计学意义（P>0.05），具有可比性。本研究已通过我院医学伦理委员会的审核，患者在知情同意下签署了知情同意书。