針灸干預(yù)痰濕體質(zhì)患者對(duì)頸動(dòng)脈斑塊的影響

廖細(xì)芳 馮智君 劉美冰 郭秋燕

[摘要]目的 探討針灸干預(yù)痰濕體質(zhì)（PDC）頸動(dòng)脈斑塊治療的臨床效果。方法 選擇2017年1月～2018年1月在我院就診屬于PDC頸動(dòng)脈斑塊80例患者作為研究對(duì)象，將其隨機(jī)分為治療組和對(duì)照組，每組各40例。治療組給予拜阿司匹林+針灸治療，對(duì)照組給予拜阿司匹林+阿托伐他汀治療;比較兩組治療前后各三維超聲參數(shù)變化情況。結(jié)果 ①兩組頸動(dòng)脈內(nèi)膜中層厚度（IMT）及斑塊面積治療后均較治療前顯著降低，且治療組的IMT及斑塊面積明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。②兩組治療后斑塊灰階中位數(shù)值（GSM）較治療前明顯升高，斑塊體積（PV）明顯降低，且治療組治療后GSM明顯高于對(duì)照組，而PV明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 針灸干預(yù)PDC者頸動(dòng)脈斑塊具有可靠的臨床效果，值得在臨床推廣應(yīng)用。

[關(guān)鍵詞]三維超聲;針灸;痰濕體質(zhì);頸動(dòng)脈斑塊

[中圖分類號(hào)] R246? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 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，缺血性腦卒中（CIS）已經(jīng)成為一種高致死率和致殘率的老年性疾病，CIS的發(fā)生與頸動(dòng)脈斑塊形成相關(guān)[1-2]。頸動(dòng)脈斑塊以生活方式干預(yù)及藥物調(diào)脂治療為主。有學(xué)者發(fā)現(xiàn)，針灸對(duì)脂質(zhì)代謝有明顯的改善作用，可防止頸動(dòng)脈斑塊的形成與發(fā)展[3-4]，具有穩(wěn)定和清除頸動(dòng)脈斑塊的作用[6-8]。目前實(shí)時(shí)三維超聲成像在頸動(dòng)脈斑塊治療效果評(píng)價(jià)方面有著較高的應(yīng)用價(jià)值。本研究通過針灸干預(yù)痰濕體質(zhì)（PDC）頸動(dòng)脈斑塊的治療，并采用三維超聲定量評(píng)價(jià)治療效果，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選擇2017年1月～2018年1月在我院就診的80例PDC頸動(dòng)脈斑塊患者作為研究對(duì)象，將其隨機(jī)分為治療組和對(duì)照組，每組各40例。治療組中，男22例（55.00%），女18例（45.00%）;年齡45～82歲，平均（60.32±4.78）歲;體重指數(shù)（BMI）18.4～25.8 kg/m2，平均（23.86±3.75）kg/m2;糖尿病30例（75.00%），高血壓23例（57.50%），吸煙史20例（50.00%）。對(duì)照組中，男23例（57.50%），女17例（43.50%）;年齡44～81歲，平均（61.15±4.88）歲;BMI 18.6～24.9 kg/m2，平均（23.62±3.51）kg/m2;糖尿病31例（77.50%），高血壓22例（55.00%），吸煙史19例（47.50%）。兩組的一般資料比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。本研究已通過我院醫(yī)學(xué)倫理委員會(huì)的審核，患者在知情同意下簽署了知情同意書。