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目的:评估脂康颗粒联合阿托伐他汀在动脉粥样硬化脑梗死二级预防中的效果。方法:180例患者随机分为对照组和观察组各90例,2组再随机分为三个亚组。对照组3个亚组分别每日顿服阿托伐他汀片10,20,40 mg;观察组3个亚组在对照组基础上加用脂康颗粒。两组均连续治疗6个月。测定治疗前、治疗3个月、治疗6个月时各组患者的血脂指标(TG、TC、LDL-C)和ALT、动脉内-中膜厚度(IMT);使用析因分析比较用药种类、阿托伐他汀剂量、治疗时间对上述指标的影响。结果:治疗3个月后,两组及各亚组TG、TC、LDL-C等血脂指标均较治疗前明显下降(P<0.05),ALT较前明显升高(P<0.05);观察组及各亚组TG、TC、LDL-C水平明显低于对照组及各相应亚组(P<0.05);两组40 mg亚组、20 mg亚组的TC、LDL-C水平均明显低于本组10 mg亚组(P<0.05)。治疗6个月后,两组及各亚组TG、TC、LDL-C等血脂指标均较治疗前进一步明显下降(P<0.05),ALT也进一步明显升高(P<0.05),两组IMT较治疗前明显降低(P<0.05);观察组及各亚组TG、TC、LDL-C水平明显低于对照组及各相应亚组(P<0.05);两组40 mg亚组的TG、TC、LDL-C水平明显低于本组10 mg亚组(P<0.05),20 mg亚组的TC、LDL-C水平明显低于本组10 mg亚组(P<0.05)。析因分析结果:增加阿托伐他汀剂量显著降低TG、TC、LDL-C和升高ALT(P<0.05)。延长治疗时间显著降低TG、TC、LDL-C、IMT和升高ALT(P<0.05)。用药种类和治疗时间对降低TC、LDL-C有交互作用,阿托伐他汀剂量和治疗时间对降低TC、LDL-C和升高ALT有交互作用(P<0.05)。结论:联用脂康颗粒提高了阿托伐他汀在动脉粥样硬化所致脑梗死二级预防中的效果。
Objective: To evaluate the effect of Zhikang granule combined with atorvastatin on secondary prevention of atherosclerotic cerebral infarction. Methods: One hundred and eighty patients were randomly divided into control group and observation group of 90 cases. Two groups were randomly divided into three subgroups. The control group of three sub-groups were daily doses of Atorvastatin tablets 10,20,40 mg; the observation group of three sub-groups in the control group plus Zhikang particles. Two groups were treated for 6 months. The levels of serum lipids (TG, TC, LDL-C), ALT, and intima-media thickness (IMT) in each group before and 3 months and 6 months after treatment were measured. Atorvastatin dose, treatment time on the above indicators. Results: At 3 months after treatment, the levels of TG, TC and LDL-C in two groups and all subgroups were significantly lower than those before treatment (P <0.05), ALT was significantly higher than before (P <0.05) (P <0.05). The levels of TC, LDL-C in 40 mg subgroup and 20 mg subgroup were significantly lower than those in control group and each corresponding subgroup The group 10 mg subgroup (P <0.05). After 6 months of treatment, the levels of TG, TC and LDL-C in two groups and subgroups were significantly lower than those before treatment (P <0.05), ALT was significantly higher (P <0.05) TG, TC and LDL-C levels in the observation group and each subgroup were significantly lower than those in the control group and each subgroup (P <0.05); TG, TC and LDL-C levels were significantly lower than the 10 mg subgroup (P <0.05). The levels of TC and LDL-C in 20 mg subgroup were significantly lower than those of the 10 mg subgroup (P <0.05). Factorial analysis: Increasing atorvastatin dose significantly reduced TG, TC, LDL-C and increased ALT (P <0.05). Prolonged treatment reduced TG, TC, LDL-C, IMT and increased ALT (P <0.05). Interaction of TC and LDL-C decreased with the type and duration of treatment. The dose and duration of atorvastatin decreased the levels of TC, LDL-C and ALT (P <0.05). Conclusion: The combination of Zhikang granules enhances the effect of atorvastatin on secondary prevention of cerebral infarction induced by atherosclerosis.