Ornish D, Brown S E, Scherwitz L W, Billings J H, Armstrong W T, Ports T A, McLanahan S M, Kirkeeide R L, Brand R J, Gould K L
Pacific Presbyterian Medical Center, Sausalito, California.
Lancet. 1990 Jul 21;336(8708):129-33. doi: 10.1016/0140-6736(90)91656-u.
In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.
在一项前瞻性、随机、对照试验中，为确定全面的生活方式改变在1年后是否会影响冠状动脉粥样硬化，28例患者被分配至试验组（低脂素食饮食、戒烟、压力管理训练和适度运动），20例被分配至常规护理对照组。通过定量冠状动脉造影分析了195处冠状动脉病变。试验组的平均直径狭窄百分比从40.0（标准差16.9）%降至37.8（16.5）%，而对照组则从42.7（15.5）%进展至46.1（18.5）%。仅分析狭窄大于50%的病变时，试验组的平均直径狭窄百分比从61.1（8.8）%降至55.8（11.0）%，对照组则从61.7（9.5）%进展至64.4（16.3）%。总体而言，82%的试验组患者平均出现了向病变消退的变化。仅1年后，全面的生活方式改变可能就能使即使是严重的冠状动脉粥样硬化发生消退，而无需使用降脂药物。
