Qin Xinzuo, Guo Xu, Liu Yijiang, Wang Zijian, Wang Xinyu, Wan Qi, Gao Mingjie, Song Juexian
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China.
Int J Gen Med. 2024 Jul 15;17:3073-3081. doi: 10.2147/IJGM.S473057. eCollection 2024.
Asymptomatic cerebral carotid artery stenosis (ACCAS) benefits from secondary prevention via statins and antiplatelets; nonetheless, the impact of medication alone is often limited. Evidence has suggested enhanced therapeutic outcomes when Chinese patent medicine-specifically, compound dilong capsules (CDC)-is integrated with conventional secondary prevention measures.
We retrospectively analyzed 319 ACCAS patients from January 2018 to December 2022 at Xuanwu Hospital, Capital Medical University. Depending on the clinical outcomes-improvement or stabilization versus progression-patients were classified into effective or ineffective treatment groups. Patient medical records and questionnaire responses were the primary data sources. The study accounted for demographic variables, clinical history, and medication details, with the primary focus on CDC use and its duration. Treatment outcomes were gauged alongside Transcranial color-coded sonography and Carotid Doppler ultrasonography findings. We employed both univariate and multivariate statistical methods to assess the data.
CDC administration (aOR=2.51, 95% CI 1.39-4.54, P=0.002) and extended usage beyond six months (aOR=3.54, 95% CI 1.71-7.32, P=0.001) demonstrate a statistically significant correlation with treatment efficacy. Gender (aOR=2.54, 95% CI 1.30-5.00, P=0.007), hypertension management (aOR=0.56, 95% CI 0.33-0.95, P=0.031), and antiplatelet therapy with aspirin (aOR=9.53, 95% CI 1.15-78.89, P=0.037) or clopidogrel (aOR=9.97, 95% CI 1.10-90.12, P=0.041) also influenced the therapeutic outcome significantly.
Incorporating CDC as part of a secondary prevention strategy for over six months can beneficially modulate and limit the progression of vascular stenosis in ACCAS. These findings underscore the value of combining traditional Chinese medicine with modern pharmacological interventions in ACCAS management.
无症状性脑颈动脉狭窄（ACCAS）可通过他汀类药物和抗血小板药物进行二级预防而获益；尽管如此，单纯药物治疗的效果往往有限。有证据表明，将中成药——具体而言，复方地龙胶囊（CDC）——与传统二级预防措施相结合，可提高治疗效果。
我们回顾性分析了2018年1月至2022年12月期间首都医科大学宣武医院的319例ACCAS患者。根据临床结果——改善或稳定与进展——将患者分为治疗有效组或无效组。患者病历和问卷调查回复是主要数据来源。该研究考虑了人口统计学变量、临床病史和用药细节，主要关注CDC的使用情况及其持续时间。治疗结果与经颅彩色编码超声和颈动脉多普勒超声检查结果一同评估。我们采用单变量和多变量统计方法对数据进行评估。
服用CDC（调整后比值比[aOR]=2.51，95%置信区间[CI]为1.39 - 4.54，P = 0.002）以及使用超过六个月（aOR = 3.54，95% CI为1.71 - 7.32，P = 0.001）与治疗效果具有显著的统计学相关性。性别（aOR = 2.54，95% CI为1.30 - 5.00，P = 0.007）、高血压管理（aOR = 0.56，95% CI为0.33 - 0.95，P = 0.031）以及使用阿司匹林（aOR = 9.53，95% CI为1.15 - 78.89，P = 0.037）或氯吡格雷（aOR = 9.97，95% CI为1.10 - 90.12，P = 0.041）进行抗血小板治疗也对治疗结果有显著影响。
将CDC纳入二级预防策略并使用超过六个月，可有益地调节并限制ACCAS中血管狭窄的进展。这些发现强调了在ACCAS管理中将中医与现代药理学干预相结合的价值。
