Fan Jianhua, Yu Chang, Tang Huan, Zhang Zhuang, Wu Qiong, Lu Licheng, Xu Cun, Xia Zhaochen, Xu Haixiang, Wen Jiasheng, Pan Wen
Department of Cardiology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu, China.
Department of Cardiology, Kunshan Integrated Traditional Chinese and Western Medicine Hospital, Suzhou, Jiangsu, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40787. doi: 10.1097/MD.0000000000040787.
Stable angina pectoris, resulting from coronary artery atherosclerosis, significantly affects quality of life and carries a high risk of cardiovascular events. Despite modern therapies, managing this condition remains challenging. Traditional Chinese medicine (TCM) views it as a syndrome of heart meridian obstruction by phlegm and blood stasis, necessitating improved circulation and phlegm resolution. This study aims to evaluate the efficacy of Jiangzhi Mai'an Granules, a TCM formulation, in treating stable angina pectoris and carotid atherosclerosis, with the goal of integrating TCM with Western medicine to enhance clinical outcomes and patients' quality of life.
A total of 120 patients diagnosed with stable angina pectoris and carotid atherosclerotic plaques of the phlegm and blood stasis types were randomly divided into 2 groups. The control group (n = 60) received standard Western medical treatment, whereas the treated group (n = 60) received JZMA in addition to the standard regimen. The treatment duration in both the groups was 3 months. The outcomes measured included carotid intima-media thickness (CIMT), carotid plaque dimensions, TCM syndrome scores, and serum lipid profiles (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], apolipoprotein B [Apo B], and non-HDL-C) and lipoprotein phospholipase A2 (Lp-PLA2) levels before and after treatment.
The treated group achieved a total efficacy rate of 93.3% (56/60), which surpassed the control group rate of 78.3% (47/60). The CIMT, carotid plaque thickness, and area in the treated group were significantly reduced posttreatment compared to baseline (P < .05) and were also lower than those in the control group (P < .05). Serum lipid levels, including TC, TG, LDL-C, ApoB and non-HDL-C were significantly decreased in both groups posttreatment (P < .05), and the treated group showed a further increase in HDL-C levels (P < .05). The treated group exhibited lower serum lipid levels than the control group posttreatment (P < .05). The TCM syndrome scores improved significantly in both groups after treatment (P < .05), with the treated group demonstrating a more pronounced reduction in scores than the control group (P < .05). The incidence of adverse events did not differ significantly between the 2 groups.
JZMA combined with standard treatment effectively reduced CIMT, plaque size, and serum lipid levels, thereby enhancing clinical outcomes in patients with stable angina and carotid atherosclerosis.
冠状动脉粥样硬化导致的稳定型心绞痛严重影响生活质量，并具有较高的心血管事件风险。尽管有现代治疗方法，但管理这种疾病仍然具有挑战性。中医将其视为痰瘀阻络型心经证候，需要改善血液循环和化痰。本研究旨在评估中药制剂降脂脉安颗粒治疗稳定型心绞痛和颈动脉粥样硬化的疗效，目的是将中医与西医相结合，以提高临床疗效和患者生活质量。
总共120例被诊断为痰瘀型稳定型心绞痛和颈动脉粥样硬化斑块的患者被随机分为两组。对照组（n = 60）接受标准西医治疗，而治疗组（n = 60）在标准治疗方案基础上还接受降脂脉安颗粒治疗。两组的治疗时间均为3个月。测量的结果包括颈动脉内膜中层厚度（CIMT）、颈动脉斑块大小、中医证候评分以及治疗前后的血脂谱（总胆固醇[TC]、甘油三酯[TG]、低密度脂蛋白胆固醇[LDL-C]、高密度脂蛋白胆固醇[HDL-C]、载脂蛋白B[Apo B]和非HDL-C）以及脂蛋白磷脂酶A2（Lp-PLA2）水平。
治疗组的总有效率为93.3%（56/60），超过对照组的78.3%（47/60）。治疗组治疗后的CIMT、颈动脉斑块厚度和面积与基线相比显著降低（P <.05），且也低于对照组（P <.05）。两组治疗后包括TC、TG、LDL-C、ApoB和非HDL-C在内的血脂水平均显著降低（P <.05），且治疗组的HDL-C水平进一步升高（P <.05）。治疗组治疗后的血脂水平低于对照组（P <.05）。两组治疗后中医证候评分均显著改善（P <.05），且治疗组的评分降低比对照组更显著（P <.05）。两组不良事件的发生率无显著差异。
降脂脉安颗粒联合标准治疗有效降低了CIMT、斑块大小和血脂水平，从而改善了稳定型心绞痛和颈动脉粥样硬化患者的临床疗效。
