目的

探讨五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果。

方法

选择2019 年10 月至2021 年9 月在山东中医药大学附属日照市中医医院确诊的中风病风痰瘀阻证型椎动脉开口支架置入的患者150 例，采用双色球分组方式将患者均分为2组，即采取常规西药治疗的对照组（75 例）和增加五虫通络胶囊治疗的观察组（75 例）。（1）比较2组患者手术前后血脂［总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）］、血清炎症因子水平［白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏C 反应蛋白（hs-CRP）］、收缩期峰值流速（PSV）、舒张末期流速（EDV）、颈动脉内膜中层厚度（IMT）、斑块数量、斑块大小积分、中医证候积分、再狭窄率情况进行比较；（2）比较2组患者手术前后肝酶指标［丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ 谷氨酰转移酶（GGT）］及血清肌酐（SCr）指标；（3）比较2组患者手术前后胃肠道反应发生情况。

结果

2组术前的PSV、EDV、IMT、斑块数量、斑块大小积分、中医证候积分等比较，差异均无统计学意义（P 均＞0.05）；术后6 个月，观察组TC、TG、LDL-C、IL-6、TNF-α、hs-CRP、PSV、EDV、IMT、斑块数量、斑块大小积分、中医证候积分、再狭窄率等均低于对照组，差异均有统计学意义（P 均＜0.05）。2组术前以及术后6 个月ALT、AST、GGT、SCr 及胃肠道反应比较，差异均无统计学意义（P 均＞0.05）。

结论

对于椎动脉开口支架术后患者的治疗，常规西药基础上增加五虫通络胶囊能有效改善血流动力学，减少斑块，改善中医证候，调节炎症因子及血脂水平，对再狭窄的发生具有良好的防治作用。

Objective

To investigate the effect of Wuchong Tongluo Capsule in preventing and treating restenosis after vertebrobasilar artery stenting.

Methods

One hundred and fifty patients diagnosed with vertebrobasilar artery stenting， exhibiting the traditional Chinese medicine syndrome of wind， phlegm， and blood stasis due to stroke， were enrolled at our hospital from October 2019 to September 2021. These patients were randomly assigned to two groups using a double-blind method: a control group（75 cases） treated with conventional Western medicine and a treatment group （75 cases） additionally administered Wuchong Tongluo Capsule. The blood lipid levels ［total cholesterol （TC）， triglyceride （TG），low density lipoprotein cholesterol （LDL-C）］， serum inflammatory factors ［interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， hypersensitive C-reactive protein （hs-CRP）］， peak systolic flow velocity （PSV），and diastole of the two groups before and after treatment were compared end-stage flow velocity （EDV），carotid intima media thickness （IMT）， plaque number， plaque size score， TCM syndrome score and restenosis rate were compared. At the same time， liver enzyme indexes ［alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ glutamyl transferase （GGT）］， serum creatinine （Scr） were compared between the two groups before and after treatment. Gastrointestinal reactions before and after treatment were also compared.

Results

There were no significant differences in PSV， EDV， IMT， plaque number， plaque size score and TCM syndrome score between the two groups before surgery （P＞0.05）. 6 months after surgery，the values of TC， TG， LDL-C， IL-6， TNF-α， hs-CRP， PSV， EDV， IMT， plaque number， plaque size integral，TCM syndrome volume and restenosis rate in the treatment group were lower than those in the control group（P＜0.05）. There was no significant difference in ALT， AST， GGT， Scr and gastrointestinal reaction between the two groups before and after 6 months treatment （P＞0.05）.

Conclusion

In the postoperative treatment of patients with vertebrobasilar artery stenting， the addition of Wuchong Tongluo capsule on the basis of conventional western medicine can effectively improve hemodynamics， reduce plaque burden， ameliorate TCM syndrome， regulate inflammatory factors and lipid levels， demonstrating a favorable impact on the prevention and treatment of restenosis.