目的 研究三七丹参胶囊联合叶黄素和阿托伐他汀治疗颈部血管斑块的效果及安全性。方法 选取2017年1月—2018年1月安康市中医医院的98例颈部血管斑块患者作为研究对象。用抽签法随机分为对照组和观察组，每组各49例。对照组患者口服阿托伐他汀钙片，20 mg/次，1次/d；且口服叶黄素软胶囊，2粒/次，2次/d。观察组在对照组的基础上口服三七丹参胶囊，3粒/次，3次/d。两组患者均治疗3个月。观察两组患者的临床疗效，同时比较两组患者的中医症候评分、Crouse斑块积分、血管内中膜厚度（IMT）和不良心血管事件情况。结果 治疗后，观察组的总有效率为81.63%，显著高于对照组为59.18%（P<0.05）。两组治疗后的心悸不安、头痛、胸闷不舒、舌质紫暗、唇甲紫绀、结代或脉涩积分明显降低（P<0.05），观察组上述中医证候评分明显低于对照组（P<0.05）。两组治疗后的Crouse斑块积分和IMT明显降低（P<0.05），观察组Crouse斑块积分和IMT明显低于对照组（P<0.05）。治疗期间，观察组的急性心肌梗死、不稳定型心绞痛、脑出血和急性脑梗死发生率显著低于对照组（P<0.05）。结论 三七丹参胶囊联合叶黄素软胶囊能明显减轻颈部血管斑块患者的症状，促进斑块面积的缩小，安全性高，且能降低不良心血管事件的发生风险。

Objective To study the efficacy and safety of Sanqi Danshen Capsules combined with lutein and atorvastatin in treatment of cervical vascular plaques. Methods A tatal of 98 patients with cervical vascular plaques in Ankang Hospital of Traditional Chinese Medicine from January 2017 to January 2018 were selected as the research objects. And the patients were randomly divided into control group and observation group with 49 cases in each group. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. And Lutein Soft Capsules 2 grains/time for twice daily. Patients in the observation group were po administered with Sanqi Danshen Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in both groups were treated for 3 months. After treatment, the clinical efficacy in two groups were observed, and the traditional Chinese medicine syndrome score, Crouse plaque score, IMT and adverse cardiovascular events of two groups were compared. Results After treatment, the total effective rate in the observation group was 81.63%, which was significantly higher than 59.18% of the control group (P<0.05). After treatment, palpitation and discomfort, headache, chest discomfort, purplish color of tongue, cyanosis of labial nail, knot or pulse-astringency scores were significantly reduced in two groups (P<0.05), and the TCM syndrome score in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the Crouse plaque scores and IMT in two groups were significantly reduced (P<0.05), and the Crouse plaque scores and IMT in the observation group were significantly lower than those of the control group (P<0.05). During treatment, the incidence of acute myocardial infarction, unstable angina pectoris, cerebral hemorrhage, and acute cerebral infarction in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Sanqi Danshen Capsules combined with Lutein Soft Capsules can significantly reduce the symptoms of cervical vascular plaque patients, promote the reduction of plaque area, with high safety, and reduce the risk of adverse cardiovascular events.

R972

安康市科学技术研究发展项目（AK2019-SF-099）