目的 探討通脈顆粒聯(lián)合甲鈷胺和葉酸治療高同型半胱氨酸血癥（HHcy）的臨床療效。方法 選取唐山市第九醫(yī)院2015年3月-2016年3月收治的HHcy患者86例，根據(jù)治療方案的差別分為對照組和治療組，每組各43例。對照組患者口服甲鈷胺片，1片/次，3次/d；同時口服葉酸片，1片/次，1次/d。治療組在對照組的基礎(chǔ)上口服通脈顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療6周。觀察兩組患者的臨床療效，同時比較兩組治療前后同型半胱氨酸（Hcy）、三酰甘油（TG）、總膽固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、血清NO、內(nèi)皮素-1（ET-1）、超氧化物歧化酶（SOD）和丙二醛（MDA）的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為76.74%、93.02%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組TC、TG、LDL-C、Hcy水平均顯著降低，HDL-C水平則升高，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療后治療組這些觀察指標顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組ET-1、MDA、SOD、NO水平均較治療前明顯改善，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 通脈顆粒聯(lián)合甲鈷胺和葉酸治療HHcy具有顯著的臨床療效，可明顯降低血脂和機體氧化應(yīng)激水平，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical curative effect of Tongmai Granules combined with mecobalamin and folic acid in treatment of HHcy. Methods Patients (86 cases) with HHcy in the Ninth Hospital of Tangshan from March 2015 to March 2016 were divided into control and treatment groups based on different treatment methods, and each group had 43 cases. Patients in the control group were po administered with Mecobalamin Tablets, 1 tablet/time, three times daily. And they were also po administered with Folic Acid Tablets, 1 tablet/time, once daily. The patients in the treatment group were po administered with Tongmai Granules on the basis of the control group, 1 bag/time, three times daily. The patients in two groups were treated for 6 weeks. After treatment, the efficacy was evaluated, and the changes of Hcy, TG, TC, LDL-C, HDL-C, NO, ET-1, SOD, and MDA in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74% and 93.02%, respectively, and there were differences between two groups (P<0.05). After treatment, the levels of TC, TG, LDL-C, and Hcy in two groups were significantly decreased, HDL-C level was increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of ET-1, MDA, SOD, and NO were significantly improved, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongmai Granules Combined with mecobalamin and folic acid has a good clinical curative effect in treatment of HHcy, can obviously reduce the levels of blood lipid and oxidative stress, which has a certain clinical application value.

河北省科學技術(shù)廳資助項目（20140673）