Herbal cake-insulated moxibustion in auxiliary treatment of carotid atherosclerosis with interaction of phlegm and blood stasis: a randomized controlled trial

To observe the clinical effect and safety of herbal cake-insulated moxibustion in the auxiliary treatment of carotid atherosclerosis (CAS) differentiated as interaction of phlegm and blood stasis.

Sixty-three patients with CAS differentiated as interaction of phlegm and blood stasis were randomly divided into an experimental group (33 cases, 4 cases dropped out) and a control group (30 cases, 3 cases dropped out). In the experimental group, herbal cake-insulated moxibustion was delivered in combination with oral administration with atorvastatin. In the control group, atorvastatin was administered orally. The duration of treatment in either group was composed of 12 weeks. Common carotid intima-media thickness (cIMT), the total area of carotid plaque, common carotid blood flow parameters, blood lipids contents (4 items) and traditional Chinese medicine (TCM) syndrome score were compared between the two groups before and after treatment. Blood routine and liver and kidney function were detected before and after treatment, and adverse events were recorded to evaluate safety.

Compared with those before treatment, the bilateral cIMT and the contents of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in serum were reduced after treatment (P<0.05, P<0.001), the scores of the primary symptoms and secondary symptoms of TCM, as well as the total score were lower (P<0.001) in the two groups. The left cIMT and the contents of the serum TC, TG and LDL-C in the experimental group were lower than those of the control group (P<0.05, P<0.01), and the scores of the primary symptoms and secondary symptoms of TCM, as well as the total score were lower than those of the control group (P<0.001, P<0.01). After treatment, the bilateral peak systolic velocity (PSV) and end diastolic velocity (EDV) were increased in the experimental group (P<0.001), the right EDV was increased in the control group (P<0.001), and the bilateral PSV and EDV in the experimental group were higher than those of the control group (P<0.05, P<0.01, P<0.001). After treatment, there was no significant difference in the total area of carotid plaque between the two groups. After treatment, there were no significant abnormalities in blood routine and liver and kidney functions in both groups, and the safety was good.

On the basis of conventional medication, the herbal cake-insulated moxibustion as an auxiliary treatment, presents its synergistic effect on CAS of interaction of phlegm and blood stasis syndrome in the patients, and this therapy is safe in clinical application.