摘要
目的观察化痰祛瘀通脉汤加减治疗冠心病不稳定型心绞痛的疗效及对心肌酶谱、血清基质金属蛋白酶9(MMPs-9)及可溶性细胞间黏附因子-1(sICAM-1)水平的影响。方法选取2017年7月—2020年6月期间淮北市人民医院收治的60例冠心病不稳定型心绞痛患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各30例。两组患者入院后均给予抗血小板、调脂类、降压类、抗凝等药物基础治疗;对照组在上述治疗的基础上给予口服消心痛治疗,若心绞痛发作则给予舌下含服硝酸甘油;观察组在对照组治疗的基础上给予化痰祛瘀通脉汤加减。治疗3个月后,观察两组患者治疗前后中医证候积分、临床疗效、血脂[高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)]、血液流变学[纤维蛋白原(Fid)、血浆黏度(PV)、血黏度(CP)]、心肌酶谱[磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、MMPs-9、sICAM-1。结果治疗后观察组总有效率96.67%(29/30)明显高于对照组76.67%(23/30),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后中医证候积分较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者HDL-C较治疗前升高,TG、LDL-C、TC水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后TG、LDL-C、TC水平均较对照组降低,HDL-C水平较对照组升高,差异有统计学意义(P<0.05)。治疗后两组患者Fid、PV、CP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后Fid、PV、CP水平均较对照组降低,差异有统计学意义(P<0.05)。治疗后两组患者CK、CK-MB、LDH水平较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后CK、CK-MB、LDH水平均较对照组降低,差异有统计学意义(P<0.05)。治疗后两组患者MMPs-9、sICAM-1水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后MMPs-9、sICAM-1水平较对照组降低,差异有统计学意义(P<0.05)。结论采用化痰祛瘀通脉汤加减治疗冠心病不稳定型心绞痛患者效果显著,可降低心肌酶谱、MMPs-9及sICAM-1水平,值得临床推广应用。
Objective To observe the curative effect of Huatan Quyu Tongmai Decoction in the treatment of unstable angina pectoris of coronary heart disease and its effect on myocardial enzymes,serum matrix metalloproteinase-9(MMPs-9)and soluble intercellular adhesion factor-1(sICAM-1)Level of influence.Methods From July 2017 to June 2020,60 patients with unstable angina pectoris of coronary heart disease admitted to Huaibei City People′s Hospital were selected as the research objects,and they were divided into observation group and control group according to the randomnumber table method,with 30 cases in each group.After admission,the two groups of patients were given basic antiplatelet,lipid-regulating,antihypertensive,anticoagulant and other basic treatments;the control group was given oral sosotherapy on the basis of the above treatments,and sublingual nitroglycerin was given to sublingual nitroglycerin if angina occurred On the basis of the treatment of the control group,the observation group was given the addition and subtraction of Huatan Quyu Tongmai Decoction.After 3 months of treatment,the scores of TCM syndromes,clinical efficacy,blood lipids[high density lipoprotein cholesterol(HDL-C),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C)before and after treatment in the two groups of patients,Total cholesterol(TC)],hemorheology[fibrinogen(Fid),plasma viscosity(PV),blood viscosity(CP)],myocardial enzyme spectrum[phosphocreatine kinase(CK),phosphocreatine kinase with the same Industrial enzymes(CK-MB),lactate dehydrogenase(LDH)],MMPs-9,and sICAM-1 of two groups before and after treatment were compared.Results After treatment,the total effective rate of the observation group was 96.67%(29/30)was significantly higher than that of the control group 76.67%(23/30),the difference was statistically significant(P<0.05).After treatment,the TCM syndrome scores of the two groups of patients were lower than before treatment,and the difference was statistically significant(P<0.05);and the observation group was significantly lower than the control group after treatment,and the difference was statistically significant(P<0.05).After treatment,the HDL-C of the two groups of patients was higher than before treatment,and the levels of TG,LDL-C,and TC were lower than before treatment.The difference was statistically significant(P<0.05);and the observation group had TG,LDL-C,The level of TC was lower than that of the control group,and the level of HDL-C was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of Fid,PV,and CP of the two groups of patients were lower than before treatment,and the difference was statistically significant(P<0.05);and the levels of Fid,PV,and CP of the observation group after treatment were lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CK,CK-MB,and LDH in the two groups were lower than before treatment,and the difference was statistically significant(P<0.05);and the levels of CK,CK-MB,and LDH in the observation group after treatment were lower than those in the control group,and there were differences Statistically significant(P<0.05).After treatment,the levels of MMPs-9 and sICAM-1 in the two groups were lower than before treatment,and the difference was statistically significant(P<0.05);and the levels of MMPs-9 and sICAM-1 in the observation group were lower than those in the control group after treatment,statistically significant(P<0.05).Conclusion Huatan Quyu Tongmai Decoction is effective in treating patients with unstable angina pectoris of coronary heart disease.It can reduce the levels of myocardial enzyme spectrum,MMPs-9 and sICAM-1,which is worthy of clinical application.
作者
杜倩
郑蛟东
DU Qian;ZHENG Jiao-dong(Huaibei People's Hospital,Huaibei Anhui 235000)
出处
《世界中西医结合杂志》
2021年第12期2255-2260,共6页
World Journal of Integrated Traditional and Western Medicine
基金
安徽省自然科学基金资助项目(18JJ30138)。
关键词
化痰祛瘀通脉汤加减
冠心病不稳定型心绞痛
血脂
血液流变学
心肌酶谱
Huatan Quyu Tongmai Decoction
Unstable Angina Pectoris Of Coronary Heart Disease
Blood Lipids
Hemorheology
Myocardial Enzyme Spectrum
