摘要
目的观察温阳活血方辅助治疗冠心病经皮冠状动脉介入术(PCI)后心绞痛(阳虚血瘀证)患者心肌功能及炎症反应的疗效。方法选取冠心病PCI后心绞痛患者88例,随机分为观察组与对照组各44例。对照组给予西医常规治疗,观察组在此基础上联合使用温阳活血方,持续治疗1个月。评价两组临床疗效,比较治疗前后心绞痛发作情况、中医证候积分、心功能指标[每搏输出量(SV)、左室射血分数(LVEF)、B型脑尿钠肽(BNP)]、血液流变学指标[红细胞比容(HCT)、纤维蛋白原(FIB)]、血脂指标[胆固醇(TC)、甘油三酯(TAG)及高、低密度脂蛋白胆固醇(HDL-C、LDL-C)]、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,并观察不良反应发生情况。结果观察组治疗总有效率为95.45%,高于对照组的81.82%(P<0.05);观察组治疗后心绞痛发作频次少于对照组,发作持续时间短于对照组(P<0.05);观察组治疗后中医证候积分低于对照组(P<0.05);治疗后,观察组LVEF、SV高于对照组,BNP表达低于对照组(P<0.05);治疗后,观察组HCT、FIB水平低于对照组(P<0.05);观察组治疗后TC、LDL-C、TAG水平低于对照组,HDL-C水平高于对照组(P<0.05);观察组治疗后血清IL-6、CRP水平低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论温阳活血方辅助治疗可有效减轻冠心病PCI后心绞痛患者临床症状,改善其心功能,改善血液流变学指标,降低患者血脂水平,调节机体炎症反应,修复内皮功能。
Objective:To observe the effect of Wenyang Huoxue Decoction as adjuvant therapy on myocardial function and inflammatory response in patients with angina pectoris after percutaneous coronary intervention(PCI)for coronary heart disease(syndrome of yang deficiency and blood stasis).Methods:A total of 88 patients with angina pectoris after PCI for coronary heart disease were selected and randomly divided into an observation group and a control group,with 44 cases in each group.The control group was given conventional western medicine treatment,while the observation group was treated with Wenyang Huoxue Decoction on this basis for 1 month.The clinical efficacy of the two groups was evaluated.The angina pectoris attack status,TCM syndrome scores,cardiac function indexes[stroke volume(SV),left ventricular ejection fraction(LVEF),B-type natriuretic peptide(BNP)],hemorheology indexes[hematocrit(HCT),fibrinogen(FIB)],blood lipid indexes[total cholesterol(TC),triglyceride(TAG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)]and inflammatory factor levels[C−reactive protein(CRP),interleukin-6(IL−6)]before and after treatment were compared between the two groups,and the incidence of adverse reactions was observed.Results:The effective rate of treatment in the observation group was 95.45%,which was higher than 81.82%in the control group(P<0.05).After treatment,the frequency of angina pectoris attacks in the observation group was lower than that in the control group,and the duration of attacks was shorter than that in the control group(P<0.05).The TCM symptom score of the observation group after treatment was lower than that of the control group(P<O.05).After treatment,the levels of LVEF and SV in the observation group were higher than those in the control group,and the expression of BNP was lower than that in the control group(P<0.05).After treatment,the levels of HCT and FIB in the observation group were lower than those in the control group(P<0.05).The levels of TC,LDL-C and TAG in the observation group after treatment were lower than those in the control group,and the level of HDL-C was higher than that in the control group(P<0.05).The serum levels of IL−6 and CRP in the observation group after treatment were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Adjuvant therapy with Wenyang Huoxue Decoction can effectively alleviate the clinical symptoms of patients with angina pectoris after PCI for coronary heart disease,improve their cardiac function,enhance hemodynamics,reduce blood lipid levels,regulate the body's inflammatory response and repair endothelial function.
作者
王朝阳
李伟
刘玲玲
李东方
冯浩欣
徐谦
李聪聪
刘钊
欧梦仙
Wang Zhaoyang;Li Wei;Liu Lingling;Li Dongfang;Feng Haoxin;Xu Qian;Li Congcong;Liu Zhao;Ou Mengxian(beijing fengtai hospital of integrated traditional chinese and western medicine,beijing 100072,chin1.)
出处
《中国中医急症》
2026年第2期194-198,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
2022年首都卫生发展科研专项(首发2022-4-20114)。
关键词
冠心病
经皮冠状动脉介入术
心绞痛
阳虚血瘀证
温阳活血方
心肌功能
Coronary heart disease
Percutaneous coronary intervention
Angina pectoris
Syndrome of yang deficiency and blood stasis
Wenyang Huoxue Decoction
Myocardial function
