摘要
【目的】探讨血府逐瘀汤加减对冠心病不稳定型心绞痛气滞血瘀型患者心绞痛发作情况及炎性因子水平的影响,以评价其在冠心病不稳定型心绞痛治疗中的应用价值。【方法】将92例冠心病不稳定型心绞痛气滞血瘀型患者随机分为对照组和观察组,每组各46例。对照组给予西医常规治疗,观察组在对照组的基础上联合血府逐瘀汤加减治疗,疗程为4周。观察2组患者治疗前后血浆肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、细胞间黏附分子1(ICAM-1)、转化生长因子β1(TGF-β1)、基质金属蛋白酶组织抑制剂1(TIMP-1)的变化情况,比较2组患者的临床心绞痛疗效、心电图疗效和不良反应发生率。【结果】(1)临床心绞痛疗效方面:治疗4周后,观察组的总有效率为93.48%(43/46),对照组为76.08%(35/46),组间比较,观察组的临床心绞痛疗效明显优于对照组(P<0.05)。(2)心电图疗效方面:治疗4周后,观察组的总有效率为91.30%(42/46),对照组为69.56%(32/46),组间比较,观察组的心电图疗效明显优于对照组(P<0.01)。(3)炎性因子水平方面:治疗后,2组患者的血浆TGF-β1、TIMP-1水平均较治疗前明显升高(P<0.05),血浆TNF-α、IL-6、ICAM-1水平均较治疗前明显降低(P<0.05),且观察组对血浆TGF-β1、TIMP-1水平的升高幅度及对血浆TNF-α、IL-6、ICAM-1水平的降低幅度均明显优于对照组(P<0.01)。(4)不良反应方面:观察组的不良反应发生率为21.74%(10/46),对照组为26.09%(12/46),组间比较,差异无统计学意义(P>0.05)。【结论】在西医常规治疗基础上联合血府逐瘀汤加减治疗冠心病不稳定型心绞痛气滞血瘀型患者疗效显著,可有效减轻炎症反应,改善心绞痛症状,从而有助于预防心肌纤维化,提高临床疗效。
Objective To investigate the effects of modified Xuefu Zhuyu Decoction on angina attacks and the levels of inflammatory factors in patients with unstable angina pectoris of coronary heart disease,so as to evaluate its value in the treatment of unstable angina pectoris of coronary heart disease with qi stagnation and blood stasis type.Methods Ninety-two patients with unstable angina pectoris of coronary artery disease were randomly divided into a control group and an observation group,with 46 patients in each group.The control group was given conventional western medicine treatment,while the observation group was treated with modified Xuefu Zhuyu Decoction combined with conventional western medicine for the control group.Both groups were treated for a treatment course of 4 weeks.The changes in plasma tumor necrosis factorα(TNF-α),interleukin 6(IL-6),intercellular adhesion molecule 1(ICAM-1),transforming growth factorβ1(TGF-β1)and tissue inhibitor of matrix metalloproteinase 1(TIMP-1)in the two groups were observed before and after treatment.Meanwhile,the clinical efficacy of angina pectoris,electrocardiograph(ECG)efficacy and incidence of adverse effects in the two groups were compared.Results(1)After 4 weeks of treatment,the total effective rate for clinical efficacy of angina pectoris in the observation group was 93.48%(43/46),and that in the control group was 76.08%(35/46).The intergroup comparison showed that the clinical angina pectoris efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After 4 weeks of treatment,the overall effective rate for ECG efficacy in the observation group was 91.30%(42/46),and that in the control group was 69.56%(32/46)in the control group.The intergroup comparison showed that the ECG efficacy of the observation group was significantly superior to that of the control group(P<0.01).(3)After treatment,the plasma levels of inflammatory factors such as TGF-β1 and TIMP-1 in the two groups were significantly increased(P<0.05)and the plasma TNF-α,IL-6 and ICAM-1 levels were significantly decreased(P<0.05)compared with those before treatment.The increased degree in plasma TGF-β1 and TIMP-1 levels and the decreased degree in plasma TNF-α,IL-6 and ICAM-1 levels in the observation group were all significantly superior to those in the control group(P<0.01).(4)The incidence of adverse reactions in the observation group was 21.74%(10/46)and that in the control group was 26.09%(12/46).The intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion On the basis of conventional treatment with western medicine,the combination of modified Xuefu Zhuyu Decoction is effective in treating patients with unstable angina pectoris of coronary heart disease differentiated as qi stagnation and blood stasis type,which can effectively reduce the inflammatory response and relieve the symptoms of angina pectoris,thereby being beneficial to the prevention of myocardial fibrosis and the enhancement of the clinical efficacy.
作者
王转转
顾民华
李光智
余洪
WANG Zhuan-Zhuan;GU Min-Hua;LI Guang-Zhi;YU Hong(Hainan Traditional Chinese Medicine Hospital,Haikou 570203 Hainan,China)
出处
《广州中医药大学学报》
CAS
2023年第7期1608-1614,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家自然科学基金项目(编号:82160899)
海南省自然科学基金高层次人才项目(编号:821RC1128)。
关键词
血府逐瘀汤
冠心病不稳定型心绞痛
气滞血瘀型
炎性因子
Xuefu Zhuyu Decoction
unstable angina pectoris of coronary heart disease
qi stagnation and blood stasis type
inflammatory factors
