炙甘草汤加五参颗粒联合西药治疗冠心病的临床疗效及其对患者血清hs-CRP、NT-proBNP水平和内皮功能的影响
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摘要
目的:探究炙甘草汤加五参颗粒联合西药治疗冠心病的临床疗效及其对患者血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、N末端B型脑钠尿肽前体(NT-Pro-brain natriuretic peptide,NT-proBNP)水平和内皮功能的影响。方法:选取2015年12月至2017年10月在我院接受治疗的冠心病患者80例,随机分为观察组和对照组,每组各40例。对照组接受西药治疗,观察组在西药治疗的基础上联合炙甘草汤加五参颗粒治疗。比较两组临床疗效及治疗前后hs-CRP、NT-proBNP、一氧化氮(Nitric oxide,NO)和内皮素(Endothelin-1,ET-1)水平的变化。结果:观察组和对照组治疗后的总有效率分别为90%和72.5%,观察组明显优于对照组(P<0.05)。治疗前,两组血清hs-CRP、NT-pro BNP、NO、ET-1水平比较差异无统计学意义(P>0.05)。与同组内治疗前比较,两组治疗后血清NT-pro BNP、hs-CRP、ET-1水平均明显下降,血清NO水平均明显升高,且观察组血清NT-proBNP、hs-CRP、ET-1水平均明显低于对照组(P<0.05),血清NO水平显著高于对照组(P<0.05)。结论:在西药治疗的基础上加用炙甘草汤加五参颗粒治疗冠心病临床疗效明显优于单用西药治疗,可能与其显著降低炎症和改善内皮功能有关。
Objective: To explore the clinical efficacy of Zhigancao soup and Wushen granules combined with western medicine in the treatment of coronary heart disease, and explore the influence on serum hypersensitive C-reactive protein(hs-CRP), N terminal B type natriuretic peptide precursor(NT-proBNP) levels and endothelial function of patients. Methods: Eighty patients with coronary heart disease treated in our hospital from December 2015 to October 2017 were randomly subdivided into the observation group and the control group with 40 cases in each group. The control group was given western medicine treatment, and the observation group was given Zhigancao Tonga Wugang granules treatment on the basis of western medicine treatment. The changes of serum hs-CRP, NT-proBNP,Nitric oxide(NO) and Endothelin-1(ET-1) before and after treatment were compared between the two groups. Results: The total effective rate of observation group(90%) was obviously superior to that of the control group(72.5%)(P<0.05). Before treatment, there was no significant difference in the levels of serum hs-CRP, NT-proBNP, NO and ET-1 between the two groups(P>0.05). Compared with the group before treatment, the levels of serum NT-proBNP and hs-CRP were significantly decreased and the level of serum NO was significantly increased after treatment in both groups, and the serum levels of NT-proBNP, hs-CRP and ET-1 in the observation group after treatment were significantly lower than those in the control group(P<0.05), while the level of serum NO was significantly higher than that in the control group(P <0.05). Conclusions: Zhigancao Soup and Wushen Granules combined with western medicine is obviously better than western medicine alone in the treatment of coronary heart disease. It may be associated with significant reduce of inflammation and improvement of endothelial function.
Objective: To explore the clinical efficacy of Zhigancao soup and Wushen granules combined with western medicine in the treatment of coronary heart disease, and explore the influence on serum hypersensitive C-reactive protein(hs-CRP), N terminal B type natriuretic peptide precursor(NT-proBNP) levels and endothelial function of patients. Methods: Eighty patients with coronary heart disease treated in our hospital from December 2015 to October 2017 were randomly subdivided into the observation group and the control group with 40 cases in each group. The control group was given western medicine treatment, and the observation group was given Zhigancao Tonga Wugang granules treatment on the basis of western medicine treatment. The changes of serum hs-CRP, NT-proBNP,Nitric oxide(NO) and Endothelin-1(ET-1) before and after treatment were compared between the two groups. Results: The total effective rate of observation group(90%) was obviously superior to that of the control group(72.5%)(P<0.05). Before treatment, there was no significant difference in the levels of serum hs-CRP, NT-proBNP, NO and ET-1 between the two groups(P>0.05). Compared with the group before treatment, the levels of serum NT-proBNP and hs-CRP were significantly decreased and the level of serum NO was significantly increased after treatment in both groups, and the serum levels of NT-proBNP, hs-CRP and ET-1 in the observation group after treatment were significantly lower than those in the control group(P<0.05), while the level of serum NO was significantly higher than that in the control group(P <0.05). Conclusions: Zhigancao Soup and Wushen Granules combined with western medicine is obviously better than western medicine alone in the treatment of coronary heart disease. It may be associated with significant reduce of inflammation and improvement of endothelial function.
引文
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[19]黎洁雯.血管紧张素转化酶抑制剂在冠心病心力衰竭患者新发房颤中的预防作用[J].血栓与止血学,2016,22(2):140-143
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[21]黄福发,黄福,黄俊,等.冠心病中医防[J].中国中医药现代远程教育,2015,13(23):123-125
[22]黄奕旻.炙甘草汤加减治疗冠心病心律失常的疗效观察[J].云南中医中药杂志,2014,35(6):48-49
[23]高碧芸,陈学彬.加味炙甘草汤治疗缓慢性心律失常气阴两虚型临床研究[J].实用中医药杂志,2014,30(3):191-192
[24]王振琴.炙甘草汤联合盐酸美西律片治疗冠心病室性期前收缩临床观察[J].河北中医,2015,37(7):1044-1045
[25]赖天寿,丘仲柳,谭柏松,等.冠心病患者血清hs-CRP﹑c TnI和血脂水平变化及临床意义[J].中国实验诊断学,2014,18(1):49-51
[26]于乐,解赢.冠心生脉饮对冠心病患者血清hs-CRP、IL-6、TNF-α及ICAM-1水平的影响研究[J].中国生化药物杂志,2015,35(5):108-111
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[28]王朋朋.冠心病与NT-proBNP、hs-CRP的相关性研究[J].中国现代医学杂志,2014,24(16):32-35
[29]邰小燕.炙甘草汤加减联合西药治疗冠心病心律失常的临床分析[J].中西医结合心血管病电子杂志,2014,2(12):39-40
[30]袁斐,罗心平.通心络胶囊联合美托洛尔缓释片对冠心病血管内皮功能和心功能指标的影响[J].中国慢性病预防与控制,2016,24(4):300-302
[31]程杰.通心络胶囊联合阿托伐他汀对冠心病心绞痛患者疗效及内皮功能的影响[J].医药前沿,2017,7(2):95-96
[2]Ijzerman R G,De Jongh R T,Beijk M A M,et al.Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin[J].European Journal of Clinical Investigation,2015,33(7):536-542
[3]Corbex M,Poirier O,Fumeron F,et al.Extensive association analysis between the CETP gene and coronary heart disease phenotypes reveals several putative functional polymorphisms and gene-environment interaction[J].Genetic Epidemiology,2015,19(1):64-80
[4]Lu Y,Hajifathalian K,Ezzati M,et al.Metabolic mediators of the effects of body-mass index,overweight,and obesity on coronary heart disease and stroke:a pooled analysis of 97 prospective cohorts with1.8 million participants[J].Lancet,2014,383(9921):970-983
[5]Wang L Y,Zhang H L,Chen S,et al.Effect of atorvastatin combined with trimetazidine on oxidative stress,hemorheology and NT-pro BNP,hs-CRP in patients with coronary heart disease[J].Journal of Hainan Medical University,2017,23(17):2323-2327
[6]付士辉.老年冠心病患者抗血小板药物治疗进展[J].实用老年医学,2016,30(03):184-188
[7]周明俊,库洪希,李振龙,等.冠心病心绞痛患者血清hs-CRP和BNP水平的变化及临床意义[J].湖南师范大学学报(医学版),2015,12(01):93-95
[8]阚淑婷,朱颖,王瑞霞,等.血管内皮功能与同型半胱氨酸对老年冠心病病人病情的影响[J].实用老年医学,2017,31(05):454-457
[9]王健.短期强化阿托伐他汀治疗对冠心病患者血清脂肪相关因子、血管内皮功能障碍及心衰发生率的影响[J].湖南师范大学学报(医学版),2017,14(06):145-148
[10]中华人民共和国卫生部.冠状动脉粥样硬化性心脏病诊断标准[S].北京:中国质检出版社,2010:1-4
[11]邹小健.中医中药治疗冠心病进展分析[J].中国实用医药,2017,12(03):190-191
[12]Heusch G,Libby P,Gersh B,et al.Cardiovascular remodelling in coronary artery disease and heart failure[J].Lancet,2014,383(9932):1933-1943
[13]Rees K,Bennett P,West R,et al.Psychological interventions for coronary heart disease[J].International Journal of Behavioral Medicine,2014,21(1):109-121
[14]Reddy K K,Rao A P,Reddy T P.Socioeconomic status and the prevalence of coronary heart disease risk factors[J].Asia Pacific Journal of Clinical Nutrition,2015,11(2):98-103
[15]Peloso G M,Auer P L,Bis J C,et al.Association of low-frequency and rare coding-sequence variants with blood lipids and coronary heart disease in 56,000 whites and blacks[J].American Journal of Human Genetics,2014,94(2):223-232
[16]毕颖斐,毛静远,王贤良,等.中医药防治冠心病临床优势及有关疗效评价的思考[J].中医杂志,2015,56(5):437-440
[17]刘善淘,郭军,莫健姣,等.他汀类药物对冠心病患者心房颤动预防效果的Meta分析[J].临床心血管病杂志,2015,31(11):1186-1191
[18]付鑫,卢杰,张继红,等.不同他汀类药物治疗早发冠心病急性心肌梗死患者的疗效分析[J].中国医药指南,2015,13(09):5-6
[19]黎洁雯.血管紧张素转化酶抑制剂在冠心病心力衰竭患者新发房颤中的预防作用[J].血栓与止血学,2016,22(2):140-143
[20]董文杰.冠心病中医治疗临床观察[J].内蒙古中医药,2014,33(7):41-42
[21]黄福发,黄福,黄俊,等.冠心病中医防[J].中国中医药现代远程教育,2015,13(23):123-125
[22]黄奕旻.炙甘草汤加减治疗冠心病心律失常的疗效观察[J].云南中医中药杂志,2014,35(6):48-49
[23]高碧芸,陈学彬.加味炙甘草汤治疗缓慢性心律失常气阴两虚型临床研究[J].实用中医药杂志,2014,30(3):191-192
[24]王振琴.炙甘草汤联合盐酸美西律片治疗冠心病室性期前收缩临床观察[J].河北中医,2015,37(7):1044-1045
[25]赖天寿,丘仲柳,谭柏松,等.冠心病患者血清hs-CRP﹑c TnI和血脂水平变化及临床意义[J].中国实验诊断学,2014,18(1):49-51
[26]于乐,解赢.冠心生脉饮对冠心病患者血清hs-CRP、IL-6、TNF-α及ICAM-1水平的影响研究[J].中国生化药物杂志,2015,35(5):108-111
[27]王晓冬,曾波,许春平.阿托伐他汀联合曲美他嗪对冠心病NT-proBNP、hs-CRP、Fib及心脏功能的影响[J].疑难病杂志,2015,14(04):335-337+342
[28]王朋朋.冠心病与NT-proBNP、hs-CRP的相关性研究[J].中国现代医学杂志,2014,24(16):32-35
[29]邰小燕.炙甘草汤加减联合西药治疗冠心病心律失常的临床分析[J].中西医结合心血管病电子杂志,2014,2(12):39-40
[30]袁斐,罗心平.通心络胶囊联合美托洛尔缓释片对冠心病血管内皮功能和心功能指标的影响[J].中国慢性病预防与控制,2016,24(4):300-302
[31]程杰.通心络胶囊联合阿托伐他汀对冠心病心绞痛患者疗效及内皮功能的影响[J].医药前沿,2017,7(2):95-96