益气活血清热解毒汤治疗冠心病血运重建术后心绞痛(卒心痛)的效果
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摘要
目的:探讨冠心病血运重建术后心绞痛(卒心痛)患者中益气活血清热解毒汤的应用效果。方法:将61例冠心病血运重建术后心绞痛(卒心痛)患者以随机数字表分为对照组(30例)和研究组(31例),对照组予以常规西药治疗,研究组予以常规西药配合益气活血清热解毒汤治疗。对比治疗前后中医证候积分,临床疗效,治疗前后凝血四项,炎症因子水平,硝酸甘油停减情况。结果:治疗后研究组与对照组主症、次症积分和总积分,纤维蛋白原(FIB)、血清高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均降低(P<0.05),且治疗后研究组主症、次症积分和总积分,FIB、血清hs-CRP、IL-6和TNF-α水平均低于对照组(P<0.05);治疗后研究组和对照组凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)和凝血酶时间(TT)均延长(P<0.05),且治疗后研究组PT、APTT和TT均长于对照组(P<0.05);两组临床疗效和治疗后硝酸甘油停减情况分布差异均有统计学意义(P<0.05),且研究组总有效率和停减率均高于对照组(P<0.05)。结论:在冠心病血运重建术后心绞痛(卒心痛)患者中采用益气活血清热解毒汤治疗能够减轻症状,改善凝血功能,控制炎症反应,提高硝酸甘油停减率,疗效理想,值得借鉴。
Objective: To explore the effect of Yiqi Huoxue Qingre Jiedu Decoction in patients with angina pectoris after coronary revascularization(precordial pain). Methods: Sixty-one patients with angina pectoris after coronary revascularization(precordial pain) were randomly divided into control group(30 cases) and study group(31 cases). The control group was treated with conventional Western medicine. The study group was given conventional Western medicine combined with Yiqi Huoxue Qingre Jiedu Decoction. The TCM syndrome scores before and after treatment, clinical efficacy, four coagulation factors, the levels of inflammatory factors before and after treatment, and the situation of nitroglycerin stop were compared. Results: After treatment, the scores of main symptoms, sub symptoms and total scores, fibrinogen(FIB), serum high sensitive C reactive protein(hs-CRP), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were decreased in the study group and the control group(P<0.05), which in the study group after treatment were lower than those in the control group(P<0.05). After treatment, the prothrombin time(PT), the activated partial thromboplastin time(APTT) and the thrombin time(TT) were prolonged in the study group and the control group(P<0.05), which in the study group after treatment were longer than those in the control group(P<0.05). The distributions of clinical efficacy and nitroglycerin between the two groups were statistically different(P<0.05), and the total effective rate and stopping rate in the study group were higher than those in the control group(P<0.05). Conclusion: In the patients with angina pectoris after coronary revascularization(precordial pain), Yiqi Huoxue Qingre Jiedu Decoction can reduce the symptoms, improve the coagulation function, control the inflammatory reaction and increase the rate of nitroglycerin stop, which is worthy of reference.
Objective: To explore the effect of Yiqi Huoxue Qingre Jiedu Decoction in patients with angina pectoris after coronary revascularization(precordial pain). Methods: Sixty-one patients with angina pectoris after coronary revascularization(precordial pain) were randomly divided into control group(30 cases) and study group(31 cases). The control group was treated with conventional Western medicine. The study group was given conventional Western medicine combined with Yiqi Huoxue Qingre Jiedu Decoction. The TCM syndrome scores before and after treatment, clinical efficacy, four coagulation factors, the levels of inflammatory factors before and after treatment, and the situation of nitroglycerin stop were compared. Results: After treatment, the scores of main symptoms, sub symptoms and total scores, fibrinogen(FIB), serum high sensitive C reactive protein(hs-CRP), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were decreased in the study group and the control group(P<0.05), which in the study group after treatment were lower than those in the control group(P<0.05). After treatment, the prothrombin time(PT), the activated partial thromboplastin time(APTT) and the thrombin time(TT) were prolonged in the study group and the control group(P<0.05), which in the study group after treatment were longer than those in the control group(P<0.05). The distributions of clinical efficacy and nitroglycerin between the two groups were statistically different(P<0.05), and the total effective rate and stopping rate in the study group were higher than those in the control group(P<0.05). Conclusion: In the patients with angina pectoris after coronary revascularization(precordial pain), Yiqi Huoxue Qingre Jiedu Decoction can reduce the symptoms, improve the coagulation function, control the inflammatory reaction and increase the rate of nitroglycerin stop, which is worthy of reference.
引文
[1] 郑聪毅,王增武,陈祚,等.新疆、西藏地区居民肥胖类型与10年冠心病发病风险关系的研究[J].中华流行病学杂志,2017,38(6):721-726.
[2] 范维琥,吴宗贵,施海明.麝香保心丸治疗冠心病心绞痛中国专家共识[S].中国中西医结合杂志,2018,38(2):145-153.
[3] 王晓燕,许香梅,朱磊,等.运动平板试验对尼可地尔治疗冠心病心绞痛的效果评价[J].山东医药,2018,58(1):12-15.
[4] 宫晶书,安海英.益气温阳活血法治疗冠脉血运重建术后再发心绞痛的临床研究[J].湖北中医药大学学报,2017,19(4):77-80.
[5] 姚怡,王庆其.论《黄帝内经》“心主血脉”理论对冠心病诊治的启发[J].中华中医药杂志,2017,32(6):2397-2401.
[6] 黄森宇,覃世阳,唐耀平.瓜蒌薤白汤类方剂治疗冠心病研究近况[J].广西中医药大学学报,2017,20(3):42-44.
[7] 赵勇,吕宜凤.现代心血管病学[M].天津:天津科学技术出版社,2011:147-152.
[8] 中华中医药学会.胸痹心痛中医诊疗指南[S].中国中医药现代远程教育,2011,9(23):106-107.
[9] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:177-183.
[10] Richards SH,Anderson L,Jenkinson CE,et al.Psychological interventions for coronary heart disease:Cochrane systematic review and meta-analysis[J].Eur J Prev Cardiol,2018,25(3):247-259.
[11] 张洪兵,李七一.冠心平片对冠心病心绞痛患者抗氧化酶及炎症因子的影响[J].中成药,2017,39(7):1545-1547.
[12] 谢晓柳,汪建萍,安冬青,等.冠心病血运重建术后中医药干预的临床研究[J].中华中医药杂志,2018,33(1):390-394.
[13] 孙秀芹,包柄楠,颜迪恩,等.糖化血红蛋白与冠心病血运重建患者心功台旨的术目关性[J].中国糖尿病杂志,2017,25(1):32-36.
[14] 许颖智,张军平,任淑女,等.冠心病心绞痛的中医药干预模式综合疗效评价[J].中华中医药杂志,2017,32(8):3809-3811.
[15] 胡元会,贾秋蕾,孟昊,等.冠心病不稳定型心绞痛患者血瘀证与外周血血小板微粒膜蛋白表达的相关性[J].中医杂志,2017,58(4):321-324.
[16] Radwan H,Hussein E.Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity[J].Egypt Heart J,2017,69(2):95-101.
[17] 张煜,陈茂华,李坚,等.丹红联合瑞舒伐他汀治疗不稳定型心绞痛的临床疗效及对患者血清炎性因子和血液流变学指标的影响[J].山西医药杂志,2017,46(13):1554-1557.
[18] 王进,王晓东,双晓萍,等.从阳微阴弦探讨补肾温阳法治疗胸痹[J].中西医结合研究,2017,9(4):219-220.
[19] 吴玉婷,周迎春.冠心病从痰论治的现代理论研究[J].中国中医基础医学杂志,2017,23(7):1029-1031.
[20] 吴同茹.瓜蒌薤白桂枝汤加减辅助针灸治疗心阳不振型冠心病心绞痛的效果观察[J].世界中医药,2017,17(a1):412-413.
[21] 张建昌,曾远.益气温阳通痹汤治疗劳力性心绞痛临床疗效观察[J].中西医结合心脑血管病杂志,2017,15(6):699-701.
[22] 王哲.王保和生脉散合二至丸“子母同治”气阴两虚胸痹心痛[J].实用中医内科杂志,2017,31(6):10-11.
[23] 马月香,侯凤霞,耿亚.益气活血方药联合西药治疗冠心病心气虚证临床研究[J].辽宁中医杂志,2017,44(6):1248-1250.
[24] 江爱东.加味瓜蒌薤白半夏汤治疗冠心病心绞痛的临床疗效[J].中医临床研究,2017,9(5):38-39.
[25] 王锐,靳昭辉,温金莉,等.高普教授治疗冠心病心绞痛的临床经验[J].中医药信息,2017,34(2):52-54.
[26] 侯王君,庄贺,薛一涛,等.应用中医传承辅助平台分析冠心病不稳定型心绞痛方剂的组方用药规律[J].中国药房,2017,28(32):4478-4482.
[27] 周欢,张军平.从“疏肝气,调营卫”角度探讨柴胡桂枝汤治疗冠心病的用义与内涵[J].中华中医药学刊,2017,35(5):1170-1173.
[28] 许剑婕,仇军,张广宏,等.瓜蒌薤白半夏汤结合血府逐瘀汤治疗冠心病心绞痛的临床分析[J].中西医结合心脑血管病杂志,2017,15(18):2277-2280.
[29] 黄路梅,石立鹏,赵凤林,等.红花黄色素注射液联合左卡尼汀治疗老年冠心病稳定型心绞痛56例[J].中国中医急症,2017,26(3):473-475.
[2] 范维琥,吴宗贵,施海明.麝香保心丸治疗冠心病心绞痛中国专家共识[S].中国中西医结合杂志,2018,38(2):145-153.
[3] 王晓燕,许香梅,朱磊,等.运动平板试验对尼可地尔治疗冠心病心绞痛的效果评价[J].山东医药,2018,58(1):12-15.
[4] 宫晶书,安海英.益气温阳活血法治疗冠脉血运重建术后再发心绞痛的临床研究[J].湖北中医药大学学报,2017,19(4):77-80.
[5] 姚怡,王庆其.论《黄帝内经》“心主血脉”理论对冠心病诊治的启发[J].中华中医药杂志,2017,32(6):2397-2401.
[6] 黄森宇,覃世阳,唐耀平.瓜蒌薤白汤类方剂治疗冠心病研究近况[J].广西中医药大学学报,2017,20(3):42-44.
[7] 赵勇,吕宜凤.现代心血管病学[M].天津:天津科学技术出版社,2011:147-152.
[8] 中华中医药学会.胸痹心痛中医诊疗指南[S].中国中医药现代远程教育,2011,9(23):106-107.
[9] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:177-183.
[10] Richards SH,Anderson L,Jenkinson CE,et al.Psychological interventions for coronary heart disease:Cochrane systematic review and meta-analysis[J].Eur J Prev Cardiol,2018,25(3):247-259.
[11] 张洪兵,李七一.冠心平片对冠心病心绞痛患者抗氧化酶及炎症因子的影响[J].中成药,2017,39(7):1545-1547.
[12] 谢晓柳,汪建萍,安冬青,等.冠心病血运重建术后中医药干预的临床研究[J].中华中医药杂志,2018,33(1):390-394.
[13] 孙秀芹,包柄楠,颜迪恩,等.糖化血红蛋白与冠心病血运重建患者心功台旨的术目关性[J].中国糖尿病杂志,2017,25(1):32-36.
[14] 许颖智,张军平,任淑女,等.冠心病心绞痛的中医药干预模式综合疗效评价[J].中华中医药杂志,2017,32(8):3809-3811.
[15] 胡元会,贾秋蕾,孟昊,等.冠心病不稳定型心绞痛患者血瘀证与外周血血小板微粒膜蛋白表达的相关性[J].中医杂志,2017,58(4):321-324.
[16] Radwan H,Hussein E.Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity[J].Egypt Heart J,2017,69(2):95-101.
[17] 张煜,陈茂华,李坚,等.丹红联合瑞舒伐他汀治疗不稳定型心绞痛的临床疗效及对患者血清炎性因子和血液流变学指标的影响[J].山西医药杂志,2017,46(13):1554-1557.
[18] 王进,王晓东,双晓萍,等.从阳微阴弦探讨补肾温阳法治疗胸痹[J].中西医结合研究,2017,9(4):219-220.
[19] 吴玉婷,周迎春.冠心病从痰论治的现代理论研究[J].中国中医基础医学杂志,2017,23(7):1029-1031.
[20] 吴同茹.瓜蒌薤白桂枝汤加减辅助针灸治疗心阳不振型冠心病心绞痛的效果观察[J].世界中医药,2017,17(a1):412-413.
[21] 张建昌,曾远.益气温阳通痹汤治疗劳力性心绞痛临床疗效观察[J].中西医结合心脑血管病杂志,2017,15(6):699-701.
[22] 王哲.王保和生脉散合二至丸“子母同治”气阴两虚胸痹心痛[J].实用中医内科杂志,2017,31(6):10-11.
[23] 马月香,侯凤霞,耿亚.益气活血方药联合西药治疗冠心病心气虚证临床研究[J].辽宁中医杂志,2017,44(6):1248-1250.
[24] 江爱东.加味瓜蒌薤白半夏汤治疗冠心病心绞痛的临床疗效[J].中医临床研究,2017,9(5):38-39.
[25] 王锐,靳昭辉,温金莉,等.高普教授治疗冠心病心绞痛的临床经验[J].中医药信息,2017,34(2):52-54.
[26] 侯王君,庄贺,薛一涛,等.应用中医传承辅助平台分析冠心病不稳定型心绞痛方剂的组方用药规律[J].中国药房,2017,28(32):4478-4482.
[27] 周欢,张军平.从“疏肝气,调营卫”角度探讨柴胡桂枝汤治疗冠心病的用义与内涵[J].中华中医药学刊,2017,35(5):1170-1173.
[28] 许剑婕,仇军,张广宏,等.瓜蒌薤白半夏汤结合血府逐瘀汤治疗冠心病心绞痛的临床分析[J].中西医结合心脑血管病杂志,2017,15(18):2277-2280.
[29] 黄路梅,石立鹏,赵凤林,等.红花黄色素注射液联合左卡尼汀治疗老年冠心病稳定型心绞痛56例[J].中国中医急症,2017,26(3):473-475.