辛伐他汀联合茵陈五苓散对冠状动脉支架置入术后血脂控制和血流动力学的影响
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摘要
目的探讨辛伐他汀联合茵陈五苓散对冠状动脉支架置入术后血脂控制和血流动力学的影响。方法选择医院2016年1月至2017年12月诊治的冠状动脉支架置入术患者110例,采用随机数字表法分为观察组和对照组,各55例。两组患者均应用辛伐他汀治疗,观察组患者加用茵陈五苓散。随访6个月,记录两组心血管不良事件及再狭窄事件。结果治疗2周后,两组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、内皮素-1(ET-1)、血管性假性血友病因子(vWF)、血流动力学指标(血浆黏稠度、血小板聚集率、低切全血黏度、高切全血黏度)水平均低于治疗前(P <0. 05),高密度脂蛋白胆固醇(HDL-C)、一氧化氮(NO)水平均高于治疗前(P <0. 05),且观察组均优于对照组(P <0. 05);随访6个月后,两组再狭窄率和心绞痛再发率比较,差异均无统计学意义(P> 0. 05)。结论辛伐他汀联合茵陈五苓散应用于冠状动脉支架置入术后患者,能更好地调节血脂,改善血管内皮功能和血流动力学,值得临床推广。
Objective To investigate the effect of simvastatin combined with Yinchen Wuling Powder on blood lipid control and hemodynamics after intracoronary stent implantation. Methods Totally 110 patients undergoing intracoronary stent implantation from January2016 to December 2017 were selected and divided into the observation group and the control group, 55 cases in each group. The patients in the two groups were treated with simvastatin,on this basis,the patients in the observation group were treated with Yinchen Wuling Powder. All the patients were followed up for 6 months, the incidence of adverse cardiovascular events and restenosis were recorded in two groups. Results After 2 weeks of treatment,the levels of total cholesterol( TC),triglyceride( TG),low-density lipoprotein cholesterol( LDL-C), endothelin-1( ET-1), von Willebrand factor( v WF), hemodynamic parameters( plasma viscosity, platelet aggregation rate,low shear whole blood viscosity and high shear whole blood viscosity) in the two groups were lower than those before treatment( P < 0. 05), while the levels of high-density lipoprotein cholesterol( HDL-C) and nitric oxide( NO) in the two groups were higher than those before treatment( P < 0. 05), and those in the observation group were better than those in the control group( P < 0. 05).After 6 months of follow-up, there were no significant differences in the incidence rate of restenosis and recurrence rate of angina pectoris between the two groups( P > 0. 05). Conclusion Simvastatin combined with Yinchen Wuling Powder in the treatment of patients undergoing intracoronary stent implantation can better regulate blood lipid,improve vascular endothelial function and hemodynamics,which is worthy of clinical promotion.
Objective To investigate the effect of simvastatin combined with Yinchen Wuling Powder on blood lipid control and hemodynamics after intracoronary stent implantation. Methods Totally 110 patients undergoing intracoronary stent implantation from January2016 to December 2017 were selected and divided into the observation group and the control group, 55 cases in each group. The patients in the two groups were treated with simvastatin,on this basis,the patients in the observation group were treated with Yinchen Wuling Powder. All the patients were followed up for 6 months, the incidence of adverse cardiovascular events and restenosis were recorded in two groups. Results After 2 weeks of treatment,the levels of total cholesterol( TC),triglyceride( TG),low-density lipoprotein cholesterol( LDL-C), endothelin-1( ET-1), von Willebrand factor( v WF), hemodynamic parameters( plasma viscosity, platelet aggregation rate,low shear whole blood viscosity and high shear whole blood viscosity) in the two groups were lower than those before treatment( P < 0. 05), while the levels of high-density lipoprotein cholesterol( HDL-C) and nitric oxide( NO) in the two groups were higher than those before treatment( P < 0. 05), and those in the observation group were better than those in the control group( P < 0. 05).After 6 months of follow-up, there were no significant differences in the incidence rate of restenosis and recurrence rate of angina pectoris between the two groups( P > 0. 05). Conclusion Simvastatin combined with Yinchen Wuling Powder in the treatment of patients undergoing intracoronary stent implantation can better regulate blood lipid,improve vascular endothelial function and hemodynamics,which is worthy of clinical promotion.
引文
[1]冯敏.冠状动脉造影及冠脉内支架植入术后并发症护理措施研究[J].实用临床医药杂志,2016,20(4):4-7.
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[9]杨珂,王振兴.冠心病支架内再狭窄中西医研究进展[J].中西医结合心脑血管病杂志,2016,14(3):273-276.
[10]刘慕.茵陈五苓散治疗非酒精性脂肪肝疗效观察[J].现代中西医结合杂志,2016,25(6):636-638.
[11]吴朦,胡镜清,江丽杰,等.冠心病中医证分类及其关联理化指标的研究[J].世界科学技术·中医药现代化,2016,18(5):776-785.
[12]黄文胜,杜礼兵,冷利华,等.冠状动脉支架术后辛伐他汀与瑞舒伐他汀钙干预的对比研究[J].海军医学杂志,2016,37(4):323-325.
[13]孙波,马瑛,席萍,等.麝香保心丸对冠心病患者血管内皮功能的影响[J].中医学报,2016,31(9):1380-1383.
[14]刘天戟,吴若然,姜南,等.茵陈蒿汤对中老年高脂血症患者血脂、血管内皮功能及血管动脉硬化程度的影响[J].中国实验诊断学,2015,19(9):1512-1514.
[15]徐硕,姜文清,邝咏梅,等.茯苓的化学成分及生物活性研究进展[J].西北药学杂志,2016,31(3):327-330.
[16]邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.
[2]何晨,袁晋青.冠状动脉支架置入术后再狭窄的治疗研究进展[J].心血管病学进展,2016,37(4):350-353.
[3]林红,时学昆,乔瑞.依折麦布联合辛伐他汀治疗对冠心病患者经皮冠状动脉介入术后血脂的影响[J].实用心脑肺血管病杂志,2016,24(11):145-146.
[4]任冬冬,贾合磊,郭燕可,等.活血通脉汤联合西药对冠状动脉支架植入术后再狭窄患者的影响[J].中医杂志,2016,57(4):311-315.
[5]山缨,范维琥. 2008年美国心脏协会(AHA)心血管影像学会关于CT和磁共振血管造影诊断冠心病的介绍[J].国际心血管病杂志,2008,35(6):341-343.
[6]任君文,朱旭,张维丽.瑞舒伐他汀对冠脉支架介入术后患者再狭窄率、血脂及IL-8水平的影响[J].广西医科大学学报,2017,34(1):48-51.
[7]王冬梅,黄爽,刘志江,等.冠状动脉支架植入术后再狭窄危险因素的分析[J].第三军医大学学报,2016,38(19):2174-2177.
[8]梁泽明.中西医联合用药预防冠心病冠状动脉支架置入术后支架内再狭窄疗效观察[J].现代中西医结合杂志,2018,27(8):829-832.
[9]杨珂,王振兴.冠心病支架内再狭窄中西医研究进展[J].中西医结合心脑血管病杂志,2016,14(3):273-276.
[10]刘慕.茵陈五苓散治疗非酒精性脂肪肝疗效观察[J].现代中西医结合杂志,2016,25(6):636-638.
[11]吴朦,胡镜清,江丽杰,等.冠心病中医证分类及其关联理化指标的研究[J].世界科学技术·中医药现代化,2016,18(5):776-785.
[12]黄文胜,杜礼兵,冷利华,等.冠状动脉支架术后辛伐他汀与瑞舒伐他汀钙干预的对比研究[J].海军医学杂志,2016,37(4):323-325.
[13]孙波,马瑛,席萍,等.麝香保心丸对冠心病患者血管内皮功能的影响[J].中医学报,2016,31(9):1380-1383.
[14]刘天戟,吴若然,姜南,等.茵陈蒿汤对中老年高脂血症患者血脂、血管内皮功能及血管动脉硬化程度的影响[J].中国实验诊断学,2015,19(9):1512-1514.
[15]徐硕,姜文清,邝咏梅,等.茯苓的化学成分及生物活性研究进展[J].西北药学杂志,2016,31(3):327-330.
[16]邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.