加味补阳还五汤对血管痉挛性心绞痛患者Lp-PLA2、hs-CRP及GDF-15表达的影响
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摘要
目的:观察加味补阳还五汤治疗血管痉挛性心绞痛的临床疗效以及对患者脂蛋白磷脂酶(Lp-PLA2)、超敏C-反应蛋白(hs-CRP)及生长分化因子(GDF-15)表达的影响。方法:将62例血管痉挛性心绞痛患者随机分为2组,对照组30例接受阿司匹林抗血小板聚集、阿托伐他汀钙片调脂抗炎、硝酸酯类扩张冠状动脉、钙离子通道阻滞剂减轻冠状动脉痉挛等西医常规治疗;治疗组32例在对照组的基础上加用加味补阳还五汤治疗;2组均以4周为1疗程,分别观察2组治疗前后中医证候积分、Lp-PLA2、hs-CRP及GDF-15表达水平的差异,比较2组临床疗效。结果:临床疗效显效率治疗组为46.88%,对照组为23.33%,2组比较,差异有统计学意义(P<0.01);总有效率治疗组为93.75%,对照组为90.00%,2组比较,差异无统计学意义(P>0.05)。治疗后2组中医症状积分均较治疗前明显下降(P<0.01);且治疗组证候积分下降较对照组更显著(P<0.05)。治疗后2组患者Lp-PLA2、hs-CRP、GDF-15值均较治疗前明显下降(P<0.05);且治疗组上述指标改善较对照组更显著(P<0.05)。治疗过程中2组均未见明显不良反应。结论:在西医常规治疗的基础上,联合加味补阳还五汤可明显改善血管痉挛性心绞痛患者的临床症状,提高临床疗效,其作用机制可能与减轻机体血管炎症反应、改善冠状动脉痉挛相关。
Objective:To observe the clinical effect of modified Buyang Huanwu tang in treating patients with vasospastic angina and its effect on the expression of lipoprotein-associated phospholipase A2(Lp-PLA2), hypersensitive C-reactive protein(hs-CRP) and growth differentiation factor-15(GDF-15). Methods:Divided 62 cases of patients with vasospastic angina into two groups randomly. The30 cases in the control group received the routine western medicine treatment including antiplatelet aggregation with aspirin,lipid-regulation and anti-inflammation with atorvastatin calcium tablets,dilation of coronary arteries with nitrate esters and alleviation in coronary artery spasm with calcium channel blockers, while the 32 cases in the treatment group were additionally given modified Buyang Huanwu tang for treatment. One course of treatment for both groups lasted for 4 weeks. Respectively observed the differences of Chinese syndrome scores and the expression of Lp-PLA2,hs-CRP and GDF-15 in both groups before and after treatment,and compared the clinical effect in both groups. Results: The obvious effective rate of the clinical effect was 46.88% in the treatment group and23.33% in the control group, difference being significant(P < 0.01); the total effective rate was 93.75% in the treatment group and90.00% in the control group, difference being insignificant(P > 0.05). After treatment, Chinese syndrome scores in both groups were significantly lower than those before treatment(P < 0.01); and Chinese syndrome scores in the treatment group were decreased more evidently than those in the control group(P < 0.05). After treatment, the expression of Lp-PLA2, hs-CRP and GDF-15 of patients in both groups was significantly lower than that before treatment(P < 0.05);and each index above in the treatment group was reduced more obviously than that in the control group(P < 0.05). No adverse reactions occurred in both groups during treatment. Conclusion:On the basic of routine western medicine treatment, the combination of modified Buyang Huanwu tang can significantly improve the clinical symptoms of patients with vasospastic angina,promote the clinical effect,and its functional mechanism may be related to reducing the vascular inflammatory response,improving coronary artery spasm.
Objective:To observe the clinical effect of modified Buyang Huanwu tang in treating patients with vasospastic angina and its effect on the expression of lipoprotein-associated phospholipase A2(Lp-PLA2), hypersensitive C-reactive protein(hs-CRP) and growth differentiation factor-15(GDF-15). Methods:Divided 62 cases of patients with vasospastic angina into two groups randomly. The30 cases in the control group received the routine western medicine treatment including antiplatelet aggregation with aspirin,lipid-regulation and anti-inflammation with atorvastatin calcium tablets,dilation of coronary arteries with nitrate esters and alleviation in coronary artery spasm with calcium channel blockers, while the 32 cases in the treatment group were additionally given modified Buyang Huanwu tang for treatment. One course of treatment for both groups lasted for 4 weeks. Respectively observed the differences of Chinese syndrome scores and the expression of Lp-PLA2,hs-CRP and GDF-15 in both groups before and after treatment,and compared the clinical effect in both groups. Results: The obvious effective rate of the clinical effect was 46.88% in the treatment group and23.33% in the control group, difference being significant(P < 0.01); the total effective rate was 93.75% in the treatment group and90.00% in the control group, difference being insignificant(P > 0.05). After treatment, Chinese syndrome scores in both groups were significantly lower than those before treatment(P < 0.01); and Chinese syndrome scores in the treatment group were decreased more evidently than those in the control group(P < 0.05). After treatment, the expression of Lp-PLA2, hs-CRP and GDF-15 of patients in both groups was significantly lower than that before treatment(P < 0.05);and each index above in the treatment group was reduced more obviously than that in the control group(P < 0.05). No adverse reactions occurred in both groups during treatment. Conclusion:On the basic of routine western medicine treatment, the combination of modified Buyang Huanwu tang can significantly improve the clinical symptoms of patients with vasospastic angina,promote the clinical effect,and its functional mechanism may be related to reducing the vascular inflammatory response,improving coronary artery spasm.
引文
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[2]周生辉,缪黄泰,聂绍平.血管痉挛性心绞痛诊断与治疗研究进展[J].临床心血管病杂志,2017,33(4):304-308.
[3]向定成,曾定尹,霍勇.冠状动脉痉挛综合征诊断与治疗中国专家共识[J].中国介入心脏病学杂志,2015,23(4):181-186.
[4]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:68-73.
[5]吴东南,范世平,王世承,等.加味补阳还五汤对心肌梗死后慢性心力衰竭患者Lp-PLA2、hs-CRP及NT-pro BNP的影响[J].现代中医临床,2017,24(3):16-19.
[6]范世平,吴东南,何凤屏,等.加味补阳还五汤对心肌梗死后患者心室重构及mi RNA-21、GDF-15表达的影响[J].辽宁中医杂志,2016,43(4):754-757.
[7]白会强,孙学刚,范钦,等.补阳还五汤对稳定性心绞痛患者hs-CRP、IL-6和IL-18的影响及其相关性研究[J].中药药理与临床,2009,25(2):110-113.