中医疏肝理气法治疗冠心病效果及对血管内皮功能、血液流变学指标的影响
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摘要
目的:探讨采用中医疏肝理气法治疗冠心病患者的临床疗效及对血管内皮功能、血液流变学指标的影响。方法:140例冠心病患者,采用随机数字表法分为试验组(西医基础治疗+疏肝理气活血类中药治疗)和对照组(西医基础治疗)各70例,对比两组患者治疗前后的中医证候积分、血清内皮素-1(ET-1)、血栓素(TXB2)、一氧化氮(NO)、全血黏度低切、全血黏度中切、全血黏度高切及临床疗效。结果:治疗前,两组患者的各项中医证候积分差异不具有统计学意义(P>0.05);治疗后,试验组患者的胸痛、胸闷、心悸、腹肋胀满善太息、失眠多梦、气短评分均低于对照组(P<0.05);治疗前,两组患者的血清ET-1、TXB2、NO差异不具有统计学意义(P>0.05);治疗后,试验组患者的ET-1低于对照组(P<0.05),血清NO水平高于对照组(P<0.05);治疗前,两组患者的全血黏度低切、全血黏度中切、全血黏度高切差异不具有统计学意义(P>0.05);治疗后,试验组患者的全血黏度低切、全血黏度中切、全血黏度高切低于对照组(P<0.05);治疗后,试验组的临床治疗效果优于对照组(P<0.05)。结论:中医疏肝理气法治疗冠心病患者能显著的改善患者的临床症候、血管内皮功能、血液流变学指标,提高临床效果。
Objective:To explore the clinical effect of traditional Chinese medicine treatment of coronary heart disease. Methods:140 cases of coronary heart disease patients were selected and randomly divided into experimental group(Western medicine therapy + soothing liver and regulating Qi and activating blood therapy) and control group(Western medicine),70 cases in each. Two groups' TCM syndrome integral, serum endothelin-1(ET-1), thromboxane(TXB2), nitric oxide(NO), whole blood viscosity, low shear whole blood viscosity, whole blood viscosity at high shear rate cut and clinical curative effect were compared before and after treatment. Results:Before treatment, TCM symptom scores between the two groups was not statistically significant(P>0.05). After treatment, the experiment group's chest pain, chest tightness, heart palpitations, abdominal distension full rib sigh, insomnia and shortness of breath scores were lower than those of the control group(P<0.05). Before treatment, two groups' s serum ET-1, TXB2 NO were not statistically significant(P>0.05). After treatment, experimental group's ET-1 was ower than that of the control group(P<0.05). The serum level of NO was higher than that of control group(P<0.05). The two groups' whole blood viscosity, low shear whole blood viscosity and whole blood viscosity at high shear rate cut were not statistically significant before treatment(P>0.05). After treatment, the experiment group's low shear whole blood viscosity, whole blood viscosity and whole blood viscosity at high shear rate cut were lower than those of the control group(P<0.05). After treatment, the clinical treatment effect in the experimental group was better than that in the control group(P<0.05). Conclusion:Chinese medicine soothing liver and regulating Qi method can significantly improve the clinical symptoms, vascular endothelial function and hemorheology indexes of patients with coronary heart disease, and improve the clinical effect.
Objective:To explore the clinical effect of traditional Chinese medicine treatment of coronary heart disease. Methods:140 cases of coronary heart disease patients were selected and randomly divided into experimental group(Western medicine therapy + soothing liver and regulating Qi and activating blood therapy) and control group(Western medicine),70 cases in each. Two groups' TCM syndrome integral, serum endothelin-1(ET-1), thromboxane(TXB2), nitric oxide(NO), whole blood viscosity, low shear whole blood viscosity, whole blood viscosity at high shear rate cut and clinical curative effect were compared before and after treatment. Results:Before treatment, TCM symptom scores between the two groups was not statistically significant(P>0.05). After treatment, the experiment group's chest pain, chest tightness, heart palpitations, abdominal distension full rib sigh, insomnia and shortness of breath scores were lower than those of the control group(P<0.05). Before treatment, two groups' s serum ET-1, TXB2 NO were not statistically significant(P>0.05). After treatment, experimental group's ET-1 was ower than that of the control group(P<0.05). The serum level of NO was higher than that of control group(P<0.05). The two groups' whole blood viscosity, low shear whole blood viscosity and whole blood viscosity at high shear rate cut were not statistically significant before treatment(P>0.05). After treatment, the experiment group's low shear whole blood viscosity, whole blood viscosity and whole blood viscosity at high shear rate cut were lower than those of the control group(P<0.05). After treatment, the clinical treatment effect in the experimental group was better than that in the control group(P<0.05). Conclusion:Chinese medicine soothing liver and regulating Qi method can significantly improve the clinical symptoms, vascular endothelial function and hemorheology indexes of patients with coronary heart disease, and improve the clinical effect.
引文
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[11] 晋玉梅,杨宇平,方芳,等.益气养阴活血祛湿法干预稳定型冠心病心力衰竭及对心室重构的影响[J].中国中医急症,2016,25(2):320-323.
[12] 党红絮,康兴茂,董博,等.活血益气降糖汤治疗糖尿病合并冠心病的临床疗效[J].陕西中医,2016,37(9):1151-1152.
[13] 高嘉良,李军,王阶,等.“扶阳活血法”在冠心病不稳定性心绞痛治疗中的运用[J].中国中药杂志,2016,41(3):550-552.
[14] 胡川海,胡志希,马丽,等.中医补气活血法在冠心病心肌缺血治疗中的应用效果[J].实用心脑肺血管病杂志,2016,24(2):82-83,90.
[15] 熊恬,杨建全.通络补心化瘀汤联合八段锦和运动康复训练对冠心病合并急性心力衰竭病人心率恢复和运动功能的影响[J].中西医结合心脑血管病杂志,2017,15(11):1296-1300.
[16] 孙增建,宫丽鸿.祛痰化瘀中药联合体外反搏治疗冠心病不稳定型心绞痛的临床研究[J].中国中医急症,2016,25(11):2112-2114.
[17] 王玉晓.豁痰化瘀方联合西药对冠心病非经皮冠状动脉介入治疗患者血浆同型半胱氨酸水平的影响[J].中医杂志,2016,57(10):852-855.
[18] 吴建龙,张艳利,乔建勇,等.高血压脑出血血肿周围脑组织中TNF-α、VEGF以及ET-1的表达及其意义[J].中华神经外科杂志,2017,33(5):498-501.
[19] 王志军,贾岛,周建芝,等.冠心病合并糖尿病患者血浆11-dh-TXB2水平变化及意义[J].山东医药,2016,56(36):43-45.
[20] 张志荣.胺碘酮联合参松养心胶囊对老年冠心病合并心律失常患者的疗效及对血流动力学的影响[J].国际医药卫生导报,2017,23(4):553-555.
[2] Stinson LJ,Stroud LR,Buka SL,et al.Prospective Evaluation of Associations Between Prenatal Cortisol and Adulthood Coronary Heart Disease Risk: The New England Family Study[J].Psychosomatic Medicine: Journal of the American Psychosomatic Society,2015,77(3):237-245.
[3] 周玉凤.宽胸理气疏肝法辨证治疗冠心病心绞痛患者的临床观察[J].光明中医,2017,32(24):3574-3576.
[4] 张永珍,高炜.稳定性冠心病诊治策略的选择:欧美指南给我们的提示[J].北京大学学报(医学版),2014,46(6):832-835.
[5] 陆再英,钟南山,谢毅,等.内科学[M].8版.北京:人民卫生出版社,2011:274.
[6] 周仲瑛.中医内科学[M].北京:中国中医药出版社,2003:144.
[7] 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,2002:69.
[8] Fiska BS,Ariansen I,Graff-Iversen S,et al.Family history of premature myocardial infarction, life course socioeconomic position and coronary heart disease mortality-A Cohort of Norway (CONOR) study[J].International Journal of Cardiology,2015,112(190):302-307.
[9] 帕则来提·莫合买提,伊力哈木江·克尤木,帕力旦·莫合买提,等.乌鲁木齐市新市区杭州路社区老年2型糖尿病合并冠心病现状及相关危险因素[J].中国老年学杂志,2017,37(21):5422-5424.
[10] 廖火城,钟思干,刘凌,等.冠心病预测评分系统的建立及评价[J].山东医药,2016,56(31):58-60.
[11] 晋玉梅,杨宇平,方芳,等.益气养阴活血祛湿法干预稳定型冠心病心力衰竭及对心室重构的影响[J].中国中医急症,2016,25(2):320-323.
[12] 党红絮,康兴茂,董博,等.活血益气降糖汤治疗糖尿病合并冠心病的临床疗效[J].陕西中医,2016,37(9):1151-1152.
[13] 高嘉良,李军,王阶,等.“扶阳活血法”在冠心病不稳定性心绞痛治疗中的运用[J].中国中药杂志,2016,41(3):550-552.
[14] 胡川海,胡志希,马丽,等.中医补气活血法在冠心病心肌缺血治疗中的应用效果[J].实用心脑肺血管病杂志,2016,24(2):82-83,90.
[15] 熊恬,杨建全.通络补心化瘀汤联合八段锦和运动康复训练对冠心病合并急性心力衰竭病人心率恢复和运动功能的影响[J].中西医结合心脑血管病杂志,2017,15(11):1296-1300.
[16] 孙增建,宫丽鸿.祛痰化瘀中药联合体外反搏治疗冠心病不稳定型心绞痛的临床研究[J].中国中医急症,2016,25(11):2112-2114.
[17] 王玉晓.豁痰化瘀方联合西药对冠心病非经皮冠状动脉介入治疗患者血浆同型半胱氨酸水平的影响[J].中医杂志,2016,57(10):852-855.
[18] 吴建龙,张艳利,乔建勇,等.高血压脑出血血肿周围脑组织中TNF-α、VEGF以及ET-1的表达及其意义[J].中华神经外科杂志,2017,33(5):498-501.
[19] 王志军,贾岛,周建芝,等.冠心病合并糖尿病患者血浆11-dh-TXB2水平变化及意义[J].山东医药,2016,56(36):43-45.
[20] 张志荣.胺碘酮联合参松养心胶囊对老年冠心病合并心律失常患者的疗效及对血流动力学的影响[J].国际医药卫生导报,2017,23(4):553-555.