养心通脉汤治疗冠脉支架植入术后再狭窄疗效及对患者血清肿瘤坏死因子-α和C反应蛋白的影响
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摘要
目的:探究养心冠脉汤对冠脉支架植入术患者再狭窄的治疗效果,分析其对患者血清TNF-α(肿瘤坏死因子-α)和CRP(C反应蛋白)的影响。方法:选取行冠脉支架介入术治疗的患者60例,采用随机数字表法分成治疗组30例和对照组30例。对照组采用阿司匹林肠溶片、氯吡格雷片、阿托伐他汀钙片等药物治疗,治疗组在对照组的治疗基础上加用养心通脉汤口服治疗,所有患者均治疗6个月。统计两组患者再发生冠脉狭窄的比例、中医证候疗效、心电图疗效,及治疗前后血清TNF-α水平、CRP水平、血脂水平。结果:治疗组患者冠脉再狭窄比例较对照组显著降低,差异具有统计学意义(P<0.05)。治疗组患者LDL-C(低密度脂蛋白胆固醇)、TG(甘油三酯)、TC(总胆固醇)水平显著低于低于对照组(P<0.05),HDL-C(高密度脂蛋白胆固醇)较对照组显著提高,差异具有统计学意义(P<0.05)。治疗组中医证候疗效总有效率显著高于对照组,差异具有统计学意义(P<0.05)。治疗组心电图疗效总有效率显著高于对照组,差异具有统计学意义(P<0.05)。治疗组患者TNF-α和CRP水平较对照组显著降低,差异具有统计学意义(P<0.05)。结论:养心通脉汤能有效降低冠脉支架植入术后再狭窄的发生率,改善血脂水平、心电图和中医证候,并降低血清内CRP水平和TNF-α水平。
Objective:To explore the therapeutic effect of Yangxin Guanmai decoction on restenosis in patients undergoing coronary stenting, and to analyze its effect on serum TNF-α(tumor necrosis factor-α) and CRP(C-reactive protein).Methods:Sixty patients who underwent coronary stenting were enrolled. The patients were divided into treatment group(30 cases) and control group(30 cases) by random number table. The control group was treated with aspirin enteric-coated tablets, clopidogrel tablets, and atorvastatin calcium tablets. The treatment group was treated with Yangxin Tongmai decoction on the basis of the treatment of the control group. All patients were treated for 6 months. The proportion of recurrent coronary stenosis, TCM syndrome efficacy, electrocardiogram efficacy, serum TNF-α level, CRP level and blood lipid level before and after treatment were counted.Results:The proportion of coronary restenosis in the treatment group was significantly lower than that in the control group and the difference was statistically significant(P<0.05).The levels of LDL-C(low-density lipoprotein cholesterol), TG(triglyceride), and TC(total cholesterol) in the treatment group were significantly lower than those in the control group(P<0.05), HDL-C(high-density lipoprotein cholesterol). The difference was significantly higher than the control group was statistically significant(P<0.05).The total effective rate of TCM syndromes in the treatment group was significantly higher than that in the control group and the difference was statistically significant(P<0.05). The total effective rate of electrocardiogram in the treatment group was significantly higher than that in the control group and the difference was statistically significant(P<0.05).The levels of TNF-α and CRP in the treatment group were significantly lower than those in the control group and the difference was statistically significant(P<0.05).Conclusion:Yangxin Tongmai decoction can effectively reduce the incidence of restenosis after coronary stent implantation, improve blood lipid levels, electrocardiogram and TCM syndrome, and reduce serum CRP levels and TNF-α levels.
Objective:To explore the therapeutic effect of Yangxin Guanmai decoction on restenosis in patients undergoing coronary stenting, and to analyze its effect on serum TNF-α(tumor necrosis factor-α) and CRP(C-reactive protein).Methods:Sixty patients who underwent coronary stenting were enrolled. The patients were divided into treatment group(30 cases) and control group(30 cases) by random number table. The control group was treated with aspirin enteric-coated tablets, clopidogrel tablets, and atorvastatin calcium tablets. The treatment group was treated with Yangxin Tongmai decoction on the basis of the treatment of the control group. All patients were treated for 6 months. The proportion of recurrent coronary stenosis, TCM syndrome efficacy, electrocardiogram efficacy, serum TNF-α level, CRP level and blood lipid level before and after treatment were counted.Results:The proportion of coronary restenosis in the treatment group was significantly lower than that in the control group and the difference was statistically significant(P<0.05).The levels of LDL-C(low-density lipoprotein cholesterol), TG(triglyceride), and TC(total cholesterol) in the treatment group were significantly lower than those in the control group(P<0.05), HDL-C(high-density lipoprotein cholesterol). The difference was significantly higher than the control group was statistically significant(P<0.05).The total effective rate of TCM syndromes in the treatment group was significantly higher than that in the control group and the difference was statistically significant(P<0.05). The total effective rate of electrocardiogram in the treatment group was significantly higher than that in the control group and the difference was statistically significant(P<0.05).The levels of TNF-α and CRP in the treatment group were significantly lower than those in the control group and the difference was statistically significant(P<0.05).Conclusion:Yangxin Tongmai decoction can effectively reduce the incidence of restenosis after coronary stent implantation, improve blood lipid levels, electrocardiogram and TCM syndrome, and reduce serum CRP levels and TNF-α levels.
引文
[1] 李梅,王亚琦.血糖水平与冠状动脉支架植入术后再狭窄发生率的分析[J].心脑血管病防治,2018,18(6):483-485.
[2] 李家海,曾凡鹏,吴杨武.老年冠心病患者PCI术后支架内再狭窄的危险因素分析[J].微创医学,2018,13(5):615-617.
[3] 盛文娟,侯炽均,叶小汉,等.心脉康片对冠状动脉介入术后患者hs-CRP、IL-6、TNF-α水平的影响[J].中西医结合研究,2017,9(3):120-122.
[4] 陈强,陈丽珠,张娟,等.冠心病患者PCI术后24 h血清hs-CRP、SAA水平对支架内再狭窄的预测价值[J].山东医药,2018,58(4):48-50.
[5] 李云虎.养心通脉汤治疗冠心病不稳定型心绞痛效果与安全性[J].黑龙江中医药,2018,47(1):40-41.
[6] 沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-219.
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[9] 程龙.《中药、天然药物治疗冠心病心绞痛临床研究指导原则》解读[J].中国执业药师,2012,9(3):3-6.
[10] 黄莹,郭媛利.冠状动脉支架植入术后再狭窄与血浆脑钠肽、超敏C反应蛋白水平的关系[J].中国现代药物应用,2016,10(16):50-51.
[11] 陈敏.养心通脉汤辨证治疗冠心病心绞痛50例[J].中国中医药现代远程教育,2016,14(10):92-93.
[12] 张婉,张治祥.养心通脉汤治疗冠心病稳定型心绞痛60例[J].现代中医药,2015,35(5):17-19.
[13] 沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-219.
[14] 周景妍.养心通脉汤联合复方丹参滴丸治疗胸痹随机平行对照研究[J].实用中医内科杂志,2015,29(2):59-61.
[15] 孙腾飞.养心通脉汤治疗慢性心力衰竭的临床研究[D].山东中医药大学,2014.
[16] 陈玺全,邓小军,段青松,等.血清MCP-1、OPG与急性心肌梗死患者PCI后再狭窄的关系[J].海南医学,2017,28(24):3983-3985.
[2] 李家海,曾凡鹏,吴杨武.老年冠心病患者PCI术后支架内再狭窄的危险因素分析[J].微创医学,2018,13(5):615-617.
[3] 盛文娟,侯炽均,叶小汉,等.心脉康片对冠状动脉介入术后患者hs-CRP、IL-6、TNF-α水平的影响[J].中西医结合研究,2017,9(3):120-122.
[4] 陈强,陈丽珠,张娟,等.冠心病患者PCI术后24 h血清hs-CRP、SAA水平对支架内再狭窄的预测价值[J].山东医药,2018,58(4):48-50.
[5] 李云虎.养心通脉汤治疗冠心病不稳定型心绞痛效果与安全性[J].黑龙江中医药,2018,47(1):40-41.
[6] 沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-219.
[7] 王建国.冠心病中医证型与冠状动脉造影相关性研究现状与展望[A].中国中西医结合学会诊断专业委员会.中国中西医结合学会第八届全国诊断学术会议学术论文集[C].中国中西医结合学会诊断专业委员会:中国中西医结合学会,2014:5.
[8] 韩雅玲.中国经皮冠状动脉介入治疗指南2012(简本)[J].中华危重症医学杂志:电子版,2012,5(3):169-180.
[9] 程龙.《中药、天然药物治疗冠心病心绞痛临床研究指导原则》解读[J].中国执业药师,2012,9(3):3-6.
[10] 黄莹,郭媛利.冠状动脉支架植入术后再狭窄与血浆脑钠肽、超敏C反应蛋白水平的关系[J].中国现代药物应用,2016,10(16):50-51.
[11] 陈敏.养心通脉汤辨证治疗冠心病心绞痛50例[J].中国中医药现代远程教育,2016,14(10):92-93.
[12] 张婉,张治祥.养心通脉汤治疗冠心病稳定型心绞痛60例[J].现代中医药,2015,35(5):17-19.
[13] 沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-219.
[14] 周景妍.养心通脉汤联合复方丹参滴丸治疗胸痹随机平行对照研究[J].实用中医内科杂志,2015,29(2):59-61.
[15] 孙腾飞.养心通脉汤治疗慢性心力衰竭的临床研究[D].山东中医药大学,2014.
[16] 陈玺全,邓小军,段青松,等.血清MCP-1、OPG与急性心肌梗死患者PCI后再狭窄的关系[J].海南医学,2017,28(24):3983-3985.