丹蒌片治疗冠心病痰瘀互结证的疗效及对血清炎性因子的影响
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摘要
目的观察丹蒌片治疗冠心病(痰瘀互结证)的疗效及对病人血清炎性因子的影响。方法选取我院2016年1月—2018年1月就诊的冠心病(痰瘀互结证)病人197例,依据治疗方式不同分组。对照组98例采取阿司匹林+阿托伐他汀治疗,研究组99例在对照组基础上采用丹蒌片治疗,比较两组治疗前、治疗1个月后血清分泌型磷脂酶A_2(sPLA_2)、脂蛋白相关磷脂酶A_2(LP-PLA_2)、氧化型低密度脂蛋白(ox-LDL)、单核细胞趋化蛋白-1(MCP-1)水平及世界卫生组织生活质量(WHOQOL-100)评分及两组临床疗效、不良反应发生率。结果治疗1个月后,研究组总有效率93.94%,较对照组79.59%高(P <0.05);血清sPLA_2、LP-PLA_2、ox-LDL、MCP-1水平较对照组降低(P <0.05)。研究组与对照组不良反应总发生率比较,差异无统计学意义(P>0.05)。两组治疗1个月后WHOQOL-100评分均较治疗前升高,且研究组较对照组高(P <0.05)。结论采用丹蒌片治疗冠心病(痰瘀互结证)疗效确切,能显著降低其血清炎性因子水平,提高病人生活质量,且具有安全性。
Objective To observe the curative effect of Danlou tablet(DLT)in the treatment of coronary heart disease(CHD)with phlegm and blood stasis syndrome and on serum inflammatory factors.Methods One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups:control group(n =98)treated with aspirin plus atorvastatin,and study group(n =99)treated with DLT and aspirin plus atorvastatin for 1 month.The curative effect and incidence of adverse reactions were observed.Serum secretory phospholipase A_2(sPLA_2),lipoprotein-associated phospholipase A_2(LP-PLA_2),oxidized low-density lipoprotein(ox-LDL),monocyte chemoattractant protein-1(MCP-1)and World Health Organization Quality of Life(WHOQOL-100)scores were compared before and after 1 month of treatment.Results The total effective rate was 93.94% in the study group,which was higher than that in the control group(79.59%,P <0.05).The levels of serum sPLA_2,LP-PLA_2,ox-LDL and MCP-1 in the study group were lower than those in the control group after 1 month of treatment(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P >0.05).After 1 month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the study group than that in the control group(P <0.05).Conclusion DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.
Objective To observe the curative effect of Danlou tablet(DLT)in the treatment of coronary heart disease(CHD)with phlegm and blood stasis syndrome and on serum inflammatory factors.Methods One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups:control group(n =98)treated with aspirin plus atorvastatin,and study group(n =99)treated with DLT and aspirin plus atorvastatin for 1 month.The curative effect and incidence of adverse reactions were observed.Serum secretory phospholipase A_2(sPLA_2),lipoprotein-associated phospholipase A_2(LP-PLA_2),oxidized low-density lipoprotein(ox-LDL),monocyte chemoattractant protein-1(MCP-1)and World Health Organization Quality of Life(WHOQOL-100)scores were compared before and after 1 month of treatment.Results The total effective rate was 93.94% in the study group,which was higher than that in the control group(79.59%,P <0.05).The levels of serum sPLA_2,LP-PLA_2,ox-LDL and MCP-1 in the study group were lower than those in the control group after 1 month of treatment(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P >0.05).After 1 month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the study group than that in the control group(P <0.05).Conclusion DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.
引文
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[12]张玥,王居新,李婷.倍他乐克联合稳心颗粒治疗肥厚型心肌病伴恶性室性心律失常疗效观察[J].现代中西医结合杂志,2017,26(16):1766-1768.
[13]任得志,张军茹,申仙利.丹蒌片治疗痰瘀互结型冠心病不稳定型心绞痛的临床观察[J].中西医结合心脑血管病杂志,2014,12(8):1022-1023.
[14]刘建勋,林成仁,任建勋,等.痰瘀同治方对痰瘀互结证冠心病小型猪心肌组织的保护作用[J].中国中药杂志,2014,39(4):726-731.
[15]李鑫池,白瑞娜,臧明洁,等.丹蒌片治疗痰瘀互结型冠心病的Meta分析[J].中西医结合心脑血管病杂志,2015,13(18):2033-2037.
[16]刘津,应国光,田刚,等.联合检测冠心病患者ⅡA分泌型磷脂酶A2和脂蛋白相关磷脂酶A2的临床意义[J].现代检验医学杂志,2014,29(2):55-57.
[2]Sarwar N,Butterworth AS,Freitag DF,et al.Interleukin-6 receptor pathways in coronary heart disease:a collaborative meta-analysis of 82studies[J].Lancet,2012,379(9822):1205-1213.
[3]李春兰,陈哲林,陈冠成.丹参多酚酸盐对冠心病心绞痛经皮冠脉介入治疗围手术期心肌损伤的影响[J].中国中医急症,2015,24(7):1235-1237.
[4]White HD,Held C,Stewart R,et al.Darapladib for preventing ischemic events in stable coronary heart disease[J].N Engl J Med,2014,370(18):1702-1711.
[5]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:177-256.
[6]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:30.
[7]史瑞娜,杨富强,李镝,等.阿司匹林联合氯吡格雷治疗不稳定型心绞痛200例临床疗效分析[J].现代生物医学进展,2015,15(4):700-702.
[8]冯治宽,王恒亮,杨宁.稳心颗粒联合胺碘酮治疗冠心病室性心律失常疗效观察[J].陕西中医,2017,38(7):857-858.
[9]Pereira M,Azevedo A,Lunet N,et al.Explaining the decline in coronary heart disease mortality in Portugal between 1995 and2008[J].Circ Cardiovasc Qual Outcomes,2013,6(6):634-642.
[10]陈秋芳,朱晓峰,韩莉,等.丹参川芎嗪注射液治疗不稳定型心绞痛的Meta分析[J].中成药,2016,38(2):272-277.
[11]景强强,白峥嵘,贺继忠.麝香保心丸联合稳心颗粒治疗不稳定型心绞痛的临床研究[J].现代药物与临床,2017,32(1):34-37.
[12]张玥,王居新,李婷.倍他乐克联合稳心颗粒治疗肥厚型心肌病伴恶性室性心律失常疗效观察[J].现代中西医结合杂志,2017,26(16):1766-1768.
[13]任得志,张军茹,申仙利.丹蒌片治疗痰瘀互结型冠心病不稳定型心绞痛的临床观察[J].中西医结合心脑血管病杂志,2014,12(8):1022-1023.
[14]刘建勋,林成仁,任建勋,等.痰瘀同治方对痰瘀互结证冠心病小型猪心肌组织的保护作用[J].中国中药杂志,2014,39(4):726-731.
[15]李鑫池,白瑞娜,臧明洁,等.丹蒌片治疗痰瘀互结型冠心病的Meta分析[J].中西医结合心脑血管病杂志,2015,13(18):2033-2037.
[16]刘津,应国光,田刚,等.联合检测冠心病患者ⅡA分泌型磷脂酶A2和脂蛋白相关磷脂酶A2的临床意义[J].现代检验医学杂志,2014,29(2):55-57.