心安宁防治冠心病的临床研究
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摘要
本文根据西医方法确诊冠心病，对具有心绞痛的患者进行中医辩证，并在西药治疗基础上，加用中药心安宁，同时与单用西药者进行疗效比较。
目的：以西医药治疗为本，在加上中药的配合，来探讨中西药并用，以中西结合治疗，对冠心病的治疗。通过临床的研究，明确心安宁合剂对已经有受西药治疗的病人有更好的治疗。
方法：以轻和中度的冠心病患者为对象，随机分为治疗组(西药常规治疗加心安宁)和对照组(西药常规治疗)。观察两组治疗的前后症状，体征和试验室检查变化。
结果：临床结果显示，治疗组临床疗效优于对照组。其心绞痛发生率有低于对照组。治疗组在改善其冠心病的其他指标，如胆固醇和半胱氨酸(homocysteine)，都有显著的效果。
结论：心安宁合剂能改善已接受常规西药治疗的冠心病患者的心绞痛发生率和能改善其他影响冠心病的因素。所以，心安宁中药合剂在正在接受西药治疗的冠心病病人，有显著的效果。
In coronary artery disease (CAD), the definition has been clear that this is a
narrowing of the coronary arteries, giving rise to symptom like chest pain and
breathlessness.
On the modern definition of CAD, we attempt to classify people with angina
pectoris into TCM clinical syndromes and treat the syndrome with the Chinese
herbal formulation, Xin An Ning, in addition to their regular CAD treatment
Aim: The aim of this paper is to look into the effect of combination of Chinese medicine with western medicine , in patient already on conventional western treatment for CAD, and see if this addition of herbal preparation will improve the outcome of the patient, both in symptoms and long term outcome.
Methodology: 40 patient with CAD were randomized to 2 group of 20, one group will continue to receive conventional therapy for CAD. The other group of 20 will receive the Chinese herbal preparation , Xin An Ning.
Results: The patients that receive Xin AN Ning in addition to their regular western medicine show a improvement in the frequency of chest pain and also a greater reduction in cholesterol and homocysteine level, which are some of the factors that predict the outcome of coronary artery disease.
Conclusion: The outcome of this study indicate that the Chinese herbal preparation, xin an ning is important in the treatment of CAD. It can be augment the action of the conventional treatment on CAD and it improve the outcome of the disease.
目的：以西医药治疗为本，在加上中药的配合，来探讨中西药并用，以中西结合治疗，对冠心病的治疗。通过临床的研究，明确心安宁合剂对已经有受西药治疗的病人有更好的治疗。
方法：以轻和中度的冠心病患者为对象，随机分为治疗组(西药常规治疗加心安宁)和对照组(西药常规治疗)。观察两组治疗的前后症状，体征和试验室检查变化。
结果：临床结果显示，治疗组临床疗效优于对照组。其心绞痛发生率有低于对照组。治疗组在改善其冠心病的其他指标，如胆固醇和半胱氨酸(homocysteine)，都有显著的效果。
结论：心安宁合剂能改善已接受常规西药治疗的冠心病患者的心绞痛发生率和能改善其他影响冠心病的因素。所以，心安宁中药合剂在正在接受西药治疗的冠心病病人，有显著的效果。
In coronary artery disease (CAD), the definition has been clear that this is a
narrowing of the coronary arteries, giving rise to symptom like chest pain and
breathlessness.
On the modern definition of CAD, we attempt to classify people with angina
pectoris into TCM clinical syndromes and treat the syndrome with the Chinese
herbal formulation, Xin An Ning, in addition to their regular CAD treatment
Aim: The aim of this paper is to look into the effect of combination of Chinese medicine with western medicine , in patient already on conventional western treatment for CAD, and see if this addition of herbal preparation will improve the outcome of the patient, both in symptoms and long term outcome.
Methodology: 40 patient with CAD were randomized to 2 group of 20, one group will continue to receive conventional therapy for CAD. The other group of 20 will receive the Chinese herbal preparation , Xin An Ning.
Results: The patients that receive Xin AN Ning in addition to their regular western medicine show a improvement in the frequency of chest pain and also a greater reduction in cholesterol and homocysteine level, which are some of the factors that predict the outcome of coronary artery disease.
Conclusion: The outcome of this study indicate that the Chinese herbal preparation, xin an ning is important in the treatment of CAD. It can be augment the action of the conventional treatment on CAD and it improve the outcome of the disease.
引文
1. Libby P. Current concepts of the pathogenesis of the coronary syndromes. Circulation 2001;104:365-372
2. Meuwissen M, Van der Wal AC, Koch KT,et al. Association between complex coronary artery stenosis and unstable angina and the extend of plaque formation. Am J Med 2003;114(7):521-527.
3. Vainas T, Kurvers HAJM, Mess WH, et al. Chlamydia pneumonia serology is associated with thrombosis-related but not with plaque related microembolization during carotid endarterectomy. Stroke 2002; 33(5); 1249-1254
4. kansai PM,Sinkey CA, Browning RL, et al. Role of oxidant stress in endothelialdysfunction produced by experimental hyperhomocystinemia in human. Circulation. 1999;100:1161-1168
5. Ventura P, Panini R, Verlato C, et al. Peroxidation indices and total antioxidant capacity in plasma during hyperhomocysteinemia induced by methionine oral loading. Metabolism. 2000;49:225-228
6. Osganian SK, Stamper MJ, Rimme E et al. Vitamin C and risk of coronary heart disease in woment. J Am coll Cardiol 2003;42:246-252
7. Eidelmam RS, Hebert PR, Weisman SM, Hennekens CH. An update on Aspirin in the primary prevention of cardiovascular disease. Arch Intern Med 2003; 163(17);2006-2010
8. John Danesh,Jeremy G Wheeler, et al. C reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. New England Journal of Medicine 2004; 350:1387-1397
9. Boushey C J, Beresford SA, Omen GS,et al. A quantitative assessment of plasma homocysteine as a risk for vascular disease. A quantitative of plasma homocysteine as a risk factor for vascular disease. Probable benefit of increasing folic acid intakes, JAMA. 1995;274:1049-1057
10. LIPID Study Group. The long term intervention with pravastatin in ischaemic disease.Preventation of cardiovascular events and death with pravastatin in patient with coronary heart disease and a broad range of intial cholesterol levels. N England J Med 1998;339:1349-1357
11. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patient with coronary heart disease: the Scandinavian Simvastatin Survival Study(4S). Lancet 1994;344:1383-1389
12. Sacks F M, Pfeffer MA, Moyle L A, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996;335:1001-1009
13．彭仁绣，杨德章，叶青等．当归对心血管系统的药理作用．中草药，1981：12(7)：33-36
14．李立，王僦，赵群仁．附子，当归的抗氧化作用及对微循环障碍的影响．山西医学院学报，1990；21(1)4-9
15．王亚平，祝彼得．当归的药理研究进展．重庆医学 1989；18(4)：39
16．张明发．阿魏酸抗动脉粥样硬化研究进展．中草药．1990；21(1)：41-42
17．胡慧娟，杭鉴茜，王朋书．当归的抗炎作用．中国中药杂志，1991：16(11)：684
18．王开贞，鹿坏兴，刁万祥等．党参对试验性心肌缺血的保护作用．中草药，1989；20(2)：29
19．刘干中，周金黄．党参化学成份及药理作用研究进展．中西医结合杂志，1983；3(2)：11
20．王开贞，鹿坏兴，刁万祥等．党参对微循环障碍的影响．山东中医医学院，1989；13(3)48
21．黄娥梅，刘绍虎，彭永芳等．人参党参甘草对家兔晚期失血性休克的影响．湖北中医杂志，1984；(6)：51
22．王筠默．几种中药降低血压作用的初步观察．上海中医药杂志，1956；(1)：36-41
23．王硕仁，徐西，吕西滢等．党参不同提取物的活化作用研究．北京中医学院学报，1993；16(5)：60-62
24．陈建伟，许益民，王亚淑，等．江苏栽培与野生明党参中氨基酸组成分析．南京中医学院学报，1993；9(2)：26-27
25．余传隆，黄泰康，丁志遵．中药辞海(第一卷)．北京：中国医药科技出版社，1993：832
26．许青媛，杨浦昭，陈瑞明．肉桂对正常和病态大鼠血液动力学及左心室功能的影响．中国中西医结合杂志，1990；10(2)：742
27．原田正敏．常用东方药物的3种成份对植物神经系统的作用．国外药学．中医中医分册，1981；6(5)：32
28．何欣，林紫云，朱莉亚．肉桂酰胺及α-苯基肉桂酰胺衍生物的合成及扩血管活性．药学学报，1999；34(3)：192-194
29．陈一，钟正贤，黄风娇．中药肉桂的药理研究：对血液和心血管系统的影响．中药通报，1981：6(5)：32
30．王桂杰，欧芹，魏晓东，等．雌性大鼠抗氧化系统的增龄性变化及肉桂抗衰老作用的试验研究．中国老年学杂志，1998；18(4)：241-243
31．Takechi M, et al. Planta, Med, 1982, 45(4): 252
32．石琳，等．中国药理学报，1988，9(6)：555
33．冈木彰佑，等．国外医学，中医中药分册 1984，6(1)：54
34．李新芳，吴永杰，郭朝晖，等．18β-甘草次酸钠都试验性心律失常的影响．中国中药杂志，1992；17(3)：176-178
35．Tawata M, Yoda Y, Aida K, et al. Anti platelet action of GU-7,a 3arylcoumarin derivative. purified from glycyrrhizae radix. Planta Medica, 1990; 56(3): 256-263
36．王浴生主编．中药药理与应用．第一版，北京：人民卫生出版社，1983：264
37．山内康平，恒松德五．甘草甜素对动脉硬化症的抗补体和抗炎作用．国外医学．中医中药分册，1985；7(6)：8
38．邓柯玉，辛洪波，张宝恒，等．云南甘草总皂甙清除氧自由基和抗脂肪过氧化作用．中国药理学通报，1993；9(5)：350
39．张宝恒．甘草药理作用研究进展．医学学报，1963；10(11)688
40．时镇州，刘树威，秦葵，等．酸枣根与酸枣仁中抑制作用比较．西北药学杂志．1996；7(4)：212-213
41．刘菊芳，古维新，杨素勤，等．酸枣仁抗大鼠试验性心律失常和心肌缺血作用的研究．第一军医大学学报，1985：5(1)：31-33
42．古维新，刘菊芳，张家新，等．酸枣仁对血压及离体豚鼠心脏的影响．中药药理与临床，1985：创刊号：145-146
2. Meuwissen M, Van der Wal AC, Koch KT,et al. Association between complex coronary artery stenosis and unstable angina and the extend of plaque formation. Am J Med 2003;114(7):521-527.
3. Vainas T, Kurvers HAJM, Mess WH, et al. Chlamydia pneumonia serology is associated with thrombosis-related but not with plaque related microembolization during carotid endarterectomy. Stroke 2002; 33(5); 1249-1254
4. kansai PM,Sinkey CA, Browning RL, et al. Role of oxidant stress in endothelialdysfunction produced by experimental hyperhomocystinemia in human. Circulation. 1999;100:1161-1168
5. Ventura P, Panini R, Verlato C, et al. Peroxidation indices and total antioxidant capacity in plasma during hyperhomocysteinemia induced by methionine oral loading. Metabolism. 2000;49:225-228
6. Osganian SK, Stamper MJ, Rimme E et al. Vitamin C and risk of coronary heart disease in woment. J Am coll Cardiol 2003;42:246-252
7. Eidelmam RS, Hebert PR, Weisman SM, Hennekens CH. An update on Aspirin in the primary prevention of cardiovascular disease. Arch Intern Med 2003; 163(17);2006-2010
8. John Danesh,Jeremy G Wheeler, et al. C reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. New England Journal of Medicine 2004; 350:1387-1397
9. Boushey C J, Beresford SA, Omen GS,et al. A quantitative assessment of plasma homocysteine as a risk for vascular disease. A quantitative of plasma homocysteine as a risk factor for vascular disease. Probable benefit of increasing folic acid intakes, JAMA. 1995;274:1049-1057
10. LIPID Study Group. The long term intervention with pravastatin in ischaemic disease.Preventation of cardiovascular events and death with pravastatin in patient with coronary heart disease and a broad range of intial cholesterol levels. N England J Med 1998;339:1349-1357
11. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patient with coronary heart disease: the Scandinavian Simvastatin Survival Study(4S). Lancet 1994;344:1383-1389
12. Sacks F M, Pfeffer MA, Moyle L A, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996;335:1001-1009
13．彭仁绣，杨德章，叶青等．当归对心血管系统的药理作用．中草药，1981：12(7)：33-36
14．李立，王僦，赵群仁．附子，当归的抗氧化作用及对微循环障碍的影响．山西医学院学报，1990；21(1)4-9
15．王亚平，祝彼得．当归的药理研究进展．重庆医学 1989；18(4)：39
16．张明发．阿魏酸抗动脉粥样硬化研究进展．中草药．1990；21(1)：41-42
17．胡慧娟，杭鉴茜，王朋书．当归的抗炎作用．中国中药杂志，1991：16(11)：684
18．王开贞，鹿坏兴，刁万祥等．党参对试验性心肌缺血的保护作用．中草药，1989；20(2)：29
19．刘干中，周金黄．党参化学成份及药理作用研究进展．中西医结合杂志，1983；3(2)：11
20．王开贞，鹿坏兴，刁万祥等．党参对微循环障碍的影响．山东中医医学院，1989；13(3)48
21．黄娥梅，刘绍虎，彭永芳等．人参党参甘草对家兔晚期失血性休克的影响．湖北中医杂志，1984；(6)：51
22．王筠默．几种中药降低血压作用的初步观察．上海中医药杂志，1956；(1)：36-41
23．王硕仁，徐西，吕西滢等．党参不同提取物的活化作用研究．北京中医学院学报，1993；16(5)：60-62
24．陈建伟，许益民，王亚淑，等．江苏栽培与野生明党参中氨基酸组成分析．南京中医学院学报，1993；9(2)：26-27
25．余传隆，黄泰康，丁志遵．中药辞海(第一卷)．北京：中国医药科技出版社，1993：832
26．许青媛，杨浦昭，陈瑞明．肉桂对正常和病态大鼠血液动力学及左心室功能的影响．中国中西医结合杂志，1990；10(2)：742
27．原田正敏．常用东方药物的3种成份对植物神经系统的作用．国外药学．中医中医分册，1981；6(5)：32
28．何欣，林紫云，朱莉亚．肉桂酰胺及α-苯基肉桂酰胺衍生物的合成及扩血管活性．药学学报，1999；34(3)：192-194
29．陈一，钟正贤，黄风娇．中药肉桂的药理研究：对血液和心血管系统的影响．中药通报，1981：6(5)：32
30．王桂杰，欧芹，魏晓东，等．雌性大鼠抗氧化系统的增龄性变化及肉桂抗衰老作用的试验研究．中国老年学杂志，1998；18(4)：241-243
31．Takechi M, et al. Planta, Med, 1982, 45(4): 252
32．石琳，等．中国药理学报，1988，9(6)：555
33．冈木彰佑，等．国外医学，中医中药分册 1984，6(1)：54
34．李新芳，吴永杰，郭朝晖，等．18β-甘草次酸钠都试验性心律失常的影响．中国中药杂志，1992；17(3)：176-178
35．Tawata M, Yoda Y, Aida K, et al. Anti platelet action of GU-7,a 3arylcoumarin derivative. purified from glycyrrhizae radix. Planta Medica, 1990; 56(3): 256-263
36．王浴生主编．中药药理与应用．第一版，北京：人民卫生出版社，1983：264
37．山内康平，恒松德五．甘草甜素对动脉硬化症的抗补体和抗炎作用．国外医学．中医中药分册，1985；7(6)：8
38．邓柯玉，辛洪波，张宝恒，等．云南甘草总皂甙清除氧自由基和抗脂肪过氧化作用．中国药理学通报，1993；9(5)：350
39．张宝恒．甘草药理作用研究进展．医学学报，1963；10(11)688
40．时镇州，刘树威，秦葵，等．酸枣根与酸枣仁中抑制作用比较．西北药学杂志．1996；7(4)：212-213
41．刘菊芳，古维新，杨素勤，等．酸枣仁抗大鼠试验性心律失常和心肌缺血作用的研究．第一军医大学学报，1985：5(1)：31-33
42．古维新，刘菊芳，张家新，等．酸枣仁对血压及离体豚鼠心脏的影响．中药药理与临床，1985：创刊号：145-146