益心舒胶囊对不稳定型心绞痛患者的症状改善作用及其对血清核因子κB、基质金属蛋白酶1水平的影响
|
摘要
目的探讨益心舒胶囊对不稳定型心绞痛(UAP)患者的症状改善作用及其对血清核因子κB(NF-κB)、基质金属蛋白酶1(MMP-1)水平的影响。方法选取2018年1—6月西安市中医医院收治的UAP患者76例,采用随机数字表法分为对照组和观察组,每组38例。对照组患者给予常规西药治疗,观察组患者在对照组基础上给予益心舒胶囊;两组患者连续治疗1个月。比较两组患者心电图改善效果,治疗前后心绞痛症状〔包括发作频次、持续时间、模拟视觉评分法(VAS)评分〕、心功能指标〔包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心脏指数(CI)〕、血清NF-κB、MMP-1水平,并观察两组患者治疗期间不良反应发生情况。结果 (1)观察组患者心电图改善总有效率高于对照组(P<0.05)。(2)治疗前两组患者心绞痛发作频率、持续时间、VAS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者心绞痛发作频率、VAS评分低于对照组,持续时间短于对照组(P<0.05)。(3)治疗前两组患者LVEF、LVEDD、CI比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEF、CI高于对照组,LVEDD短于对照组(P<0.05)。(4)治疗前两组患者血清NF-κB、MMP-1水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清NF-κB、MMP-1水平低于对照组(P<0.05)。(5)两组患者治疗期间头晕、乏力、低血压、心动过缓发生率比较,差异无统计学意义(P>0.05)。结论益心舒胶囊可有效改善UAP患者心电图表现、心功能,减轻心绞痛症状,降低血清NF-κB、MMP-1水平,有利于减轻炎性反应并降低不稳定斑块破裂风险,且安全性较高。
Objective To investigate the symptom improvement effect of Yixinshu Capsule on unstable angina pectoris(UAP)and its impact on serum levels of NF-κB and MMP-1. Methods A total of 76 patients with UAP were selected in the Traditional Chinese Medicine Hospital of Xi'an from January to June 2018,and they were divided into control group and observation group according to random number table method,with 38 cases in each group. Patients in control group received conventional Western medicine,while patients in observation group received Yixinshu Capsule based on that of control group;both groups continuously treated for 1 month. Improvement effect of electrocardiogram,pre-and post-treatment symptoms of angina pectoris(including attack frequency,duration and VAS score),index of cardiac function(including LVEF,LVEDD and CI),serum levels of NF-κB and MMP-1 were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Total effective rate of electrocardiogram improvement in observation group was statistically significantly higher than that in control group(P<0.05).(2)No statistically significant difference of attack frequency or duration of angina pectoris,or VAS score was found between the two groups before treatment(P>0.05);after treatment,attack frequency of angina pectoris and VAS score in observation group were statistically significantly lower than those in control group,and duration of angina pectoris in observation group was statistically significantly shorter than that in control group(P<0.05).(3)No statistically significant difference of LVEF,LVEDD or CI was found between the two groups before treatment(P>0.05);after treatment,LVEF and CI in observation group were statistically significantly higher than those in control group,and LVEDD in observation group was statistically significantly shorter than that in control group(P<0.05).(4)No statistically significant difference of serum level of NF-κB or MMP-1 was found between the two groups before treatment(P>0.05),while serum levels of NF-κB and MMP-1 in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of incidence of dizziness,fatigue,hypotension or bradycardia was found between the two groups during treatment(P>0.05). Conclusion In patients with UAP,Yixinshu Capsule can effectively improve the electrocardiogram presentation and cardiac function,relieve the symptoms of angina pectoris,reduce the serum levels of NF-κB and MMP-1,is helpful to relieve the inflammatory reaction and reduce the risk of unstable plaque rupture,with relatively high safety.
Objective To investigate the symptom improvement effect of Yixinshu Capsule on unstable angina pectoris(UAP)and its impact on serum levels of NF-κB and MMP-1. Methods A total of 76 patients with UAP were selected in the Traditional Chinese Medicine Hospital of Xi'an from January to June 2018,and they were divided into control group and observation group according to random number table method,with 38 cases in each group. Patients in control group received conventional Western medicine,while patients in observation group received Yixinshu Capsule based on that of control group;both groups continuously treated for 1 month. Improvement effect of electrocardiogram,pre-and post-treatment symptoms of angina pectoris(including attack frequency,duration and VAS score),index of cardiac function(including LVEF,LVEDD and CI),serum levels of NF-κB and MMP-1 were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Total effective rate of electrocardiogram improvement in observation group was statistically significantly higher than that in control group(P<0.05).(2)No statistically significant difference of attack frequency or duration of angina pectoris,or VAS score was found between the two groups before treatment(P>0.05);after treatment,attack frequency of angina pectoris and VAS score in observation group were statistically significantly lower than those in control group,and duration of angina pectoris in observation group was statistically significantly shorter than that in control group(P<0.05).(3)No statistically significant difference of LVEF,LVEDD or CI was found between the two groups before treatment(P>0.05);after treatment,LVEF and CI in observation group were statistically significantly higher than those in control group,and LVEDD in observation group was statistically significantly shorter than that in control group(P<0.05).(4)No statistically significant difference of serum level of NF-κB or MMP-1 was found between the two groups before treatment(P>0.05),while serum levels of NF-κB and MMP-1 in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of incidence of dizziness,fatigue,hypotension or bradycardia was found between the two groups during treatment(P>0.05). Conclusion In patients with UAP,Yixinshu Capsule can effectively improve the electrocardiogram presentation and cardiac function,relieve the symptoms of angina pectoris,reduce the serum levels of NF-κB and MMP-1,is helpful to relieve the inflammatory reaction and reduce the risk of unstable plaque rupture,with relatively high safety.
引文
[1]YILDIZ B S,BILGIN M,ZUNGUR M,et al.Manual thrombus aspiration and the improved survival of patients with unstable angina pectoris treated with percutaneous coronary intervention(30 months follow-up)[J].Medicine(Baltimore),2016,95(8):e2919.DOI:10.1097/MD.0000000000002919.
[2]张成杰,安庆华,郑玉明,等.不稳定型心绞痛患者NF-κB、TNF-α、IL-1及IL-6的表达与干预研究[J].滨州医学院学报,2018,41(3):168-170.
[3]郭溉宗,王益俊,何慧君.老年冠心病患者胱抑素C、巨噬细胞移动抑制因子及基质金属蛋白酶-1在血清中的表达分析[J].国际检验医学杂志,2015,36(13):1864-1865,1867.DOI:10.3969/j.issn.1673-4130.2015.13.026.
[4]王建安.不稳定型心绞痛和非ST段抬高型心肌梗死诊断和治疗指南[C]//第14届中国南方国际心血管病学术会议论文集.浙江大学医学院附属第二医院,2012:44-47.
[5]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.
[6]张秀芹,黄红林,毕津莲.不稳定型心绞痛治疗药物的临床应用分析[J].中国临床药理学杂志,2015,31(21):2158-2160.DOI:10.13699/j.cnki.1001-6821.2015.21.023.
[7]SCHLETT C L,NANCE J W Jr,SCHOEPF U J,et al.Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs.major adverse cardiac events[J].Eur J Radiol,2014,83(7):1113-1119.DOI:10.1016/j.ejrad.2014.04.005.
[8]孙小强,李姮,张香玲,等.达比加群酯联合替格瑞洛对老年心房颤动合并不稳定型心绞痛患者的有效性及安全性研究[J].中国全科医学,2018,21(31):3841-3845.DOI:10.12114/j.issn.1007-9572.2018.31.013.
[9]王小渠,李伯庆.中西医结合治疗冠心病不稳定型心绞痛的临床研究[J].成都医学院学报,2015,10(4):473-474.DOI:10.3969/j.issn.1674-2257.2015.04.022.
[10]邓冬,赵慧辉,陈静,等.冠心病不稳定型心绞痛中医证候及其症状分布特征的研究[J].中国中医急症,2016,25(7):1269-1271.DOI:10.3969/j.issn.1004-745X.2016.07.001.
[11]徐江林,习元堂,岑延佑,等.苦碟子注射液与丹参注射液治疗不稳定型心绞痛患者有效性及安全性的Meta分析[J].实用心脑肺血管病杂志,2018,26(12):16-21.DOI:10.3969/j.issn.1008-5971.2018.12.004.
[12]范例,顾俊,许左隽,等.益心舒胶囊治疗慢性闭塞病变冠心病患者的疗效观察[J].中西医结合心脑血管病杂志,2015,13(14):1667-1669.DOI:10.3969/j.issn.1672-1349.2015.14.031.
[13]骆杨平,唐铭翔,王鹏,等.益心舒胶囊联合美托洛尔缓释片治疗冠心病室性早搏的临床观察[J].湖南中医药大学学报,2016,36(3):60-63.DOI:10.3969/j.issn.1674-070X.2016.03.018.
[14]马芹,柳景华,朱华刚,等.益心舒胶囊对稳定型心绞痛患者临床疗效及动脉硬化程度的影响[J].中西医结合心脑血管病杂志,2015,13(5):563-565.DOI:10.3969/j.issn.16721349.2015.05.002.
[15]熊然,刘文娴,宁尚秋.益心舒胶囊治疗稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2014,12(10):1200-1202.DOI:10.3969/j.issn.16721349.2014.10.018.
[16]刘文立,陈娟.益心舒胶囊联合单硝酸异山梨酯片治疗不稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(6):627-629.DOI:10.3969/j.issn.1672-1349.2016.06.023.
[17]曹伟,吴桂平,周瀛,等.通心络胶囊对冠脉支架植入术后病人NF-κB,IL-6及TNF-α表达的影响[J].中西医结合心脑血管病杂志,2018,16(3):342-343.DOI:10.3969/j.issn.1672-1349.2018.03.025.
[18]JIA P,WU N,ZHANG X,et al.Association of matrix metalloproteinase-1-519A/G polymorphism with acute coronary syndrome:a meta-analysis[J].Int J Clin Exp Med,2015,8(4):5675-5682.
[19]刘瑞,刘艳芬.瑞舒伐他汀和阿托伐他汀对冠心病患者的临床疗效及对血清中IL-35、NF-κB水平影响的比较[J].药物评价研究,2017,40(8):1141-1144.DOI:10.7501/j.issn.1674-6376.2017.08.022.
[2]张成杰,安庆华,郑玉明,等.不稳定型心绞痛患者NF-κB、TNF-α、IL-1及IL-6的表达与干预研究[J].滨州医学院学报,2018,41(3):168-170.
[3]郭溉宗,王益俊,何慧君.老年冠心病患者胱抑素C、巨噬细胞移动抑制因子及基质金属蛋白酶-1在血清中的表达分析[J].国际检验医学杂志,2015,36(13):1864-1865,1867.DOI:10.3969/j.issn.1673-4130.2015.13.026.
[4]王建安.不稳定型心绞痛和非ST段抬高型心肌梗死诊断和治疗指南[C]//第14届中国南方国际心血管病学术会议论文集.浙江大学医学院附属第二医院,2012:44-47.
[5]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.
[6]张秀芹,黄红林,毕津莲.不稳定型心绞痛治疗药物的临床应用分析[J].中国临床药理学杂志,2015,31(21):2158-2160.DOI:10.13699/j.cnki.1001-6821.2015.21.023.
[7]SCHLETT C L,NANCE J W Jr,SCHOEPF U J,et al.Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs.major adverse cardiac events[J].Eur J Radiol,2014,83(7):1113-1119.DOI:10.1016/j.ejrad.2014.04.005.
[8]孙小强,李姮,张香玲,等.达比加群酯联合替格瑞洛对老年心房颤动合并不稳定型心绞痛患者的有效性及安全性研究[J].中国全科医学,2018,21(31):3841-3845.DOI:10.12114/j.issn.1007-9572.2018.31.013.
[9]王小渠,李伯庆.中西医结合治疗冠心病不稳定型心绞痛的临床研究[J].成都医学院学报,2015,10(4):473-474.DOI:10.3969/j.issn.1674-2257.2015.04.022.
[10]邓冬,赵慧辉,陈静,等.冠心病不稳定型心绞痛中医证候及其症状分布特征的研究[J].中国中医急症,2016,25(7):1269-1271.DOI:10.3969/j.issn.1004-745X.2016.07.001.
[11]徐江林,习元堂,岑延佑,等.苦碟子注射液与丹参注射液治疗不稳定型心绞痛患者有效性及安全性的Meta分析[J].实用心脑肺血管病杂志,2018,26(12):16-21.DOI:10.3969/j.issn.1008-5971.2018.12.004.
[12]范例,顾俊,许左隽,等.益心舒胶囊治疗慢性闭塞病变冠心病患者的疗效观察[J].中西医结合心脑血管病杂志,2015,13(14):1667-1669.DOI:10.3969/j.issn.1672-1349.2015.14.031.
[13]骆杨平,唐铭翔,王鹏,等.益心舒胶囊联合美托洛尔缓释片治疗冠心病室性早搏的临床观察[J].湖南中医药大学学报,2016,36(3):60-63.DOI:10.3969/j.issn.1674-070X.2016.03.018.
[14]马芹,柳景华,朱华刚,等.益心舒胶囊对稳定型心绞痛患者临床疗效及动脉硬化程度的影响[J].中西医结合心脑血管病杂志,2015,13(5):563-565.DOI:10.3969/j.issn.16721349.2015.05.002.
[15]熊然,刘文娴,宁尚秋.益心舒胶囊治疗稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2014,12(10):1200-1202.DOI:10.3969/j.issn.16721349.2014.10.018.
[16]刘文立,陈娟.益心舒胶囊联合单硝酸异山梨酯片治疗不稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(6):627-629.DOI:10.3969/j.issn.1672-1349.2016.06.023.
[17]曹伟,吴桂平,周瀛,等.通心络胶囊对冠脉支架植入术后病人NF-κB,IL-6及TNF-α表达的影响[J].中西医结合心脑血管病杂志,2018,16(3):342-343.DOI:10.3969/j.issn.1672-1349.2018.03.025.
[18]JIA P,WU N,ZHANG X,et al.Association of matrix metalloproteinase-1-519A/G polymorphism with acute coronary syndrome:a meta-analysis[J].Int J Clin Exp Med,2015,8(4):5675-5682.
[19]刘瑞,刘艳芬.瑞舒伐他汀和阿托伐他汀对冠心病患者的临床疗效及对血清中IL-35、NF-κB水平影响的比较[J].药物评价研究,2017,40(8):1141-1144.DOI:10.7501/j.issn.1674-6376.2017.08.022.