瓜蒌薤白半夏汤联合银杏酮酯分散片对冠心病心绞痛患者心电图、MMP-9、EMPs水平的影响分析

Effect of Gualou Xiebai Banxia Decoction(瓜蒌薤白半夏汤)Combined with Ginkgo Ester Dripping Pills on ECG and Levels of MMP-9 and EMPs in Patients with Angina Pectoris of Coronary Heart Disease

目的观察瓜蒌薤白半夏汤联合银杏酮酯分散片对冠心病心绞痛患者心电图、MMP-9、EMPs水平的影响分析。方法纳入120例冠心病稳定型心绞痛痰浊闭阻证患者,按随机数表法随机分为观察组及对照组各60例。两组均给予冠心病稳定型心绞痛治疗常规用药,对照组给予银杏酮酯分散片,观察组在对照组基础上联合瓜蒌薤白半夏汤治疗,两组均治疗8周。治疗结束后观察两组治疗前后临床疗效、心绞痛发作情况、中医临床症状积分、心电图疗效、血脂水平及血管性血友病因子(von willebrand Factor,vWF)、基质金属蛋白酶-9(matrix metallopeptidase-9,MMP-9)、内皮细胞微粒(endothelial microparticles,EMPs)水平的变化情况。结果治疗8周后,观察组总有效率为88.33%(53/60),显著高于对照组的71.67%(43/60)(P<0.05);两组患者心绞痛发作次数及持续时间均较治疗前有显著改善(P<0.05),且观察组显著优于对照组(P<0.05);治疗后两组中医临床症状积分均有显著改善,观察组在胸闷、胸痛、气短喘促、痰多纳呆、身体困重症状积分显著优于对照组(P<0.05);观察组心电图总有效率为85.00%(51/60),显著高于对照组的60.00%(36/60)(P<0.05);同时两组患者治疗后总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low-density lipoprotein cholesterol,LDL-C)水平也明显改善(P<0.05),观察组TG、TC及LDL-C显著低于对照组(P<0.05),HDL-C则高于对照组(P<0.05);对照组及观察组经治疗后vWF、MMP-9、EMPs水平均较治疗前提升降低(P<0.05),同时观察组改善显著优于对照组(P<0.05)。结论冠心病稳定型心绞痛在常规治疗基础上采用瓜蒌薤白半夏汤联合银杏酮酯分散片治疗可有效减少患者心绞痛发作,改善临床症状及心电图情况,调节血脂水平,降低患者vWF、MMP-9、EMPs水平,提高临床治疗效果。

Objective To analyze the effects of Gualou Xiebai Banxia Decoction(瓜蒌薤白半夏汤)combined with Ginkgo Es⁃ter Dispersible Tablet on electrocardiogram(ECG)and the levels of matrix metalloproteinase 9(MMP-9)and endothelial micro⁃particles(EMPs)in patients with angina pectoris of coronary heart disease(CHD).Methods A total of 120 patients with stable angina pectoris with CHD were included in the hospital and randomly divided into observation group and control group with 60 pa⁃tients in each group according to random number table method.Both groups were given the usual medication for the treatment of stable angina pectoris in CHD.The control group was given Ginkgo Ester Dispersible Tablet and the observation group was trea⁃ted with Gualou Xiebai Banxia Decoction on the basis of the control group.Both groups were treated for 8 weeks.After treat⁃ment,the clinical curative effect,angina attack,TCM clinical symptom scores,electrocardiogram effect,blood lipid level,von Will⁃ebrand Factor(vWF)and the levels of MMP-9 and EMPs were observed before and after treatment in both groups.Results After 8 weeks of treatment,the total effective rate of the observation group was 88.33%(53/60),which was significantly higher than that of the control group(71.67%,43/60)(P<0.05).The frequency and duration of angina attacks in two groups were significantly improved compared with those before treatment(P<0.05),and the frequency and duration of angina attacks of the obser⁃vation group were significantly better than those of the control group(P<0.05).After treatment,the scores of TCM clinical symptoms in the two groups were significantly improved,and the scores of chest tightness,chest pain,shortness of breath,phlegm dork and body lethargy in the observation group were significantly better than those in the control group(P<0.05).The total ef⁃fective rate of ECG in the observation group was 85.00%(51/60),which was significantly higher than that in the control group(60.00%,36/60)(P<0.05).Meanwhile,the levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cho⁃lesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)after treatment in both groups were also significantly im⁃proved(P<0.05)and the levels of TG,TC and LDL-C in the observation group were significantly lower than those in the con⁃trol group(P<0.05).HDL-C was higher than that of control group(P<0.05).After treatment,the levels of vWF,MMP-9 and EMPs in two groups were decreased compared with those before treatment(P<0.05)and the improvement in the observation group was significantly better than that in control group(P<0.05).Conclusion Based on conventional treatment of stable angina pectoris with CHD,Gualou Xiebai Banxia Decoction combined with Ginkgo Ester Dispersible Tablet can effectively reduce the an⁃gina attacks,improve the clinical symptoms and ECG,regulate blood lipid levels,reduce the levels of vWF,MMP-9 and EMPs and improve the clinical therapeutic effect.