稳斑汤联合体外反搏治疗冠心病PCI术后心绞痛临床疗效及对血清ET-1和NO影响

Clinical Effects of Wenban Decoction Combined with External Counterpulsation in Treatment of Angina Pectoris after PCI and Its Influence on the Content of Serum ET-1 and NO

目的观察稳斑汤联合体外反搏治疗冠心病经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)术后心绞痛患者的临床疗效及对血清内皮素-1(ET-1)、一氧化氮(NO)的影响,并对其疗效机制进行探讨。方法将符合纳入标准的60例冠心病PCI术后患者(痰瘀互结型),随机分为对照组和治疗组各30例。对照组采用常规西药加稳斑汤治疗,治疗组在对照组基础上联合体外反搏治疗,疗程均为5周,疗程前后根据CRF表评定两组受试者中医证候积分、中医证候疗效,采用ELISA双抗体夹心法检测血清ET-1的含量,硝酸还原酶法检测血清NO的含量,并进行统计分析。结果疗程结束后,两组均能有效改善冠心病PCI术后心绞痛患者的中医症候;与治疗前相比,对照组与治疗组的中医证候积分、血清ET-1含量均显著降低,NO含量均显著升高(P<0.05);组间比较,治疗组较对照组更能有效改善冠心病PCI术后心绞痛患者中医证候,降低中医证候积分,降低血清ET-1含量,升高血清NO含量(P<0.05)。结论稳斑汤联合体外反搏治疗能有效改善冠心病PCI术后心绞痛患者的中医证候、降低中医证候积分,其降低血清中ET-1的含量,提高NO的含量,从而改善血管内皮功能,促进冠脉侧支循环的建立可能是其疗效机制之一。

Objective To observe the clinical effects of Wenban Decoction combined with external counterpulsation in treatment of angina pectoris after PCI and its influence on the content of serum ET-1 and NO,and discuss its curative effect mechanism.Methods According to the inclusion criteria,60 cases of coronary heart disease patients after PCI of phlegm and blood stasis were randomly divided into control group and treatment group,each group contains 30 cases.The control group use conventional Western medicine plus Wenban Decoction treatment,the treatment group use the method of the control group combined with external counterpulsation therapy.Both group treat for 5 week.Before and after the treatment,according to the CRF table evaluation of two groups of subjects with the score of TCM syndrome and the curative effect of TCM syndrome,the content of serum ET-1 was detected by double antibody sandwich ELISA method,the content of serum NO was detected by nitrate reductase method,and statistical analysis.Results After the end of the course of treatment,the two groups can effectively improve the TCM symptoms of patients with Angina pectoris after PCI.Compared with before treatment,the TCM syndrome scores and serum ET-1 content of the control group and the treatment group were significantly reduced,and the NO content was significantly increased(P<0.05).Compared with the control group,the treatment group can improve the TCM syndromes,reduce the TCM syndrome score,reduce the serum ET-1 content,and increase the serum NO content of patients with angina pectoris after PCI more effectively.Conclusion Wenban Decoction combined with external counterpulsation therapy can effectively improve the TCM syndromes,reduce the TCM syndrome score of patients with Angina pectoris after PCI.It may be one of the therapeutic mechanisms to reduce the content of serum ET-1,improve the content of serum NO,improve the vascular endothelial function and promote the establishment of the collateral circulation of the coronary artery.