化湿和化瘀法治疗冠心病的临床观察

Clinical Study of Eliminating Dampness and Removing Blood Stasis in Treating Coronary Heart Disease-The Summary about Serial Study of Blood Stasis Due to Dampness

目的：阐明湿和瘀间的关系。方法：本研究选择多年生活在岭南地区的痰湿证和血瘀证冠心病患者各１２８例、６９例，分别用化湿法和化瘀法治疗。结果：（１）痰湿证和血瘀证患者在血液流变学、氧自由基、血脂和血管活性物质方面有类似的变化。（２）两法均能缓解冠心病心绞痛，有效率为８８．３％和８９．９％，能改善心电图缺血表现及减少硝酸甘油用量（Ｐ＜０．００１），改善血液流变学异常（Ｐ＜０．００１），并能升高前列环素（ＰＧＩ２）、超氧化物歧化酶（ＳＯＤ）（Ｐ＜０．０１），降低血栓素Ａ２（ＴＸＡ２）、丙二醛（ＭＤＡ）、心钠素（ＡＮＰ）、内皮素（ＥＴ）及血脂（Ｐ＜０．００１）。（３）两法均能调整ＰＧＩ２／ＴＸＡ２、ＳＯＤ／ＭＤＡ失衡。结论：化湿法具有与化瘀法相似的药理或药效作用，据此似可从临床角度印证“因湿致瘀”的学术观点。

To elucidate the relationship between Dampness and blood stasis in patients with coronary heart disease (CHD). Methods:One hundred and twenty-eight CHD patients with Phlegm-Dampness Syndrome (PDS) and69 with blood stasis syndrome (BSS) were chosen and treated by eliminating Dampness and removing bind stasis.ResultS: (1)CHD-PDS and-BSS possed the similar changes on hemorheology, oxygen free radical, blood lipidsand vascular active substance. (2) Both of these two methods could alleviate angina (effective rate was 88. 3%,89. 9%), improve ischemic S-T segment changes in ECG obviously and reduce consumption of nitroglycerin significantly (P<0. 01 ), improve abnormal hemorheology obviously (P<0. 001 ), raise PGI2, SOD obviously (P<0. 01) and lowered TXA2, MDA, ANP, ET and blab lipids significantly (P<0. 001 ). (3)The two methods couldregulate imbalanced state of PGI2/TXA2, SOD/MDA. Condusions: CHD-PDS and-BSS had similar pathologic basisor pathologic changes, could eliminate the Dampness abc had possessed similar pharmacologic or pharmacodynamicaction of removing blood stapis. According to this, the viewpoint of 'blood stasis due to Dampness'might be provedfrom clinical aspect.