大蒜素对不同中医证型不稳定性心绞痛的作用及与血脂和GMP-140的关系

Effect of Garlicin on Unstable Angina Pectoris and Its Relationship with Blood Lipid and GMP-140

目的 :观察大蒜素注射液对不稳定性心绞痛的临床疗效及与中医证型的关系。方法 :将 5 5例不稳定性心绞痛患者随机分为治疗组(3 4例)和对照组(2 1例) ,每组依中医辨证再分为偏寒和偏热型及重度瘀血和轻度瘀血型。治疗组和对照组分别每天静脉滴注大蒜素 60mg和硝酸甘油5mg,疗程 1 0天。根据疗程前后症状和心电图变化评定疗效 ,并测定血脂、脂蛋白、载脂蛋白和血小板α颗粒膜蛋白(GMP 1 40 )。结果 :大蒜素组疗效与对照组相比无显著性差异 ;大蒜素对偏寒型的疗效明显优于偏热型 (P <0 0 1 ) ,并显著升高偏寒型患者的高密度脂蛋白与低密度脂蛋白比值和载脂蛋白A1 水平(P <0 0 5 ) ,偏热型出现相反趋势 ;大蒜素可使轻度瘀血型的GMP 1 40明显降低 (P <0 0 5 )。结论 :大蒜素对不稳定性心绞痛有较好的疗效 ,对寒瘀型的不稳定性心绞痛患者 ,疗效更佳。其机理与改善血脂和促进血小板活化有关。

Objective: To observe the clinical effect of Garlicin on unstable angina pectoris (UAP) and to explore the relationship between Garlicin's effect and Syndrome Differentiation of TCM. Methods: Fifty five patients of UAP were divided randomly into the Garllcin group (34 cases) and the control group (21 cases) and classified based on Syndrome Differentiation of TCM into Cold Syndrome type, Heat Syndrome type, severe blood stasis (SBS) type or mild blood stasis (MBS) type. Garlicin 60 mg or nitroglycerin 5 mg were given to the two groups respectively by intravenous drip for 10 days as one therapeutic course. The curatic effect was evaluated by changes of symptoms and electrocardiogram, and some indexes, such as blood lipid, lipoprotein, apolipoprotein and GMP 140 among different groups and types were compared Results: The difference of effective rate between the Garlicin group and the control group was insignificant. In the Garlicin group, the effective rate of Cold Syndrome type was higher than that of Heat Syndrome type (P<0 01), and HDL/LDL ratio and apoA 1 level raised markedly in the former type (P<0 05) while an oppositive trend revealed in the Heat Syndrome type. Garlicin showed a higher effect on SBS type than that on MBS type and cause GMP 140 of the MBS type decreased obviously. Conclusion: Garlicin is effective on UAP patients and its effect was more evident on those with Cold Syndorme type or SBS type. Its mechanism may be related to its effect in improving blood lipid and enhancing activation of platelet.