体外反搏联合补肾通络方抑制冠状动脉炎症反应临床研究

Clinical Study of Enhanced External Counterpulsation with Bushentongluo Prescription for Antagonizing Inflammatory Response of Coronary Artery

目的观察体外反搏联合补肾通络方对冠心病(CHD)肾阳亏虚兼痰瘀内阻证患者的临床疗效、心功能变化以及对冠状动脉炎症反应的抑制作用。方法将70例冠心病不稳定型心绞痛患者,随机分为治疗组(36例)和对照组(34例),两组患者基础治疗相同。治疗组给予体外反搏联合补肾通络方治疗,每日反搏1次,每次1 h,12次为1疗程,连续治疗3个疗程;同时给予中药补肾通络方治疗,每日水煎取汁200 mL,分两次口服,共服药6周。对照组口服麝香保心丸,每次2粒(每粒22.5 mg),每日3次,共服药6周。分别于治疗前后采集空腹肘静脉血,测定血清高敏C-反应蛋白(hs-CRP)、白细胞介素-18(IL-18)、巨噬细胞集落刺激因子(M-CSF)。结果两组治疗后血清hs-CRP、IL-18、M-CSF水平均明显降低(P<0.05或P<0.01),且治疗组治疗后hs-CRP、IL-18、M-CSF水平低于对照组(P<0.05或P<0.01)。心功能部分指标改善治疗组优于对照组(P<0.05)。结论体外反搏联合补肾通络方具有良好的临床疗效,其抑制冠状动脉炎症反应作用可能是其治疗冠心病肾阳亏虚兼痰瘀内阻证的机制之一。

Objective To study the effects of enhanced external counterpulsation （EECP） with Bushentongluo prescription on in- flammatory response in patients （pts） with coronary heart disease （CHD） and syndrome of kidney - Yang deficiency, stagnation of phlegm and blood stasis. Methods Seventy pts with CHD were randomly divided into two groups：Treatment group （n=36） treated by EECP with Bushentongluo prescription and control group （n= 34） treated by Shexiangbaoxin pill for six weeks. The clinical therapeutic effects and heart function were observed. The levels of serum high sensitivity C- reactive protein （hs - CRP）, interleukin - 18 （IL - 18） and macrophage - colony stimulating factor （M - CSF） were detected. Results Following treatment for 6 weeks, the levels of serum hs -CRP, IL- 18 and M- CSF in two groups were all decreased significantly（P〈0.05 or P〈0.01）. The levels of serum hs- CRP, IL - 18 and M -CSF in treatment group were lower than that in control group （P〈0.05 or P〈0.01）. The clinical therapeutic effects and heart function in treatment group were better than that in control group （P〈0. 05 or P〈0.01）. Conclusion EECP with Bushentongluo prescription was effective in antagonizing inflammatory response of coronary artery,which might be one of mechanisms for treatment of CHD with syndrome of kidney - Yang deficiency and stagnation of phlegm and blood stasis.