参七汤干预冠心病支架植入术后再狭窄临床研究

Clinical Study of Shenqi Decoction in Treating Restenosis after Implantation of Stents in Patients with Coronary Artery Disease

目的观察参七汤对冠心病支架植入术后炎症免疫反应、机体免疫状态以及再狭窄的影响,并探讨其作用机理。方法冠心病支架植入术后患者88例,采用随机、对照方法分为治疗组45例和对照组43例。对照组采用西医常规治疗,治疗组在其基础上加用参七汤,疗程6个月,观察再狭窄发生率、超敏C-反应蛋白(hsCRP)、活化的T淋巴细胞(CD3+/HLA-DR+)、可溶性白细胞介素-2受体(SIL-2R)及血瘀证、气虚证积分。结果治疗组再狭窄率低于对照组(P<0.05)。冠状动脉介入术后,CD3+/HLA-DR+较术前降低,SIL-2R、hsCRP较术前升高,治疗组治疗后CD3+/HLA-DR+水平较对照组升高(P<0.01),SIL-2R、hsCRP水平较对照组降低(P<0.01),血瘀证积分和气虚证积分亦显著低于对照组(P<0.01),且持续到术后6个月。结论参七汤能有效减少冠心病冠状动脉介入术后再狭窄的发生。减少支架引起的炎症免疫反应,调节机体免疫状态,是其预防冠状动脉介入术后再狭窄的机制之一。

Objective To observe the effect of Shenqi Decoction on inflammation and immune reaction, immune state, restenosis （RS） after implantation of stents in patients with coronary artery disease, and to investigate its mechanism. Methods Eighty-eight patients with coronary artery disease after implantation of stents were randomly divided into the treatment group （45 cases） and the control group （43 cases）. The control group was treated with routine treatment, and the treatment group was treated with Shenqi Decoction additionally for six months. RS rate, the level of hs-CRP, the marker of activation of T lymphocytes （CD3^＋/HLA^-DR^＋）, sIL-2R and the scores of blood-stasis syndrome and deficiency of Qi syndrome were observed. Results The RS rate in the treatment group was lower than that in the control group （P〈0.05）. After PCI, the level of CD3^＋/HLA^-DR^＋ was lower while hs-CRP and sIL-2R was higher than before. After treatment with Shenqi Decoction, the level of CD3^＋/HLA^-DR^＋ and hs-CRP was obviously advanced, and sIL-2R was obviously degraded than that of control group （P〈0.01）. The scores of blood-stasis syndrome and deficiency of Qi syndrome in the treatment group was significantly lowered compared with that in the control group （P〈0.01）, and remained to 6 months. Conclusion Shenqi Decoction can effectively reduce the occurrence of RS after PCI. Reducing the inflammation and immune reaction of the stents and regulating the immune state is one of its mechanisms.