蛭龙活血胶囊治疗不稳定型心绞痛的疗效及对血管内皮功能和血小板功能的影响

Curative Effect of Zhilong Huoxue Capsule on Unstable Angina and its Influence on Vascular Endothelial Function and Platelet Function

目的:探讨蛭龙活血胶囊治疗不稳定型心绞痛(UA)的疗效及对血管内皮功能和血小板功能的作用机制。方法:将80例UA患者随机按数字法分为观察组和对照组各40例。两组均给予常规治疗,对照组采用复方丹参片,1.2 g·d-1,3次/d,口服。观察组采用蛭龙活血胶囊,1.2 g·d-1,3次/d,口服。疗程均为8周。观察心绞痛发作情况、记录硝酸甘油用量;记录气虚血瘀证证候积分;检测肱动脉血流介导的血管扩张变化率(FMD);检测血浆内皮素(ET)、一氧化氮(NO)、血管性血友病因子(vWF)及血小板α-膜颗粒蛋白(GMP-140)水平。结果:观察组疾病疗效总有效率为92.5%,优于对照组的72.5%(P<0.05);观察组心电图疗效总有效率90.0%,优于对照组的75.5%(P<0.05);治疗后观察组心绞痛发作次数、硝酸甘油用量均少于对照组(P<0.01);治疗后观察组FMD及NO高于对照组(P<0.01),观察组ET和vWF水平低于对照组(P<0.01);治疗后观察组GMP-140水平低于对照组(P<0.01);治疗后气虚血瘀证积分低于对照组(P<0.01)。结论:蛭龙活血胶囊改善了UA患者临床症状、减少了硝酸甘油用量,减少了心绞痛发作次数,提高了临床疗效,其作用机制可能与改善血管内皮和血小板功能,从而改善血管舒张功能、微循环状态、增加心肌供氧有关。

Objective： The purpose is to study the curative effect of Zhilong Huoxue capsule on unstable angina （UA） and its influence on vascular endothelial function and platelet function. Method： Eighty cases of UA patients were randomly divided into control group （40 cases） and observation group （40 cases） according to digital method. Patients in both groups were given conventional treatment. Patients in control group took Fufang, 1.2 g·d-1, 3 times/day, orally. Patients in observation group took Zhilong Huoxue capsule, 1.2 g·d-1, 3 times/day, orally. Treatment course was 8 weeks. The condition of angina pain occurring was observed. The nitroglycerin dosage and the syndrome integral and Qi deficiency syndrome of blood stasis were recorded. Levels of flow mediated vasodilation （FMD）, plasma endothelin （ET）, nitric oxide （NO）, von willebrand factor （vWF） and platelet α-membrane particles protein （GMP-140） were detected. Result： The total effective rate of observing group was 92.5%, superior to 72.5% of the control group （P〈0.05）. The total effective rate of electrocardiogram curative effect of observation group was 90.0%, superior to 75.5% in the control group （P〈0.05）. After treatment, the anginal attacks and nitroglycerin consumption of observation group were less than the control group （P〈0.01）. The FMD and NO of observation group were higher than the control group （P〈0.01）, while the ET and vWF of observation group lower than the control group （P〈0.01）. GMP-140 level of observation group was lower than the control group （P〈0.01）. The Qi deficiency syndrome of blood stasis score of observation group was lower than the control group （P〈0.01）. Conclusion： Zhilong Huoxue capsule can improve the UA patients＇ clinical symptoms and clinical curative effect and decrease the nitroglycerin dosage and the times of angina pain occurring. Its mechanism may be related to improve the function of vascular endothelium and platelet and thus improving vasodilatation function, microcirculation status and increasing myocardial oxygen supply.