白花丹参饮对冠心病患者血管内皮功能的影响

The Influence of Baihua Danshen Decoction on the Vascular Endothelial Function of Patients with Coronary Heart Disease

目的:从血管内皮功能的角度探讨白花丹参饮治疗冠心病(CHD)的作用机制。方法:88例患者随机按住院顺序分为对照组和观察组各44例。对照组参照"慢性稳定型心绞痛诊断与治疗指南"常规予抗凝、降压、调脂、改善冠脉供血等治疗。观察组在对照组治疗的基础上加用白花丹参饮,1剂/d。两组疗程均为12周。采用超声评价肱动脉内皮依赖性血管舒张功能(FMD);检测治疗前后血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;采用放射免疫法测定血浆内皮素-1(ET-1)、血栓素2(TXB2)及6-酮前列腺素Fla(6-Keto-PGF la)水平,采用硝酸还原法测定一氧化氮(NO)水平;记录心绞痛发作次数及持续时间。结果:治疗期间观察组心绞痛发作次数及持续时间均少于对照组(P<0.05);治疗后两组TC,TG及LDL-C水平均下降,观察组低于对照组(P<0.01),两组治疗后HDL-C均升高,观察组高于对照组(P<0.01);治疗后两组ET-1,TXB2及ET-1/NO均比治疗前下降,观察组上述指标均低于对照组(P<0.01);治疗后NO和6-Keto-PGF la均比治疗前上升,观察组高于对照组(P<0.01);观察组FMD的改善优于对照组(P<0.01)。结论:白花丹参饮能改善CHD患者心绞痛,调节脂代谢,其作用机制可能与调节失衡的ET/NO和TXB2/6-Keto-PGF la状态,改善CHD患者血管内皮功能有关。

Objective： The purpose is to study the mechanism of Baihua Danshen decoction in treatment of coronary heart disease （CHD） from the view point of endothelial function. Method： Eighty-eight cases of patients were divided into control group （44 cases） and observation group （44 cases） according to the hospital sequence. Based on ＇The guide to the diagnosis and treatment of chronic stable angina＇, the patients in control group took conventional treatment, including anticoagulation, antihypertensive, fat adjustment and improvement of coronary blood flow. On the basis of control group, the patients in observation group took Baihua Danshen decoction, 1 dose/day. The treatment course is 12 weeks. Ultrasound is used to evaluate the function of flow-mediated dilatation （FMD）. The levels plasma total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C） were detected before and after treatment. Ria method is used to determine the levels of plasma endothelin-1 （ET-1）, thromboxane 2 （TXB2） and 6-ketone prostaglandin F1a （6-Keto-PGF1a）. The nitrate reduction method is used to evaluate nitric oxide （NO） level. The times and duration of angina are recorded. Result： During the treatment, the times and duration of angina in observation group were less than the control group （P〈0.05）. After the treatment, the levels of TC, TG, LDL-C of both groups were decreased, while observation group is lower than the control group （P〈0.01）. The level of HDL-C of two groups was increased, while the observation group was higher than control group （P〈0.01）. The levels of TXB2, ET-1 and ET-1/NO ratio were declined after the treatment, while the observation group are lower than the control group （P〈0.01）. The levels of NO and 6-Keto-PGF1a were increased after the treatment, while the observation group was higher than control group （P〈0.01）. The improvement of FMD in observation group is better than that of control group （P〈0.01）. Conclusion： Baihua Danshen decoction can improve angina pectoris of patients with CHD and regulate fat metabolism. Its mechanism may be related to adjust the imbalance of ET/NO and TXB2/6-Keto-PGF1a state and improve vascular endothelial function of patients with CHD.