稳斑汤联合体外反搏治疗冠心病PCI术后患者的临床疗效及对血清VEGF和Ang Ⅱ的影响

Clinical Effect of Wenban Decoction Combined with External Counterpulsation in the Treatment of PCI Postoperative Patients with Coronary Heart Disease and Its Influence on the Serum VEGF and Ang Ⅱ

目的:观察稳斑汤联合体外反搏治疗经皮冠脉介入术后冠心病患者的临床疗效及对VEGF和AngⅡ血清水平的影响,并探讨其作用机制。方法:选取60例经皮冠脉介入术后冠心病(辨证为痰瘀互结型)患者,随机分为常规治疗组(采用常规西药加稳斑汤治疗)和体外反搏组(在常规治疗组基础上加用体外反搏治疗),每组30例,4周为1个疗程。分别于治疗前及治疗4周后评价两组患者的中医证侯积分、临床疗效、心绞痛症状积分,采用ELISA检测两组患者VEGF和AngⅡ水平。结果:疗程结束后,两组患者中医证候积分、心绞痛症状积分较治疗前显著降低(P<0.05),VEGF水平显著升高,AngⅡ水平显著降低(P<0.01);体外反搏组患者治疗后中医证候积分、心绞痛症状积分显著低于常规治疗组,VEGF水平显著高于对照组,AngⅡ水平显著低于对照组,差异具有统计学意义(P<0.05)。结论:稳斑汤联合体外反搏治疗能有效改善冠心病(辨证为痰瘀互结型)PCI术后患者的临床症状及中医证候,其作用机制可能与提高VEGF水平、下调AngⅡ水平有关。

Objective:To observe the clinical effect of Wenban Decoction combined with Enhanced external counterpulsation in the treatment of Percutaneous coronary intervention(PCI)Postoperative Patients with coronary heart disease and its influence on the serum levels of VEGF and AngⅡ,and discuss its mechanism.Methods:60 patients with PCI postoperative patients with coronary heart disease were randomly divided into Conventional treatment group(treated with basic treatment of Western Medicine and Wenban Decoction),and Enhanced external counterpulsation group(added with external counterpulsation on the basis of the control group treatment plan),30 cases in each group,treatment for 4 weeks is a course of treatment.Two groups of subjects were respectively before treatment and after treatment for 4 weeks,according to Case Report Form to assess angina symptoms integral,angina pectoris curative effect,TCM syndrome integral,TCM syndrome curative effect.The content of VEGF and AngⅡin serum of each group was detected by ELISA,and the statistical analysis of the above data was performed by SPSS18.0.Results:After the course of treatment,compared with pretreatment:the conventional treatment group’s angina symptom score was decreased(P<0.05),Control angina pectoris symptom integral reduced(P<0.05),TCM syndrome integral significantly reduced,the serum level of VEGF was significantly increased,the serum level of AngⅡ was significantly decreased(P<0.01);Compared with before treatment,enhanced external counterpulsation group angina symptoms,TCM syndrome integral were significantly lower,the serum level of VEGF was significantly increased,the serum level of AngⅡ was significantly decreased(P<0.01);Comparison between groups:compared with conventional treatment group,enhanced external counterpulsation group was significantly reduce the score of angina symptoms,TCM syndrome points was significantly increased,the serum level of VEGF was significantly increased,the serum level of AngⅡ was significantly decreased(P<0.01),TCM syndrome score was reduced,TCM syndrome curative effect was increased(P<0.05).Conclusion:Wenban Decoction combined with External Counterpulsation therapy are more effective in the treating PCI postoperative patients with CHD,the mechanism of its action may be related to the increase the serum level of VEGF and the decrease the serum level of AngⅡ.