化痰活血颗粒对急性冠脉综合征痰瘀互结患者炎症凝血因子的干预研究

Intervention of Huatan Huoxue Decoction on Acute Coronary Syndrome Patients of Phlegm and Blood Stasis with Inflammatory Phlegm Coagulation Factors

目的从炎症凝血角度探讨化痰活血颗粒对冠心病急性冠脉综合征(ACS)痰瘀互结证的相关作用机制。方法将100例ACS痰瘀互结证患者按随机数字表法分为对照组和观察组。对照组参照指南给予抗血小板、抗凝、调脂治疗和抗心肌缺血治疗等,观察组西医治疗同对照组,并加用化痰活血颗粒,每日2次,疗程4周。分别于第1天和第31天抽血检测高敏C反应蛋白(hs-CRP)、P选择素(PS)和纤维蛋白原(FIB)水平,同时分别评估治疗前后中医症状体征积分。结果治疗4周后,两组hs-CRP、PS、FIB水平均比治疗前明显下降(P<0.05),观察组下降幅度比对照组更为显著(P<0.05);两组中医症状积分在治疗后,均比治疗前明显下降(P<0.05),观察组下降幅度比对照组更为显著(P<0.05)。结论化痰活血颗粒治疗急性冠脉综合征痰瘀互结证患者,能降低hs-CRP、PS、FIB水平,可能是其发挥抗炎、抗血小板作用、稳定斑块的重要机制之一,同时可以减轻临床心肌缺血症状,有助于改善患者预后。

Objective： To investigate the effect of Huatan Huoxue Decoction on acute coronary syndrome （ACS） of phlegm and blood stasis from the perspective of the inflammation coagulation mechanism. Methods： 100 pa- tients with ACS diagnosed phlegm and blood stasis syndrome were randomly divided into the control group and the observation group. The control group, according to the guidelines,were given antiplatelet and anticoagulation, lipid-lowering therapy and anti-myocardial ischemia treatment,while the observation group was added Western medicine treatment combined with Huatan Huoxue Decoction,2 times/ day for 4 weeks. Respectively on 1st day and 31st day,blood was drawn to test high sensitive C reactive protein（hs-CRP）,p-selectin（PS） and fibrinogen （FIB）. At the same time,TCM symptoms and signs were assessed before and after treatment. Results： 4 weeks after treatment,hs-CRP,PS and FIB levels in both groups dropped compared with those before treatment （P 〈 0.05）;the observation group declined more significantly than the control group （P〈0.05）;TCM symptom scores of the two groups, compared with those before treatment, decreased significantly （P〈 0.05）;the observation group de- clined more significantly than the control group（P〈 0.05）. Conclusion： Huatan Huoxue Decoction on acute coro- nary syndrome of phlegm and blood stasis syndrome can reduce hs-CRP,PS and FIB level,which is one of the important mechanisms of anti-inflammatory and antiplatelet effect,stable plaque. Meanwhile,it can relieve the clinical symptoms of myocardial ischemia,helpful to improve the prognosis of the patients.