心脉通贴散穴位贴敷联合西药治疗冠心病不稳定型心绞痛40例临床观察

Clinical Observation on Acupoint Sticking Xinmaitong Plaster(心脉通贴散) Combined with Western Medicine Treating Unstable Angina Pectoris of Coronary Heart Disease Patients

目的观察心脉通贴散穴位贴敷联合西药治疗冠心病不稳定型心绞痛的临床疗效。方法 80例冠心病不稳定型心绞痛患者随机分为对照组和治疗组各40例,两组均采用常规西药治疗,治疗组加用心脉通贴散穴位贴敷,每日1次,每次30 min,两组疗程共8周。观察心绞痛疗效及中医证候疗效,比较治疗前后心肌缺血总负荷(TIB)及血清高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)和基质金属蛋白酶9(MMP-9)的水平,并采用西雅图心绞痛量表评价生存质量。结果治疗组中医证候疗效显效率(57.5%)及总有效率(92.5%)高于对照组(P<0.05)。与本组治疗前比较,两组治疗后TIB均明显降低(P<0.05或P<0.01);治疗组治疗后TIB较对照组降低更明显(P<0.05)。与本组治疗前比较,两组治疗后血清hs-CRP和MMP-9水平均有不同程度的降低(P<0.05或P<0.01),治疗组治疗后IL-6也明显降低(P<0.05);与对照组治疗后比较,治疗组治疗后血清hs-CRP和MMP-9水平也明显降低(P<0.05)。两组治疗后生存质量均较治疗前明显提高(P<0.05或P<0.01),治疗组改善的更为明显(P<0.01)。结论心脉通贴散穴位贴敷联合西药治疗冠心病不稳定型心绞痛疗效可靠,且可明显改善心肌供血、降低血清炎症因子水平。

Objective To investigate the clinical effect of acupoint sticking Xinmaitong Plaster （心脉通贴散） on unstable angina pectoris of coronary heart disease patients. Methods 80 cases with unstable angina pectoris of coronary heart disease were randomly divided into control group and treatment group, with 40 cases in each group. Each group was treated with routine western medicine therapy. Treatment group was treated with additional acupoint sticking Xinmaitong Plaster, once a day, 30min/time. The treatment course of both groups last 8 weeks. The clinical therapeutic effect, Seattle angina questionnaire （SAQ）, total myocardial ischemia burden （TIB） and the levels of serum high sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6） and matrix metalloproteinase （MMP-9） were measured before and after treatment, and SAQ was used to assess the quality of life. Results The marked curative rate （57.5%） and the total effective rate （92.5%） of the treatment group was higher than that of the control group in TCM syndrome score (P 〈 0. 05). Compared with before treatment, TIB scale was significantly reduced after treatment in two groups （P 〈0. 05 or P 〈0. 01). Compared with the control group after treatment, that of treatment group was significantly lower （P 〈 0. 05). Compared with before treatment within group, and plasma concentration of hs-CRP and MMP-9 after treatment in the two groups was significantly lower （P 〈 0.05 or P 〈 0. 01), while plasma IL-6 level was reduced after treatment in two groups (P 〈 0. 05 or P 〈 0. 01). Compared with control group after treat-ment, plasma concentration of hs-CRP and MMP-9 was markedly reduced (P 〈 0. 05). The quality of life of two groups were significantly improved after treatment （P 〈 0.05 or P 〈 0.01), and the treatment group was better （P 〈 0. 01). Conclusion Acupoint sticking Xinmaitong Plaster combined with western medicine in the treatment of un-stable angina pectoris of coronary heart disease has reliable curative effect, which can effectively improve myocardial blood supply and reduce serum inflammatory factor levels.