前列地尔联合通脉颗粒治疗不稳定型心绞痛的疗效及其血清IL-6、hs-CRP的变化分析

Curative efficacy of Alprostadil combined with Tongmai particles in treatment of unstable angina pectoris and its effects on carotid atherosclerotic plaque,IL-6 and hs-CRP

目的 探讨前列地尔联合通脉颗粒治疗不稳定型心绞痛的疗效及其血清IL-6、hs-CRP的变化。方法 选择2016年1月至12月我院接诊的不稳定型心绞痛老年患者84例，按抛硬币法随机分为观察组和对照组，各42例。对照组患者进行常规治疗，观察组在其基础上加以前列地尔联合通脉颗粒进行治疗。治疗2周后，对比两组血脂、血液流变学、治疗效果、颈动脉粥样硬化斑块情况、血清白细胞介素-6（IL-6）及高敏C反应蛋白（hs-CRP）水平。结果 治疗后，观察组纤维蛋白原（Fbg）、三酰甘油（TG）及血清总胆固醇（TC）水平均低于对照组[（3.55±1.36）g/L vs（4.15±1.24）g/L，（1.23±0.22）mmol/L vs（1.97±0.68）mmol/L，（5.25±0.82）mmol/L vs（6.23±0.96）mmol/L] （P＜0.05）；观察组总有效率高于对照组[95.24%（40/42）vs 78.57%（33/42）] （P＜0.05）；观察组患者颈动脉粥样硬化斑块的数量、大小、厚度及颈动脉内膜中层厚度（IMT）均低于对照组[（3.02±0.84）个vs（3.55±0.93）个，（0.05±0.04）cm2 vs（0.07±0.03）cm2，（1.78±0.49）mm vs（2.05±0.42）mm，（1.22±0.58）mm vs（1.62±0.68）mm] （P＜0.05）；观察组血清IL-6、hs-CRP水平均低于对照组[（3.25±2.95）pg/L vs（5.56±3.31）pg/L，（6.35±2.88）mg/L vs（9.24±3.02）mg/L] （P＜0.05）。结论前列地尔联合通脉颗粒治疗不稳定型心绞痛可有效调节血脂，并改善患者颈动脉粥样硬化斑块情况，同时降低血清IL-6、hs-CRP水平，减少炎症反应，在治疗中具有阻断和逆转作用，疗效确切，值得推广应用。

Objective To study Curative efficacy of Alprostadil combined with Tongmai particles in treat- ment of unstable angina peetoris and its effects on carotid atherosclerotic plaque, IL-6 and hs-CRP. Methods 84 patients of unstable angina pectoris who received therapy from Jan 2016 to Dec 2016 in our hospital were selected. All the patients were randomly divided into observation group and control group, each 42 cases. The control group was treated with conventional treatment, while the observation group was treated with Alprostadil combined with Tongmai particles on this basis, 10 p±g of Alprostadil was instilled with 250 ml of 10% glucose injection, and T0 mg of Tongmai Granule was administered for treatment. After 2 weeks of treatment, the blood lipids, hemorheology, treatment, carotid atherosclerotic plaque, the level of IL-6 and hs-CRP were compared. Results After treatment, the levels of fibrinogen（Fbg）, triglyceride（TG） and serum total cholesterol（TC ） in the observation group were lower than those in the control group [（3.55±1.36）g/L vs. （4.15±1.24）g/L, （1.23±0.22）mmol/L vs. （1.97±0.68） mmol/L, （5.25±0.82）mmol/L vs. （6.23±0.96）mmol/L]（P〈0.05）. The total effective rate of the observation group was higher than that of the control group [95.24%（40/42） vs. 78.57% （33/42）] （P〈0.05）. The number, size, thickness and carotid intima-media thickness （IMT） of carotid atherosclerotic plaques in the observation group were lower than those in the control group[ （3.02±0.84）piece vs. （3.55±0.93）piece, （0.05±0.04）cm2 vs. （0.07±0.03）cm2, （ 1.78±0.49 ）ram vs. （2.05±0.42）mm, （ 1.22±0.58 ）mm vs. （ 1.62±0.68 ）mm ] （P〈0.05）. The levels of serum IL-6 and hs-CRP in the observation group were lower than those in the control group[ （3.25±2.95）pg/L vs. （5.56±3.31） pg/L, （6.35±2.88）mg/L vs. （9.24±3.02）mg/L]（P〈0.05）. Conclusion Alprostadil combined with Tongmai parti- cles treatment of unstable angina can effectively regulate blood lipids, and improve patients with carotid atheroscle- rotie plaque, while reducing serum IL-6, hs-CRP levels, reduce the inflammatory response, in the treatment of blocking and reversal effect, effective and worthy of promotion and application.