热敏灸联合活血化瘀解毒方对冠心病心绞痛病人血清瘦素、C-反应蛋白及肿瘤坏死因子-α的影响

The Inluence of Heat-sensitive Moxibustion Combined with Huoxue Huayu Jiedu Decoction on Serum Leptin,C-reactive Protein and TNF in Patients with Angina Pectoris

目的探讨热敏灸联合活血化瘀解毒方对冠心病心绞痛病人血清瘦素(LP)、C-反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)的影响。方法选择2016年2月—2017年4月我院收治的90例冠心病心绞痛血瘀阻证病人为研究对象,按照随机数字表法分为对照组(45例)和观察组(45例)。在西医常规治疗基础上,对照组给予热敏灸治疗,观察组给予热敏灸联合活血化瘀解毒方治疗。2周后观察两组病人的临床疗效、中医证候积分,比较血浆黏度(PV)、全血黏度(WBV)、红细胞聚集指数(AI)及血细胞比容(HCT)等血液流变学指标和治疗后LP、CRP及TNF-α水平。结果治疗2周后观察组总有效率为93.33%,显著高于对照组的75.56%,差异有统计学意义(χ~2=5.414,P=0.020)。治疗后观察组胸痛、胸闷、心悸和舌苔证候积分均低于对照组,差异有统计学意义(P<0.05);观察组的PV、WBV、AI及HCT均显著低于对照组,差异有统计学意义(P<0.05);观察组血清LP、CRP和TNF-α因子水平均显著低于对照组,差异有统计学意义(P<0.05)。结论在西医常规治疗基础上以热敏灸联合活血化瘀解毒方可提高冠心病心绞痛血瘀阻证的临床疗效,降低中医证候积分,改善血液流变学指标,减轻炎症反应。

Objective To investigate the effects of heat-sensitive moxibustion and Huoxue Huayu Jiedu decoction（ HHJD） on serum leptin,Creactive protein（ CRP） and tumor necrosis factor（ TNF-α） in patients with angina pectoris.Methods Ninety patients with angina pectoris and blood stasis syndrome from February 2016 to April 2017 were randomly divided into two groups： control group（ n =45） treated with heat-sensitive moxibustion,and treatment group（ n = 45） treated with heat-sensitive moxibustion and HHJD in the basis of routine treatment for 2 weeks.After 2 weeks,the clinical efficacy and traditional Chinese medicine（ TCM） scores were observed.The blood rheology indexes and plasma viscosity（ PV）,whole blood viscosity（ WBV）,erythrocyte aggregation index（ RCAI） and hematocrit（ RCPP） were compared.Serum leptin,CRP and TNF-α levels were measured.Results The total effective rate was significantly higher in the treatment group than that in the control group（ 93.33% vs 75.57%,χ^2= 5.414,P = 0.020）.The scores of chest pain,chest tightness,palpitations and tongue coating were lower in the observation group than that in the control group（ P〈0.05）.The PV,WBV,RCAI and RCPP in the observation group were significantly lower than that in control group（ P〈0.05）.The levels of serum leptin,CRP and TNF-α in the observation group were significantly lower than those in the control group（ P〈0.05）.Conclusion Heat-sensitive moxibustion and HHJD can improve the clinical efficacy,reduce TCM symptom scores,improve blood rheology index and reduce inflammation in.patients with angina pectoris and blood stasis syndrome.