心脑通络液治疗气虚血瘀型冠心病合并颈动脉粥样硬化的临床疗效及对患者血管内皮细胞功能与血栓素B2、丙二醛、超氧化物歧化酶水平的影响

Effect of Xinnao Tongluo liquid on Qi deficiency and Blood stasis type coronary heart disease complicated with carotid atherosclerosis and its effect on vascular endothelial cell function

目的观察心脑通络液对气虚血瘀型冠心病合并颈动脉粥样硬化的临床疗效及对患者血管内皮细胞功能与血栓素B2(TXB2)、丙二醛(MDA)、超氧化物歧化酶水平(SOD)的影响。方法将84例冠心病合并颈动脉粥样硬化患者按照随机数字表法分为2组。对照组42例予西医常规心血管病二级预防治疗;治疗组42例在对照组基础上加用心脑通络液治疗。2组均治疗30 d为1个疗程,治疗3个疗程后统计疗效。观察比较2组治疗前后内皮素1(ET-1)、TXB2、可溶性细胞间黏附分子-1(s ICAM-1)、可溶性血管细胞黏附分子-1(s VCAM-1)、MDA、SOD及一氧化氮(NO)水平变化情况,比较2组治疗前后颈动脉中层内膜厚度(IMT)值及斑块Crouse积分变化情况。结果治疗组总有效率90.48%,对照组总有效率71.40%,治疗组疗效优于对照组(P<0.05);与本组治疗前比较,2组治疗后ET-1、TXB2、s ICAM-1、s VCAM-1及MDA水平均降低(P<0.05),SOD及NO水平均升高(P<0.05),且治疗组治疗后各指标改善均优于对照组(P<0.05);2组治疗后颈动脉IMT值及斑块Crouse积分与本组治疗前比较均降低,但仅斑块Crouse积分比较差异有统计学意义(P<0.05),且治疗后治疗组斑块Crouse积分低于对照组(P<0.05)。结论心脑通络液治疗气虚血瘀型冠心病合并颈动脉粥样硬化临床疗效确切,可明显改善患者临床症状,改善血管内皮细胞功能,抑制动脉粥样硬化斑块形成,提高临床疗效。

Objective To observe the clinical effects of Xinnao Tongluo liquid on Qi deficiency and Blood stasis type coronary heart disease complicated with carotid atherosclerosis and its effect on vascular endothelial cell function and thromboxane B2（TXB2）、malondialedhyde（MDA）,superoxide dismutase（SOD）.Methods 84 patients with coronary heart disease complicated with carotid atherosclerosis were divided into two groups according to the random number table.42 cases in control group were treated by conventional western medicine secondary prevention and42 cases in treatment group were treated by Xinnao Tongluo liquid on the basis of the control group.The 2 groups were treated for 30 d for 1 course.After 3 courses of treatment,the curative effect was statistically analyzed.The levels of endothelin-1（ET-1）intercellular adhesion molecule-1（s ICAM-1）,soluble vascular cell adhesion molecule-1（s VCAM-1）,MDA,SOD and nitric oxide（NO）were compared before and after treatment in the two groups.The carotid intima-media thickness（IMT）and plaque Crouse scores were compared before and after treatment.Results The total effective rate was 90.48%in treatment group and 71.4%in control group.The clinical curative effect of the treatment group was better than that of the control group（P〈0. 05）.Compared with the group before treatment,the levels of ET-1,TXB2,s ICAM-1,s VCAM-1 and MDA decreased after treatment（P〈0. 05）,SOD and NO levels increased（P〈0. 05）,and the improvement of each index in treatment group after treatment was better than that of the control group（P〈0. 05）.The carotid IMT values and plaque Crouse scores in the two groups were reduced compared with those in the group before treatment,but only the plaque Crouse scores were statistically significant（P〈0. 05）,and the plaque Crouse scores in the treatment group after treatment was lower than of the control group（P〈0. 05）.Conclusion Xinnao Tongluo liquid has definite clinical effects on coronary heart disease with Qi deficiency and blood stasis type complicated with carotid atherosclerosis.It can obviously improve the clinical symptoms of patients,improve the function of vascular endothelial cells,inhibit the formation of atherosclerotic plaques,and improve the clinical efficacy.