化瘀祛痰解毒方治疗不稳定性心绞痛的临床疗效及对患者血清基质金属蛋白酶9和核转录因子κB的影响

Clinical effect of Huayu Qutan Jiedu decoction on unstable angina pectoris and its effect on serum matrix metalloproteinase 9 and nuclear factor κB

目的观察化瘀祛痰解毒方治疗不稳定性心绞痛(UAP)的临床疗效及对患者血清基质金属蛋白酶9(MMP-9)和核转录因子κB(NF-κB)的影响。方法将60例UAP患者按照随机数字表法分为2组。对照组30例予常规西药治疗;治疗组30例在对照组治疗基础上加化瘀祛痰解毒方治疗。2组均连续治疗4周。比较2组心绞痛疗效、心电图疗效;观察2组治疗前后中医证候积分变化;比较2组治疗前后血清MMP-9、NF-κB水平变化。结果治疗组心绞痛总有效率83.3%,对照组总有效率70.0%,治疗组心绞痛疗效优于对照组(P<0.05)。治疗组心电图总有效率60.0%,对照组总有效率56.7%,2组心电图疗效相当(P> 0.05)。治疗组治疗后中医证候各项积分及总积分均较本组治疗前降低(P<0.05),对照组治疗后胸闷、胸痛、气短喘促积分及总积分均较本组治疗前降低(P<0.05);治疗后治疗组中医证候各项积分及总积分均低于对照组(P<0.05)。2组治疗后血清MMP-9、NF-κB均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论化瘀祛痰解毒方治疗UAP有良好的临床疗效,可缓解中医证候,降低血清MMP-9、NF-κB水平,治疗作用可能与化瘀祛痰解毒方抑制炎症反应、保护血管内皮、稳定斑块等机制有关。

Objective To observe the effects of Huayu Qutan Jiedu decoction on unstable angina pectoris （UAP） and its effect on serum matrix metalloproteinase 9 （MMP-9） and nuclear factor κB （NF-κB）. Methods 60 patients with UAP were randomly divided into two groups according to the random number table method. 30 cases in control group were treated by basic treatment of Western medicine, and 30 cases in treatment group were treated by Huayu Qutan Jiedu decoction on the basis of control group. Both groups were treated continuously for 4 weeks. The curative effect and electrocardiogram（ECG） efficacy of the two groups were compared. The changes of TCM syndrome scores before and after treatment were observed. The serum MMP-9 and NF-κB were compared before and after treatment. Results The total effective rate was 83.3 % in the treatment group and 70.0% in the control group. The curative effect of angina pectoris in the treatment group was better than that in the control group （ P 〈 0.05 ）. The total effective rate was 60.0 % in the treatment group and 56.7% in the control group.There was no significant difference in ECG effect between the two groups（ P 〉0.05）. After treatment, the each item scores and total scores of TCM syndromes in the treatment group were lower than those in the group before treatment （ P 〈0.05）. After treatment, the scores of chest tightness, chest pain, shortness of breath, and total scores of the control group were lower than those before treatment （ P 〈0.05）. After treatment, the each item scores and total scores of TCM syndromes in the treatment group were lower than those in the control group （ P 〈0.05）. The serum MMP-9 and NF-κB were significantly lower in the two groups than before treatment （ P 〈0.05）, and the treatment group was significantly lower （ P 〈0.05）. Conclusion Huayu Qutan Jiedu decoction has a good clinical effect in the treatment of UAP, which can alleviate TCM syndromes and reduce the levels of serum MMP-9 and NF-κB. The therapeutic effect may be related to the mechanism of Huayu Qutan Jiedu decoction inhibiting inflammatory reaction, protecting vascular endothelium and stabilizing plaque.