瓜蒌薤白半夏汤治疗冠状动脉粥样硬化性心脏病心绞痛疗效观察

Therapeutic effect Observation on Gualou Xiebai Banxia Decoction in Treatment of Coronary Heart Disease Angina Pectoris

目的:观察瓜蒌薤白半夏汤治疗冠状动脉粥样硬化性心脏病心绞痛患者的临床疗效,以及对患者血清中趋化因子CXC配体5(chemokine CXC ligand 5,CXCL5)表达的影响。方法:将100例冠状动脉粥样硬化性心脏病心绞痛患者按随机数表法分为对照组和观察组,每组50例。对照组患者采用西医常规治疗:阿司匹林100 mg,每天1次;瑞舒伐他汀20 mg,氯吡格雷75 mg,每晚1次;美托洛尔12. 5 mg,每天2次;单硝酸异山梨酯20 mg,每天2次;观察组患者采用西医常规治疗联合瓜蒌薤白半夏汤(瓜蒌15 g,薤白15 g,半夏15 g,枳实10 g,丹参15 g,黄芪15 g,陈皮10 g,茯苓20 g,当归15 g,大枣5个,生姜3片)治疗,4周为1个疗程。观察两组患者治疗前后血清CXCL5含量、中医证候评分和不良反应发生情况,并评价心绞痛疗效和心电图疗效。结果:两组患者经过治疗后,血清CXCL5含量均减低,观察组CXCL5含量低于对照组,差异有统计学意义(P <0. 05);两组患者经过治疗中医证候评分均减低,观察组评分低于对照组,差异有统计学意义(P <0. 05);观察组心绞痛有效率为94. 00%,高于对照组的78. 00%,差异有统计学意义(P <0. 05);观察组心电图有效率为88. 00%,高于对照组的72. 00%,差异有统计学意义(P <0. 05)。结论:采用瓜蒌薤白半夏汤治疗冠状动脉粥样硬化性心脏病临床疗效显著,其作用机制可能是通过降低血清中CXCL5的表达,抑制炎症反应。

Objective ：To observe the clinical efficacy of Gualoubai Banxia Decoction in treatment of patients with coronary heart disease angina pectoris and the expression of chemokine CXC ligand 5 （ CXCL5 ） in serum. Methods ： 100 patients with angina pectoris of coronary atherosclerotic heart disease were divided into control group and observation group according to random number table ,with 50 cases in each group. Patients in the control group were treated with western medicine：aspirin 100 mg once daily;rosuvastatin 20 mg and clopidogrel 75 mg once every evening;metoprolol 12.5 mg twice daily;isosorbide mononitrate 20 mg 2 times a day. The observation group patients were treated with Gualou Xiebai Banxia Decoction （Fructus Trichosanthis 15 g, Allium macrostemon 15 g,Pinellia 15 g,Medlar 10 g,Salvia 15 g,Astragalus 15 g,dried Tangerine peel 10 g,Poria cocos 20 g,Angelica 15 g, 5 Fructus Ziziphi Jujubae and 3 slices of ginger）. Four weeks was one course of treatment, Serum CXCL5 levels, TCM syndrome scores and adverse reactions in both groups were observed before and after treatment. The efficacy of angina pectoris and electrocardiogram were evaluated. Results ： After treatment, the serum CXCL5 levels were decreased in the two groups. The CXCL5 content in the observation group was significantly lower than that in the control group （P 〈 0.05 ）. The scores of the TCM syndromes in the two groups were reduced. The difference was statistically significant （P 〈 0.05）. The effective rate was 94.00% in the observation group and that was 78.00% in the control group. The difference was statistically significant （ P 〈 0.05 ）. The effective rate of electrocardiogram in the observation group was 88.00% ,which was significantly higher than that （72.00%） of the control group （ P 〈 0.05 ）. Conclusion ： The clinical efficacy of Gualou Xiebai Banxia Decoction in treatment of coronary heart disease coronary heart disease is significant. The mechanism may be related to the reduced expression of chemokine CXC ligand 5 in serum and inhibiting of the inflammatory response.