氯雷他定联合益气健脾活血方对冠状动脉粥样硬化血管造影过敏反应的临床研究

Effects of Yiqijianpihuoxue prescription combined with loratadine on anaphylaxis during coronary atherosclerotic angiography

目的通过探究氯雷他定联合益气健脾活血方对冠状动脉粥样硬化血管造影中过敏反应的影响,评价两药联合治疗的有效性及安全性。方法选取2017年1月至2019年2月就诊的150例诊断为冠状动脉粥样硬化的无症状性患者,采用随机数字表法将患者分为3组,每组50例。对照组进行碘过敏试验,不用相关抗过敏性药物;苯海拉明组予常规碘过敏实验,并于造影术前30 min予苯海拉明注射液20 mg肌内注射液或盐酸苯海拉明片口服;联合组予常规碘过敏实验,术前3 d予益气健脾活血方连续口服7 d联合造影术前30 min口服氯雷他定片10 mg。于术后分别观察3组患者的白细胞介素-4(IL-4)和肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、蛋白酶、脂肪酶和组胺酶,以及临床疗效、不良反应发生情况。结果术后苯海拉明组、联合组IL-4、TNF-α、CRP均低于本组治疗前及对照组治疗后(P<0.05)。术后苯海拉明组、联合组蛋白酶、脂肪酶、组胺酶水平均较本组治疗前升高(P<0.05),且术后联合组蛋白酶、脂肪酶、组胺酶水平高于苯海拉明组治疗后(P<0.05)。术后苯海拉明组、联合组临床疗效及不良反应发生率明显优于对照组,差异有统计学意义(P<0.05),且联合组临床疗效及不良反应发生率的水平明显优于苯海拉明组,差异有统计学意义(P<0.05)。结论氯雷他定联合益气健脾活血方可有效的改善患者的过敏症状,提高临床疗效及安全性系数,为患者及其家庭以及社会的可持续发展提供健康保障,为中医药事业的发展助力,且试验证明中西医结合能进一步改善患者的症状体征,值得在临床中进一步推广应用。

Objective To investigate the effects of Yiqijianpihuoxue prescription combined with loratadine on anaphylaxis during coronary atherosclerotic angiography,and to explore the effectivity and safety of two drug combination therapy.Methods A total of 174 patients with coronary atherosclerosis without clinical symptoms who were treated in our hospital from April 2015 to December 2016 were enrolled in the study,who were divided into three groups according to random number table method,with 50 cases in each group.The patientss in control group underwent iodine allergy test,without application of anti-allergic drugs,and the patients in diphenhydramine group underwent routine iodine allergy test,who were given oral diphenhydramine hydrochloride tablets 25mg or intramuscular injection(20mg)at half an hour before the surgery,moreover,the patients in combination group underwent routine iodine allergy test,who were given Yiqijianpihuoxue prescription for 7 days,and loratadine tablets 10mg at 30 minutes before the operation.After the operation,the expression levels of interleukin 4(IL-4),tumor necrosis factor alpha(TNF-alpha),C-reactive protein(CRP)and histamine enzyme as well as clinical curative effects and incidence of adverse reactions were observed and compared among the three groups.Results After the operation,the expression levels of IL-4,TNF-alpha,CRP in diphenhydramine group and combination group were significantly lower than those before treatment and those in control group after treatment(P<0.05).However the levels of prolease,lipidase and histaminase in diphenhydramine group and combination group were significantly higher than those before treatment,moreover,which in combination group were significantly higher than those in diphenhydramine group after treatment(P<0.05).In addition,after operation the therapeutic effects and incidence of adverse reactions in diphenhydramine group and combination group were superior to those in control group(P<0.05),moreover,which in combination group were significantly better than those in diphenhydramine group(P<0.05).Conclusion Yiqijianpihuoxue prescription combined with loratadine can effectively improve the patient’s allergic symptoms,improve the clinical curative effects and safety coefficient,therefor,it is worthy of further popularization and application in clinical practice.