活血化瘀养心通络方联合替格瑞洛治疗冠心病经皮冠状动脉介入术术后心绞痛的临床疗效及对血管内皮功能及炎症因子的影响

Effect of Huoxue Huayu Yangxin Tongluo Recipe Combined with Tigerol in Treatment of Angina Pectoris after PCI and Its Effect on Vascular Endothelial Function and Inflammatory Factors

目的观察活血化瘀养心通络方联合替格瑞洛治疗冠心病行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后心绞痛的临床疗效及对血管内皮功能、炎性因子的影响。方法选取100例来医院心内科就诊的冠心病PCI术后心绞痛患者,随机分为两组,每组50例。两组患者术后给予常规治疗,对照组在常规治疗的基础上口服替格瑞洛片,观察组在对照组的基础上加以活血化瘀养心通络方,两组连续治疗3个疗程。比较两组患者治疗前后中医症候积分、每周心绞痛发作次数、疼痛持续时间、硝酸甘油日消耗量、心功能指标、血管内皮指标、相关炎性因子及生活质量;比较两组的心电图疗效及心绞痛疗效。结果治疗后观察组患者心绞痛疗效、心电图疗效均明显高于对照组(P<0.05);观察组的每周心绞痛发作次数、疼痛持续时间及硝酸甘油日消耗量显著少于对照组(P<0.05);观察组主症、次症积分均显著低于对照组(P<0.05)。治疗后观察组患者SV、EF及血清IL-10、NO及VEGF水平均显著高于对照组(P<0.05),hs-CRP、IL-6及ET-1水平显著低于对照组(P<0.05);观察组患者西雅图心绞痛调查量表(SAQ)各项积分均显著低于对照组(P<0.05)。观察组MACE发生率明显较对照组低(P<0.05)。结论活血化瘀养心通络方联合替格瑞洛治疗冠心病PCI术后心绞痛疗效确切,可有效降低机体炎症反应及改善血管内皮功能,值得临床推广。

Objective To observe the clinical effect of Huoxue Huayu Yangxin Tongluo Recipe combined with tigerol in the treatment of angina pectoris after percutaneous coronary intervention(PCI) for coronary heart disease(CAD) and the effect on vascular endothelial function and inflammatory factors. Methods A total of 100 patients with angina pectoris after PCI were randomly divided into two groups, 50 patients in each group. Both groups were treated with PCI and given routine treatment after operation. The control group was treated with Tegrilol Tablets on the basis of routine treatment, and the observation group was treated with Huoxue Huayu Yangxin Tongluo Recipe on the basis of the control group. The two groups were treated for three consecutive courses. We compared TCM syndrome score, weekly angina pectoris attack times, pain duration, nitroglycerin daily consumption, cardiac function index, vascular endothelial index, related inflammatory factors and quality of life before and after treatment. And the curative effect of electrocardiogram and angina pectoris were compared between the two groups. Results After treatment, the curative effect of angina pectoris and electrocardiogram in the observation group was significantly higher than that in the control group(P<0.05).The frequency of angina pectoris attack per week, the duration of pain and the daily consumption of nitroglycerin in the observation group were significantly lower than those in the control group(P<0.05), and the scores of the main symptoms and secondary syndromes in the observation group were significantly lower than those in the control group(P<0.05). The observation group’s levels of SV and EF and serum levels of IL-10,NO and VEGF were significantly higher than those of the control group. The levels of hs-CRP, IL-6 and ET-1 were significantly lower than those of the control group, and the SAQ scores of the Seattle angina Pectoris Survey scale in the observation group were significantly lower than those in the control group. The incidence of MACE in the observation group was significantly lower than that in the control group. Conclusion Huoxue Huayu Yangxin Tongluo Recipe combined with tigerol is effective in the treatment of angina pectoris after PCI in coronary heart disease. It can effectively reduce inflammatory reaction and improve vascular endothelial function.