三九穴位贴敷治疗慢性稳定性劳力型心绞痛心肾阳虚证的疗效观察及对血管内皮功能和心功能指标的影响

Clinical effect of Sanjiu acupoint application for coronary heart disease of chronic stable angina pectoris with heart-kidney yang deficiency and its effect on function indexes of vascular endothelial cell and cardiac

目的观察三九穴位贴敷治疗慢性稳定性劳力型心绞痛心肾阳虚证的临床疗效及对血管内皮功能和心功能指标的影响。方法将80例慢性稳定性劳力型心绞痛心肾阳虚证患者按照随机数字表法分为2组。对照组40例予西医常规治疗,治疗组40例在对照组治疗基础上行三九穴位贴敷治疗。2组均治疗4周。比较2组治疗前后心功能指标[左室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、加速指数(ACI)]、血管内皮细胞功能指标[6-酮-前列腺素F 1α(6-keto-PGF 1α)、内皮素(ET)、血栓素B 2(TXB 2)],并统计2组临床疗效及心电图疗效。结果治疗组临床总有效率95.0%(38/40),对照组临床总有效率77.5%(31/40),治疗组临床疗效优于对照组(P<0.05)。治疗组心电图总有效率90.0%(36/40),对照组心电图总有效率70.0%(28/40),治疗组心电图疗效优于对照组(P<0.05)。治疗后2组LVEF、SV、CO、ACI均较本组治疗前升高(P<0.05),且治疗后治疗组均高于对照组(P<0.05)。治疗后2组6-keto-PGF 1α水平均较本组治疗前升高(P<0.05),ET、TXB 2水平均降低(P<0.05),且治疗后治疗组6-keto-PGF 1α水平高于对照组(P<0.05),ET、TXB 2水平均低于对照组(P<0.05)。结论三九穴位贴敷治疗慢性稳定性劳力型心绞痛心肾阳虚证,可改善患者血管内皮功能,并提升其心功能,其作用机制可能是通过调节ET、6-keto-PGF 1α和TXB 2表达水平,保护缺血心肌内皮细胞,抑制血小板聚集与血栓的形成。

Objective To investigate the clinical effect of Sanjiu acupoint application for coronary heart disease(CHD)of chronic stable angina pectoris with heart-kidney yang deficiency and its effect on function indexes of vascular endothelial cell and cardiac.Methods Totally 80 CHD patients with chronic stable angina pectoris(TCM heart-kidney yang deficiency)were selected and randomly divided into two groups,40 patients in control group were treated with routine western medicine,and 40 patients in treatment group were additionally treated with Sanjiu acupoint application on the basis of control group.Treated continuously for 4 weeks,aiming to observe cardiac function indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),acceleration index(ACI)],vascular endothelial cell function indexes[6-keto-prostaglandin F 1α(6-keto-PGF 1α),endothelin(ET),thrombus B 2(TXB 2)],and count the clinical efficacy and electrocardiogram(ECG)efficacy between groups.Results The total effective rates in treatment group were significantly higher than in control group[95.0%(38/40)vs 77.5%(31/40),(P<0.05),respectively].The total effective rate of ECG in treatment group was significantly higher than in control group[90.0%(36/40)vs 70.0%(28/40),(P<0.05),respectively].After treatment,elevated LVEF,SV,CO,and ACI in groups were detected,and treatment group were significantly higher than control group(P<0.05);upward 6-keto-PGF 1αlevel in groups was found,and treatment group was significantly higher than control group(P<0.05);reduced ET,TXB 2 in groups were counted,and treatment group were significantly lower than control group(P<0.05).Conclusion For CHD patients with chronic stable exertional angina pectoris(TCM heart-kidney yang deficiency),Sanjiu acupoint application can improve its cardiac function;which may be protect endothelial cells and inhibit platelet aggregation and thrombus formation through the regulation of ET,6-keto-PGFlαand TXB2 expression level.