心通口服液联合冠心病二级预防对不稳定型心绞痛疗效及其对脂蛋白、炎性因子、颈动脉斑块稳定性的影响

Effect of Xintong Oral Liquid Combined with Secondary Prevention of Coronary Heart Disease on Unstable Angina Pectoris and its Effect on Lipoprotein,Inflammatory Factors and Carotid Plaque Stability

目的探讨心通口服液联合冠心病二级预防对不稳定型心绞痛的临床疗效及其对脂蛋白、炎性因子、颈动脉斑块稳定性的影响。方法选取睢县中医院2019年3月至2020年6月心血管门诊及病房收治的冠心病不稳定型心绞痛患者100例,采用随机抽签法分为观察组及二级预防组,各50例。二级预防组给予冠心病二级预防治疗,观察组在冠心病二级预防基础上给予通心口服液治疗,两组患者均治疗3个月。观察两组患者治疗前后心绞痛症状积分、临床总有效率及颈动脉斑块稳定性变化,比较两组患者治疗前后血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、中白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)及单核细胞趋化蛋白-1(MCP-1)含量变化。结果观察组临床总有效率及颈动脉斑块稳定性高于二级预防组,差异有统计学意义(P<0.05);与治疗前比较,两组患者心绞痛症状积分、血清LDL-C、hs-CRP、IL-6、TNF-α及MCP-1水平均降低,HDL-C水平均升高,差异有统计学意义(P<0.05);与二级预防组治疗后比较,观察组上述血清指标改善趋势更加明显,差异有统计学意义(P<0.05)。结论心通口服液联合冠心病二级预防可有效增加斑块稳定性,改善心绞痛相关症状,其机制可能与降低炎性因子,改善脂蛋白含量有关。

Objective To investigate the clinical effect of Xintong oral liquid combined with secondary prevention of coronary heart disease on unstable angina pectoris and its effect on lipoprotein,inflammatory factors and carotid plaque stability.Methods 100 patients with unstable angina pectoris of coronary heart disease treated in the cardiovascular outpatient and ward of Sui County Hospital of Traditional Chinese Medicine from March 2019 to June 2020 were selected and randomly divided into observation group and secondary prevention group with 50 patients in each group.The secondary prevention group was given secondary prevention treatment of CHD,and the observation group was given xintong oral liquid treatment on the basis of secondary prevention of CHD.Both groups were treated for 3 months.Angina symptom score,total clinical response rate and carotid plaque stability were observed before and after treatment in 2 groups.The changes of serum high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(HS-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and monocyte chemoattractor protein-1(McP-1)in 2 groups before and after treatment were compared.Results The total clinical response rate and carotid plaque stability in the observation group were higher than those in the secondary prevention group,and the difference was statistically significant(P<0.05).Compared with before treatment,angina symptom score,serum LDL-C,hs-CRP,IL-6,TNF-α and McP-1 levels in 2 groups were decreased,while HDL-C level was increased,the differences were statistically significant(P<0.05).Compared with the secondary prevention group,the improvement trend of above serum indexes in the observation group was more obvious after treatment,and the difference was statistically significant(P<0.05).Conclusion Xintong oral liquid combined with secondary prevention of CORONARY heart disease can effectively increase plaque stability and improve angina pectoris-related symptoms,the mechanism may be related to reducing inflammatory factors and improving lipoprotein content.