宁心痛方治疗冠心病不稳定型心绞痛疗效及对血清生物标志物的影响

Curative effect of Ningxintong Decoction on unstable angina pectoris of coronary heart disease and its effect on serum biomarkers

目的观察宁心痛方治疗不稳定型心绞痛的临床疗效及对血清生物标志物的影响。方法将2019年2月—2020年6月南京市中医院诊治的110例冠心病不稳定型心绞痛患者随机分为治疗组和对照组各55例,最终治疗组54例、对照组52例完成研究。对照组采用西医常规治疗,治疗组在常规治疗基础上加用宁心痛方,2组疗程均为8周。比较2组患者治疗后心绞痛症状疗效、心电图疗效、中医证候疗效,观察2组治疗前后西雅图心绞痛量表(SAQ)评分及血脂、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)水平变化。结果治疗8周后,治疗组心绞痛症状和中医证候总有效率分别为94.4%(51/54)和90.7%(49/54),对照组分别为75.0%(39/52)和73.1%(38/52),治疗组均明显高于对照组(P均<0.05);2组治疗后SAQ评分中躯体活动受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)评分均明显升高(P均<0.05),且治疗组均明显高于对照组(P均<0.05);2组治疗后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP、MMP-9、IL-6、Hcy水平均明显降低(P均<0.05),且治疗组血清LDL-C、hs-CRP、MMP-9、IL-6水平均明显低于对照组(P均<0.05)。结论宁心痛方治疗不稳定型心绞痛疗效确切,其机制可能与抑制炎症因子过度激活、增加易损斑块稳定性、调节脂质代谢等相关。

Objective It is to observe the clinical efficacy of Ningxintong Decoction in the treatment of unstable angina pectoris and its influence on serum biomarkers.Methods A total of 110 cases of unstable angina patients with coronary heart disease diagnosed and treated in Nanjing Hospital of Traditional Chinese Medicine from February 2019 to June 2020 were randomly divided into a treatment group and a control group,with 55 cases in each group,54 cases in the treatment group and 52 cases in the control group finally completed the study.The control group was treated with conventional western medicine,and the treatment group was treated with Ningxintong Decoction on the basis of conventional treatment.The course of treatment in both groups was 8 weeks.The angina pectoris symptom efficacy,ECG efficacy,and TCM syndrome efficacy of the two groups were compared between the two groups after treatment,the changes in the scores of Seattle Angina questionnaire(SAQ)and the levels of blood lipids,high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9)before and after treatment were observed.Results After 8 weeks of treatment,the total effective rates of angina pectoris symptom and TCM syndromes in the treatment group were 94.4%(51/54)and 90.7%(49/54),respectively,and in the control group were 75.0%(39/52)and 73.1%(38/52),the treatment group was significantly higher than the control group(P<0.05);the scores of physical limitation(PL),angina stability(AS),angina frequency(AF),treatment satisfaction(TS)in SAQ were significantly increased after treatment in the two groups(P<0.05),and the treatment group was significantly higher than the control group(P<0.05);the levels of serum total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),hs-CRP,MMP-9,IL-6,and Hcy were significantly reduced after treatment in the two groups(all P<0.05),and the levels of serum LDL-C,hs-CRP,MMP-9,and IL-6 in the treatment group were significantly lower than those of the control group(all P<0.05).Conclusion Ningxintong Decoction is effective in treating unstable angina pectoris,and its mechanism may be related to inhibiting the excessive activation of inflammatory factors,increasing the stability of vulnerable plaques,and regulating lipid metabolism.