化痰逐瘀方联合体外反搏治疗对经皮冠状动脉介入治疗术后心绞痛患者疼痛、血管内皮因子及不良情绪的影响

Effects of Huatan Zhuyu Decoction Combined with External Counterpulsation on Pain,Vascular Endothelial Factor and Negative Emotion in Patients with Angina Pectoris after PCI

目的探讨化痰逐瘀方联合体外反搏治疗对经皮冠状动脉介入治疗(PCI)术后心绞痛患者疼痛、血管内皮因子及不良情绪的影响。方法选取2019年3月至2020年3月于沈阳市中医院老年病科住院治疗的PCI术后心绞痛患者62例作为研究对象,随机分为体外反搏组与联合治疗组,各31例。62例患者接受抗血小板聚集、稳定斑块、营养心肌、改善循环、扩张冠状动脉等基础治疗,并每日监测血氧、心率、血压等生命体征,于入院时进行双下肢彩超检查提示未见静脉血栓。体外反搏组患者在上述治疗基础上予以体外反搏治疗,联合治疗组患者在体外反搏组治疗基础上予以化痰逐瘀方治疗。比较两组患者加拿大心血管病学会(CCS)心绞痛分级、超氧化物歧化酶(SOD)、丙二醛(MDA)、血管内皮生长因子(VEGF)、一氧化氮(NO)、内皮素-1(ET-1)、焦虑自评量表(SAS)及抑郁自评量表(SDS)评分、匹兹堡睡眠质量指数量表(PSQI)评分、证候评分及治疗后硝酸甘油停减率。结果治疗后,体外反搏组及联合治疗组CCS分级、MDA水平、ET-1水平、SAS及SDS评分、PSQI评分、胸闷评分、胸痛评分、肢体困重评分、倦怠乏力评分较治疗前降低,SOD水平、VEGF水平、NO水平较治疗前升高,且联合治疗组改变程度更显著,差异有统计学意义(P<0.05)。治疗后,体外反搏组硝酸甘油停减率为67.74%,联合治疗组硝酸甘油停减率为96.77%,联合治疗组显著高于体外反搏组(P<0.05)。结论化痰逐瘀方联合体外反搏治疗具有缓解冠状动脉痉挛、提高心肌血供、修复血管内皮结构、抑制氧化反应发生、平衡内皮因子水平、重建侧支循环等功效,可改善PCI术后痰瘀互结型心绞痛患者胸闷胸痛等不适,缓解不良情绪,提高睡眠质量。

Objective To explore the effects of Huatan Zhuyu Decoction combined with external counterpulsation on pain,vascular endothelial factor and negative emotion in patients with angina pectoris after PCI.Methods A total of 62 patients with angina pectoris after PCI who were hospitalized between March 2019 and March 2020 in the Department of Geriatrics of Shenyang Hospital of Traditional Chinese Medicine were selected as the research objects and were randomly divided into a external counterpulsation group and a combined treatment group,with 31 cases in each group.A total of 62 patients received basic treatment such as anti-platelet aggregation,plaque stabilization,myocardial nutrition,circulation improvement,coronary artery dilation,and blood oxygen,heart rate,blood pressure and other vital signs were monitored daily.Color ultrasound examination of lower limbs showed no venous thrombosis on admission.Patients in extracorporeal counterpulsation group were given extracorporeal counterpulsation treatment on the basis of the above treatment,and patients in combined treatment group were given huatan zhuyu prescription treatment on the basis of extracorporeal counterpulsation group.Canada society(CCS)angina pectoris grading,superoxide dismutase(SOD),malondialdehyde(MDA),vascular endothelial growth factor(VEGF),nitric oxide(NO),endothelin 1(ET-1),self-evaluation of anxiety scale(SAS)and depression self rating scale(SDS)score,Pittsburgh sleep quality refers to the number Table(PSQI)score,syndrome score and nitroglycerin withdrawal rate after treatment were compared between the two groups.Results After treatment,the CCS grade,MDA level,ET-1 level,SAS and SDS scores,PSQI score,chest distress score,chest pain score,limb weight score and burnout score in the external counterpulsation group and the combined treatment group were lower than before treatment,while SOD level,VEGF level and NO level were higher than before treatment,and the change degree was more significant in the combined treatment group.The difference was statistically significant(P<0.05).After treatment,nitroglycerin withdrawal rate was 67.74%in the external counterpulsation group and 96.77%in the combined treatment group,which was significantly higher than that in the external counterpulsation group(P<0.05).Conclusion Huatan Zhuyu Decoction with external counterpulsation therapy has alleviate coronary artery spasm,improve myocardial blood supply,repair endothelial structure,oxidation reaction,balance the endothelial factor level to rebuild the collateral circulation,and so on,and then improve the PCI postoperative patients with phlegm and blood stasis mutual junction angina chest chest pain and discomfort,alleviate the bad mood,improve the quality of sleep.