血府逐瘀汤联合西药治疗高缺血风险慢性冠脉综合征临床研究

Clinical Study on Xuefu Zhuyu Decoction Combined with Western Medicine in the Treatment of Chronic Coronary Syndrome with High Ischemic Risk

目的 观察血府逐瘀汤联合西药治疗高缺血风险慢性冠脉综合征的临床疗效。方法 选取58例高缺血风险的慢性冠脉综合征患者,按照随机数字表法分为对照组与治疗组,每组29例。对照组给予西医常规治疗,治疗组在对照组基础上给予血府逐瘀汤加减治疗,2组疗程均为3个月。观察并比较2组临床总有效率,治疗前后总胆固醇(total cholesterol,TC)、甘油三脂(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)等血脂指标;以及超敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)、白介素-6(interleukin-6,IL-6)等炎症因子水平和活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)等凝血指标。同时比较2组治疗期间不良事件发生情况。结果 治疗后,治疗组总有效率为86.21%,对照组总有效率为75.86%,治疗组临床总有效率显著高于对照组(P<0.05)。2组TC、TG、LDL-C水平均较治疗前明显降低(P<0.05),且治疗组明显低于对照组(P<0.05);2组HDL-C水平较治疗前明显升高(P<0.05),且治疗组明显高于对照组(P<0.05)。2组hs-CRP、IL-6水平均较前降低(P<0.05),且治疗组明显低于对照组(P<0.05)。2组治疗前后的凝血指标比较,差异无统计学意义(P>0.05)。2组治疗期间出血事件发生率比较,差异无统计学意义(P>0.05)。治疗期间,对照组有5例发展为不稳定型心绞痛,发生率为17.24%;治疗组未出现明显病情演变事件,发生率为0%;组间比较,差异有统计学意义(P<0.05)。结论血府逐瘀汤加减治疗联合西药治疗高缺血风险慢性冠脉综合征能有效缓解患者临床症状,降低血脂及炎症因子水平,改善预后且不增加出血事件的发生率,安全性高。

Objective To observe the clinical efficacy of Xuefu Zhuyu decoction combined with western medicine in the treatment of chronic coronary syndrome with high ischemic risk.Methods Fifty-eight patients with chronic coronary syndrome with high ischemic risk were selected and divided into control group and treatment group according to the random number table method,with 29 cases in each group.The control group was given conventional treatment with western medicine,and the treatment group was given modified Xuefu Zhuyu decoction on the basis of the control group.The treatment course of both groups were three months.The total effective rate,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)before and after treatment were observed and compared in the two groups.The levels of inflammatory factors such as hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and coagulation indexes such as activated partial thromboplastin time(APTT)and prothrombin time(PT)were compared as well.At the same time,the occurrence of adverse events during treatment were compared in the two groups.Results After treatment,the total effective rate in the treatment group was 86.21%,while the control group was 75.86%.The clinical total effective rate in the treatment group was significantly higher than that in the control group(P<0.05).The levels of TC,TG and LDL-C in the two groups were significantly lower than those before treatment(P<0.05),and the treatment group was significantly lower than the control group(P<0.05).Meanwhile,the levels of HDL-C in the two groups were significantly higher than those before treatment(P<0.05),and the treatment group was significantly higher than the control group(P<0.05).The levels of hs-CRP and IL-6 in both groups were lower than those before treatment(P<0.05),and the treatment group was significantly lower than the control group(P<0.05).There was no significant difference in coagulation indexes in the two groups before and after treatment(P>0.05).The incidence of bleeding events during treatment in the two groups had no significant difference(P>0.05).During treatment,five cases in the control group developed unstable angina pectoris;the incidence rate was 17.24%.There was no obvious disease evolution event in the treatment group;the incidence rate was 0%;the difference between the two groups were statistically significant(P<0.05).Conclusion Modified Xuefu Zhuyu decoction combined with western medicine could effectively relieve clinical symptoms in the treatment of chronic coronary syndrome patients with high ischemic risk.It could reduce the levels of blood lipid and inflammatory factors,and improve prognosis without increasing the incidence of bleeding events,which is of high safety.