通冠宣痹汤加减联合比索洛尔治疗冠心病的效果观察

Clinical Efficacy of Modified Tongguan Xuanbi Decoction Combined with Bisoprolol Against Coronary Heart Disease

目的:分析通冠宣痹汤加减联合比索洛尔对冠心病患者血管内皮功能、可溶性细胞间黏附分子-1(sICAM-1)、骨保护素(OPG)水平的影响。方法:选取2019年6月至2020年6月湖南中医药大学第一附属医院收治的冠心病患者157例作为研究对象,按照随机数字表法随机分为对照组(n=79)和观察组(n=78)。2组患者均行临床常规治疗,对照组在此基础上采用比索洛尔治疗,观察组在对照组治疗的基础上采用通冠宣痹汤加减治疗。比较2组患者心功能改善、血管内皮功能、心功能改善幅度、血液流变学、中医证候积分等指标。结果:观察组心功能改善幅度高于对照组(P<0.05)。观察组血管内皮功能指标升高幅度、血液流变学指标降低幅度均高于对照组(均P<0.05)。观察组炎症反应指标降低幅度高于对照组(P<0.05)。观察组中医证候积分降低幅度高于对照组(P<0.05)。与对照组比较,观察组治疗总有效率升高,近期主要心血管不良事件(MACE)发生率降低(均P<0.05)。结论:通冠宣痹汤加减联合比索洛尔可明显改善患者的血管内皮功能,抑制局部炎症,促进心功能恢复,降低近期MACE发生风险,效果显著。

Objective:To analyze the effects of modified Tongguan Xuanbi Decoction combined with bisoprolol on vascular endothelial function,soluble intercellular adhesion molecule-1(sICAM-1),and osteoprotegerin(OPG)in patients with coronary heart disease.Methods:A total of 157 patients with coronary heart disease admitted to the First Affiliated Hospital of Hunan University of Chinese Medicine from June 2019 to June 2020 were enrolled and divided into a control group(n=79)and an observation group(n=78)according to the random number table method.All patients underwent conventional treatment combined with bisoprolol,while those in the observation group received additional modified Tongguan Xuanbi Decoction.The indicators,including cardiac function improvement,vascular endothelial function,improvement degree of cardiac function,hemorheology,and traditional Chinese medicine(TCM)syndrome score,were compared between the two groups.Results:The observation group was superior to the control group in the improvement degree of cardiac function(P<0.05),the enhancement degree of vascular endothelial function(P s<0.05),the reduction degree of hemodynamic indicators(P<0.05),the reduction degree of inflammatory response indicators(P<0.05),and the decrease in TCM syndrome score(P s<0.05).Compared with the control group,the observation group showed increased total effective rate and decreased incidence of major adverse cardiac events(MACE)(P<0.05).Conclusion:Modified Tongguan Xuanbi Decoction combined with bisoprolol can significantly improve vascular endothelial function,inhibit local inflammation,promote cardiac function recovery,and reduce the risk of MACE in the near future.