清痰祛瘀方辅助治疗急性冠脉综合征行经皮冠脉介入术后心绞痛痰瘀互结证52例临床观察

Clinical observation on 52 cases of angina pectoris of phlegm and blood stasis binding type after percutaneous coronary intervention for acute coronary syndrome treated with Qingtan Quyu Fang(清痰祛瘀方)as adjuvant treatment

目的观察清痰祛瘀方辅助治疗急性冠脉综合征(ACS)行经皮冠脉介入术(PCI)后心绞痛痰瘀互结证的临床疗效。方法将104例ACS行PCI后心绞痛痰瘀互结证患者采用随机数字表法分为对照组和治疗组,各52例。对照组采取西医常规治疗,治疗组在对照组治疗方法的基础上给予清痰祛瘀方治疗。治疗8周后比较2组的临床疗效,以及治疗前后中医证候积分、心绞痛发作情况(每周心绞痛发作次数、持续时间)、血清炎症因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平、血小板活性指标[P选择素(CD62p)、糖蛋白(GP)Ⅱb/Ⅲa受体复合物]水平。结果治疗组总有效率为94.23%(49/52),对照组为78.85%(41/52),2组比较差异有统计学意义(P<0.05);治疗后2组中医证候积分,血清IL-6、hs-CRP、TNF-α水平,以及CD62p、GPⅡb/Ⅲa受体复合物水平均明显降低,每周心绞痛发作次数均明显减少,心绞痛持续时间均明显缩短,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组改善更明显,与对照组治疗后比较差异均有统计学意义(P<0.01)。结论清痰祛瘀方辅助治疗ACS行PCI后心绞痛痰瘀互结证疗效显著,能明显改善患者的临床症状,减轻炎症反应,降低血小板活性指标水平。

Objective To observe the clinical efficacy of Qingtan Quyu Fang(清痰祛瘀方)in the adjuvant treatment of angina pectoris of phlegm and blood stasis binding type after percutaneous coronary intervention(PCI)for acute coronary syndrome(ACS).Methods 104 cases with angina pectoris of phlegm and blood stasis binding type after PCI for ACS were divided into a control group and a treatment group in a random number table method,with 52 cases in each group.The control group was treated with conventional Western medicine,and the treatment group was treated with Qingtan Quyu Fang on the basis of the treatment method of the control group.The clinical efficacy of the two groups after 8 weeks of treatment,as well as the score of TCM syndromes,the incidence of angina pectoris(frequency and duration of angina pectoris per week),serum inflammatory factors[interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)J,the levels of platelet activity index[Pselectin(CD62p)and glycoprotein(GP)II b/Il a receptor complex J before and after treatment were compared.Results The total effective rate of the treatment group was 94.23%(49/52),and that of the control group was 78.85%(41/52).The difference between the two groups was statistically significant(P<0.05).Afer treatment,the TCM syndrome score,serum IL-6,hs-CRP,TNF-αin the two groups and the levels of CD62p,GP II b/Ila receptor complex were significantly decreased,the frequency of angina pectoris per week was significantly reduced,the duration of angina pectoris was significantly shortened,compared with the same group before treatment,the difference was statistically significant(P<0.01),and the treatment group improved more significantly,compared with the control group after treatment,the difference was statistically significant(P<0.01).Conclusion It can significantly improve the clinical symptoms of patients,reduce inflammatory reaction,reduce the level of platelet activity index and finally receive remarkable efficacy to use Qingtan Quyu Fang in the adjuvant treatment of angina pectoris of phlegm and blood stasis binding type after PCI for ACS.