体外反搏对冠心病稳定型心绞痛气虚血瘀型患者的临床疗效

Therapeutic effect of external counterpulsation on patients with CHD stable angina pectoris of Qi-deficiency and blood-stasis type

目的:探究体外反搏对冠心病稳定型心绞痛气虚血瘀型患者心绞痛程度、血清血栓素A2(TXA2)水平及不良反应的影响。方法:选择本院收治的120例冠心病稳定型心绞痛(气虚血瘀型)患者,按照随机数字表法分为常规治疗组和体外反搏组(常规治疗的基础上采用体外反搏治疗),各60例。治疗36d后,对比两组患者血清TXA2水平,心绞痛发作持续时间、频率及心肌缺血总负荷,心绞痛分级,并发症发生情况。结果:治疗后,与常规治疗组比较,体外反搏组血清TXA2[(352.78±26.49)pg/ml比(276.54±21.62)pg/ml]水平、心绞痛发作持续时间[(3.45±1.54)min比(2.74±1.06)min]、频率[(3.64±0.98)次/周比(2.76±0.75)次/周],心肌缺血总负荷[(18.82±3.54)mm·min比(11.26±2.78)mm·min]及心绞痛2级(28.33%比11.67%)、3级(13.33%比1.67%)患者比例均显著降低,心绞痛1级患者比例(58.33%比86.67%)显著提高(P<0.05或<0.01);体外反搏组不良反应发生率显著低于常规治疗组(10.00%比25.00%,P=0.031)。结论:体外反搏治疗冠心病稳定型心绞痛可显著改善患者心绞痛严重程度,减少发作次数,减轻临床症状,抑制血小板凝聚,减少不良反应发生。

Objective:To explore influence of external counterpulsation(ECP)on severity of angina pectoris,serum thromboxane A2(TXA2)level and adverse reactions in patients with coronary heart disease(CHD)stable angina pectoris(SAP)of Qi-deficiency and blood-stasis(QDBS)type.Methods:According to random number table,a total of 120 CHD-SAP patients of QDBS type treated in our hospital were randomly and equally divided into routine treatment group and ECP group(received ECP based on routine treatment).After 36d treatment,serum TXA2 level,duration and frequency of angina pectoris onset,myocardial ischemia total burden,angina pectoris class and incidence of complications were compared between two groups.Results:Compared with routine treatment group after treatment,there were significant reductions in serum TXA2 level[(352.78±26.49)pg/ml vs.(276.54±21.62)pg/ml],duration[(3.45±1.54)min vs.(2.74±1.06)min]and frequency[(3.64±0.98)times/week vs.(2.76±0.75)times/week]of angina pectoris onset,myocardial ischemia total burden[(18.82±3.54)mm·min vs.(11.26±2.78)mm·min],percentages of patients with angina pectoris class 2(28.33%vs.11.67%)and class 3(13.33%vs.1.67%),and significant rise in percentage of patients with angina pectoris class 1(58.33%vs.86.67%)in ECP group,P<0.05 or<0.01;incidence rate of adverse reactions in ECP group was significantly lower than that of routine treatment group(10.00%vs.25.00%,P=0.031).Conclusion:ECP can significantly improve angina pectoris severity,reduce onset times,relieve clinical symptoms,inhibit platelet aggregation and reduce incidence of adverse reactions in CHD-SAP patients.