通心阳方加减联合耳穴压豆治疗冠心病稳定型心绞痛临床观察

Efficacy observation of modified Tongxinyang formula and otopoint bean pressing on coronary heart disease-caused stable angina pectoris

目的:观察通心阳方加减联合耳穴压豆治疗冠心病稳定型心绞痛的临床疗效。方法:选取符合纳入标准的128例冠心病稳定型心绞痛患者,随机分为两组各64例。对照组予常规治疗,治疗组予通心阳方加减联合耳穴压豆治疗。治疗4周后比较两组临床疗效、硝酸甘油用量、中医证候积分、颈动脉内膜中层厚度(IMT值)、睡眠质量。检测两组血小板趋化因子4(CXCL4)、内皮细胞特异分子-1(ESM-1)、C反应蛋白(CRP)的变化。结果:治疗组总有效率为89.06%高于对照组的75.00%(P﹤0.05)。治疗后,治疗组硝酸甘油用量、IMT值、中医证候积分、睡眠质量各项评分及CXCL4、ESM-1、CRP水平均低于对照组(P﹤0.05)。结论:通心阳方加减联合耳穴压豆治疗冠心病稳定型心绞痛可有效减少硝酸甘油的用量,提高睡眠质量,机制可能与降低CXCL4、ESM-1、CRP的表达有关。

Objective:To observe the clinical efficacy of modified Tongxinyang formula and otopoint bean pressing on coronary heart disease-caused stable angina pectoris.Methods:128 cases of selected patients with coronary heart disease-caused stable angina pectoris,who met inclusion criteria,were randomly divided into two groups,64 cases in each group.The control group received routine treatment,while the treatment group was treated with modified Tongxinyang formula and otopoint bean pressing.The clinical efficacy,nitroglycerin dosage,TCM syndrome score,carotid intima-media thickness(IMT value)and sleep quality were compared between two groups.The changes of platelet chemokine 4(CXCL4),endothelial cell specific molecule-1(ESM-1)and C-reactive protein(CRP)were detected in two groups.Results:The total effective rate of treatment group was 89.06%,which was higher than 75.00%of control group(P﹤0.05).After treatment,the dosage of nitroglycerin,IMT value and TCM syndrome score and the score of sleep quality of treatment group were lower than those of control group(P﹤0.05).The levels of CXCL4,ESM-1 and CRP of treatment group were lower than those of control group after treatment(P﹤0.05).Conclusion:Modified Tongxinyang formula and otopoint bean pressing for treating coronary heart disease-caused stable angina pectoris can effectively reduce the dosage of nitroglycerin and improve the quality of sleep.The mechanism may be related to reducing the expressions of CXCL4,ESM-1 and CRP.