延胡索对冠状动脉微循环功能影响的临床观察

Clinical observation of the effect of Corydalis yanhusuo on coronary microcirculation function

目的探讨延胡索对冠状动脉微循环功能的影响。方法选择2019年9月至2021年9月在温州医科大学附属第二医院心内科通过冠状动脉压力导丝检查确定有微循环阻力升高的心绞痛住院患者96例,随机分为对照组48例,观察组46例(有2例因后续随访失联剔除)。对照组进行常规抗血小板、他汀类调脂等治疗,观察组在上述药物基础上加用延胡索,连续服用并随访6个月。测定并比较两组治疗前后冠状动脉血管微循环阻力指数、血流储备分数、冠状动脉血流储备及C反应蛋白水平,比较两组患者的临床疗效。结果治疗6个月后,观察组显效率和总有效率均显著高于对照组(χ^(2)=5.163、6.362,P<0.05)。两组治疗前后比较,微循环阻力指数、冠状动脉血流储备、血流储备分数及C反应蛋白均显著改善(P<0.01)。治疗后与对照组相比,观察组微循环阻力指数和C反应蛋白下降更明显,而血流储备分数与冠状动脉血流储备则升高更明显,差异有统计学意义(t=2.464、2.754、-4.589、-2.704,P<0.05)。所有患者治疗前后微循环阻力指数的差值为13.1±3.6,C反应蛋白的差值为(1.52±0.86)mg/L,Pearson相关分析结果显示两者呈正相关(r=0.340,P<0.01)。结论延胡索可改善心绞痛患者冠状动脉微循环功能。

Objective To explore the effect of Corydalis yanhusuo on coronary microcirculation function.Methods A total of 96 inpatients with angina pectoris and elevated microvascular resistance confirmed by coronary artery pressure wire examination in the cardiology department of the Second Affiliated Hospital of Wenzhou Medical University from September 2019 to September 2021 were selected,and randomly divided into the control group(n=48)and the observation group(n=46,with 2 cases lost to follow-up).The control group was treated with routine antiplatelet,statins and other medicine,while the observation group was treated with Corydalis yanhusuo in addition to the routine treatment.The two groups were treated continuously and fowlled up for six months.The index of microvascular resistance(IMR),fractional flow reserve(FFR),coronary flow reserve(CFR)and C-reactive protein(CRP)levels were measured and compared before and after treatment in both groups.Clinical efficacy was also compared between the two groups.Results After 6 months of treatment,the observation group showed significantly higher effective rate and total effective rate compared to the control group(χ^(2)=5.163,6.362;P<0.05).Comparing before and after treatment within each group,both groups showed significant improvements in IMR,CFR,FFR and CRP levels(P<0.01).Compared to the control group,the observation group exhibited a more significant reduction in IMR and CRP levels,as well as a greater increase in FFR and CFR,with statistically significant difference(t=2.464,2.754,-4.589,-2.704;P<0.05).The difference before and after treatment in IMR was 13.1±3.6,and that in CRP was(1.52±0.86)mg/L.According to Pearson correlation analysis,there was a positive correlation(r=0.340, P < 0.01). Conclusion Corydalis yanhusuo can improve the microcirculation function of coronary artery in patients with angina pectoris.