活血化瘀养心通络方联合养心汤治疗老年冠心病PCI术后不稳定型心绞痛临床研究

Clinical Study on Huoxue Huayu Yangxin Tongluo Prescription Combined with Yangxin Decoction for Unstable Angina in Senile Patients After PCI for Coronary Heart Disease

目的:观察活血化瘀养心通络方联合养心汤治疗老年冠心病经皮冠状动脉介入治疗(PCI)术后不稳定型心绞痛(UA)患者的疗效及对内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)表达水平的影响。方法:选取96例老年冠心病UA患者,按随机数字表法分为对照组及观察组各48例。2组均行PCI术,对照组术后口服养心汤,观察组在对照组基础上服用活血化瘀养心通络方。观察2组临床疗效及不良反应发生率,比较2组治疗前后中医证候积分、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、ET-1、AngⅡ、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)指标值的变化。结果:观察组临床疗效总有效率为95.83%,对照组为83.33%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组心绞痛发作次数、持续时间、中医证候积分均较治疗前下降(P<0.05),观察组上述3项指标值均低于对照组(P<0.05)。治疗后,2组血清IL-6、TNF-α、ET-1、AngⅡ指标值均较治疗前下降(P<0.05),观察组上述4项血清指标值均低于对照组(P<0.05)。治疗后,2组血清TC、TG、LDL-C水平均较治疗前下降(P<0.05),HDL-C水平均较治疗前上升(P<0.05);观察组血清TC、TG、LDL-C水平均低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。观察组不良反应发生率为12.5%,对照组为10.4%,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:活血化瘀养心通络方联合养心汤治疗老年冠心病PCI术后UA的疗效较好,可调控炎症反应,改善血脂水平,降低血清ET-1、AngⅡ表达水平。

Objective:To observe the curative effect of Huoxue Huayu Yangxin Tongluo Prescription combined with Yangxin Decoction on unstable angina(UA)in senile patients after percutaneous coronary intervention(PCI)for coronary heart disease,and its effect on the expression levels of endothelin-1(ET-1)and angiotensinⅡ(AngⅡ).Methods:A total of 96 cases of senile patients with coronary heart disease complicated with UA were selected and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.Both groups were treated with PCI;the control group was given the oral administration of Yangxin Decoction,and the observation group was additionally treated with Huoxue Huayu Yangxin Tongluo Prescription based on the treatment of the control group.The clinical effects and the incidence of adverse reactions in the two groups were observed.The changes in traditional Chinese medicine(TCM)syndrome scores and indexes of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),ET-1,AngⅡ,total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were compared before and after treatment between the two groups.Results:The total effective rate was 95.83%in the observation group and 83.33%in the control group,the difference being significant(P<0.05).After treatment,the frequency,duration and TCM syndrome scores of angina pectoris in the two groups were decreased when compared with those before treatment(P<0.05),and the above three indexes in the observation group were lower than those in the control group(P<0.05).After treatment,the indexes of IL-6,TNF-α,ET-1 and AngⅡin serum in the two groups were decreased when compared with those before treatment(P<0.05),and the above four serum indexes in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of TC,TG,and LDL-C in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of HDL-C were increased when compared with those before treatment(P<0.05).The levels of TC,TG,and LDL-C in the observation group were lower than those in the control group(P<0.05),and the level of HDL-C was higher than that in the control group(P<0.05).The incidence of adverse reactions was 12.5%in the observation group and 10.4%in the control group,there being no significant difference between the two groups(P>0.05).Conclusion:Huoxue Huayu Yangxin Tongluo Prescription combined with Yangxin Decoction has a good effect on UA in senile patients after PCI for coronary heart disease,which can regulate inflammatory responses,improve blood lipid levels and reduce the expression levels of ET-1 and AngⅡin serum.