柴胡桂枝汤加减治疗稳定型心绞痛伴抑郁状态的疗效及对血清炎症因子和miR-126的影响

Efficacy of Modified Chaihu Guizhi Decoction on Stable Angina Pectoris with Depression and Its Effects on Serum Inflammatory Factors and miR-126

目的:探讨柴胡桂枝汤加减治疗稳定型心绞痛伴抑郁状态的疗效及对血清炎症因子和miR-126的影响。方法:前瞻性选取2022年该院收治的稳定性心绞痛伴抑郁患者100例,随机分为观察组与对照组,各50例。对照组患者予以常规西药治疗,观察组患者予以常规西药联合柴胡桂枝汤加减治疗,两组患者均治疗8周。观察两组患者治疗前后的西雅图心绞痛量表(SAQ)评分、患者健康问卷(PHQ-9)评分、中医证候评分、炎症因子[白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)和血管细胞黏附分子1(VCAM-1)]水平、miR-126相对表达量及心绞痛生活质量问卷(APQLQ)评分。结果:研究期间,对照组和观察组均剔除3例患者,最终两组各有47例患者进入本研究。治疗8周后,与对照组比较,观察组患者心绞痛稳定状态、心绞痛发作情况、治疗满意程度和疾病认知程度评分更高,躯体活动受限程度、PHQ-9评分更低,差异均有统计学意义(P<0.05)。治疗8周后,与对照组比较,观察组患者心血瘀阻证、肝气郁结证的主次证评分更低;治疗8周后,与对照组比较,观察组患者IL-1β、TNF-α和VCAM-1水平更低,miR-126相对表达量更高,差异均有统计学意义(P<0.05)。治疗8周后,与对照组比较,观察组患者APQLQ评分更低,差异有统计学意义(P<0.05)。结论:在常规西药基础上应用柴胡桂枝汤加减治疗稳定型心绞痛伴抑郁状态的疗效确切,能明显改善患者的临床症状,减轻炎症反应,保护受损心肌,促进患者生活质量提高。

OBJECTIVE:To probe into the efficacy of modified Chaihu Guizhi decoction on stable angina pectoris with depression and its effects on serum inflammatory factors and miR-126.METHODS:A total of 100 patients with stable angina pectoris with depression admitted into the hospital in 2022 were prospectively selected and randomly divided into the observation group and control group,with 50 patients in each group.The control group was treated with conventional Western medicine,while the observation group received conventional Western medicine combined with modified Chaihu Guizhi decoction.Both groups were treated for 8 weeks.Seattle angina questionnaire(SAQ)score,patient health questionnaire(PHQ-9)score,traditional Chinese medicine syndrome score,inflammatory factor levels[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),vascular cell adhesion factor-1(VCAM-1)],relative expression of miR-126 and angina pectoris quality of life questionnaire(APQLQ)score before and after treatment were observed in two groups.RESULTS:During the study period,3 patients were excluded from both the control and observation groups,resulting in 47 patients in each of two groups entering this study.After 8 weeks of treatment,compared with the control group,the observation group had higher scores for stable angina,angina attacks,treatment satisfaction and disease cognition,while the physical activity limitation and PHQ-9 score were lower,with statistically significant differences(P<0.05).After 8 weeks of treatment,compared with the control group,the observation group had lower primary and secondary syndrome scores for heart blood stasis syndrome and liver Qi stagnation syndrome;after 8 weeks of treatment,compared with the control group,the levels of IL-1β,TNF-αand VCAM-1 in the observation group were lower,and the relative expression of miR-126 was higher,with statistically significant differences(P<0.05).After 8 weeks of treatment,compared with the control group,the observation group had lower APQLQ score,with statistically significant difference(P<0.05).CONCLUSIONS:The efficacy of modified Chaihu Guizhi decoction based on conventional Western medicine has definite therapeutic effect on stable angina pectoris with depression,which can significantly improve the clinical symptoms,alleviate inflammatory reactions,protect damaged myocardium,and improve patients'quality of life.