祛痰化瘀方加减联合西药对痰浊血瘀型冠状动脉粥样硬化性心脏病患者血脂及血管内皮功能指标的影响

Effect of Modified Qutan Huayu Recipe Combined with Western Medicine on Blood Lipid and Vascular Endothelial Function in Patients with Coronary Heart Disease of Phlegm Turbidity and Blood Stasis Type

目的探讨祛痰化瘀方加减联合西药对痰浊血瘀型冠状动脉粥样硬化性心脏病(简称冠心病)患者血脂水平及血管内皮功能指标的影响。方法选取中国人民解放军联勤保障部队北戴河康复疗养中心2019年2月至2022年12月收治的痰浊血瘀型冠心病患者98例,按随机数字表法分为对照组和观察组,各49例。两组患者均予西药对症治疗,观察组患者加用祛痰化瘀方加减,均治疗28 d。结果两组患者均未发生严重不良反应。观察组总有效率为91.84%,显著高于对照组的69.39%(P<0.05)。治疗后,两组患者血清低密度脂蛋白胆固醇、甘油三酯、总胆固醇均显著低于治疗前(P<0.05),而高密度脂蛋白胆固醇显著高于治疗前(P<0.05),且观察组均显著优于对照组(P<0.05);两组患者肱动脉血管舒张功能、一氧化氮水平均显著高于治疗前(P<0.05),内皮素水平显著低于治疗前(P<0.05),且观察组均显著优于对照组(P<0.05);两组患者的西雅图心绞痛量表(SAQ)评分均显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。结论祛痰化瘀方加减联合西药治疗痰浊血瘀型冠心病的临床疗效良好,可提高患者的血管内皮功能,调节血脂代谢,提高生活质量。

Objective To investigate the effect of modified Qutan Huayu Recipe combined with Western medicine on blood lipid and vascular endothelial function in patients with coronary heart disease of phlegm turbidity and blood stasis type.Methods A total of 98 patients with coronary heart disease of phlegm turbidity and blood stasis type admitted to the Beidaihe Rehabilitation and Recuperation Center of the PLA Joint Logistic Support Force from February 2019 to December 2022 were selected and randomly divided into the control group and the observation group,with 49 cases in each group.The patients in the two groups were treated with symptomatic Western medicine,on this basis,the patients in the observation group were treated with modified Qutan Huayu Recipe.Both groups were treated for 28 d.Results No severe adverse reactions occurred in the two groups.The total effective rate in the observation group was 91.84%,which was significantly higher than 69.39%in the control group(P<0.05).After treatment,the levels of serum low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),and total cholesterol(TC)in the two groups were significantly lower than those before treatment(P<0.05),while the level of high-density lipoprotein cholesterol(HDL-C)in the two groups was significantly higher than that before treatment(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05);the flow-mediated vasodilation(FMD)of the brachial artery and the nitric oxide(NO)level in the two groups were significantly higher than those before treatment(P<0.05),while the level of endothelin(ET)in the two groups was significantly lower than that before treatment(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05);the Seattle angina questionaire(SAQ)score in the two groups was significantly higher than that before treatment(P<0.05),and that in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Modified Qutan Huayu Recipe combined with Western medicine has good clinical efficacy in the treatment of coronary heart disease of phlegm turbidity and blood stasis type,which can improve vascular endothelial function,regulate blood lipid metabolism,and improve quality of life.