宽胸祛痹汤辅助治疗对经皮冠状动脉介入术后心绞痛血管内皮功能及血清ADAMTS-13、血浆Irisin水平的影响

Effect of Adjuvant Therapy with Kuanxiong Qubi Decoction(宽胸祛痹汤)on Vascular Endothelial Function and Levels of Serum ADAMTS-13 and Plasma lisin in Patients with Angina Pectoris after PCI

目的观察宽胸祛痹汤辅助治疗对经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后心绞痛患者血管内皮功能及血清血管性血友病因子裂解酶(von willebrand factor-cleaving protease,ADAMTS-13)、血浆鸢尾素(Iri-sin)水平的影响。方法选取常州市中医医院2020年1月—2022年3月收治的80例PCI后心绞痛患者为对象,采用奇偶数分组法分为两组。对照组39例给予常规西药治疗,观察组41例给予宽胸祛痹汤联合常规西医治疗。检测两组ADAMTS-13、Irisin、P选择素(P selectin,CD62p)、肌钙蛋白l(cardiac troponin,cTnl)等相关因子的水平,评估两组中医症状积分、西雅图心绞痛量表(Seattle Angina Questionnaiire,SAQ)的差异,统计两组硝酸甘油减停率、总有效率。结果两组治疗前中医症状积分、SAQ评分比较,差异无统计学意义(P>0.05);与治疗前比,两组治疗后中医症状积分下降,且观察组更低(P<0.05);两组治疗后SAQ评分升高,且观察组更高(P<0.05)。两组治疗前相关因子比较,差异无统计学意义(P>0.05);与治疗前比,两组治疗后高敏-C反应蛋白(High sensitivity-C reactive protein,hs-CRP)、CD62p、内皮素-1(Endothelin-1,ET-1)、cTnl、糖蛋白Ⅱb/Ⅲa(GlycoproteinⅡb/Ⅲa,GPⅡb/Ⅲa)受体复合物下降,且观察组更低(P<0.05),两组治疗后一氧化氮(Nitric oxide,NO)、ADAMTS-13、Irisin升高,且观察组更高(P<0.05)。观察组硝酸甘油减停率和总有效率分别为92.68%(38/41)和90.24%(37/41),高于对照组的76.92%(30/39)和71.79%(28/39),差异有统计学意义(P<0.05)。结论宽胸祛痹汤联合西医可改善PCI后心绞痛患者血管内皮功能,增加ADAMTS-13、Irisin的表达,提高疗效。

Objective To observe the effects of Kuanxiong Qubi Decoction(宽胸祛痹汤)combined with western medicine on vascular endothelial function and the levels of serum von Willebrand factor lyase(ADAMTS-13)and plasma irisin in patients with angina pectoris after percutaneous coronary intervention(PCI).Methods Eighty patients with angina pectoris after PCI ad-mitted to Changzhou Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were selected and were divided into two groups by odd even number grouping method.Thirty-nine cases in the control group were treated with conventional western medicine,while 41 cases in the observation group were treated with Kuanxiong Qubi Decoction combined with convention-al western medicine.The levels of ADAMTS-13,irisin,P-selectin(CD62p),cardiac troponin l(cTnl)and other related factors in the two groups were detected.The differences between the two groups in TCM symptom scores and Seattle Angina Scale(SSAQ)were evaluated and the reduction rate of nitroglycerin and the total effective rate in the two groups were counted.Results There was no significant difference in TCM symptom score or SAQ score between the two groups before treatment(P>0.05).Compared with that before treatment,the scores of TCM symptoms in the two groups decreased after treatment,and that in the ob-servation group was lower(P<0.05).The SAQ scores of the two groups were increased after treatment,and the score of the ob-servation group was higher(P<0.05).There was no significant difference between the two groups before treatment(P>0.05).Compared with that before treatment,the levels of high-sensitivity C-reactive protein(hs-CRP),CD62p,endothelin-1(ET-1),cTnl and glycoproteinⅡb/Ⅲa(GPⅡb/Ⅲa)receptor complexes in the two groups were decreased after treatment,and the levels in the observation group were lower(P<0.05),and the levels of nitric oxide(NO),ADAMTS-13 and irisin in the two groups were increased after treatment,and the levels in the observation group were higher(P<0.05).The reduction rate and to-tal effective rate of nitroglycerin in the observation group were 92.68%(38/41)and 90.24%(37/41),respectively,which were higher than 76.92%(30/39)and 71.79%(28/39)in the control group(P<0.05).Conclusion Kuanxiong Qubi Decoction combined with western medicine can improve the vascular endothelial function of patients with angina pectoris after PCI,increase the expressions of ADAMTS-13 and irisin and improve the curative effect.