三七参芪汤对冠心病患者肥胖且低密度脂蛋白胆固醇未达标的干预价值研究

Clinical observation of Sanqi Shenqi decoction in the intervention of substandard low-density lipoprotein cholesterol in obese patients with coronary heart disease

目的:观察三七参芪汤对冠心病患者中肥胖且低密度脂蛋白胆固醇(LDL-C)不达标的稳定型心绞痛(SAP)患者的干预价值。方法:选取肥胖且LDL-C不达标SAP患者80例,所有患者通过乱数表工具以随机抽样法分为对照组和观察组各40例,对照组以西药疗法治疗,观察组在对照组基础上加用三七参芪汤。比较两组患者心电图及心绞痛症状的疗效,干预前后的中医症候各主、次症积分,干预前后1周的临床表现(心绞痛发作频率及其持续时长、服用硝酸甘油量),干预前后的血脂指标[总胆固醇(TC)、甘油三酯(TG)、LDL-C、高密度脂蛋白胆固醇(HDL-C)]及其差值,以及干预前后的其他血清学指标[内皮素-1(ET-1)、一氧化氮(NO)、N末端B型利钠脑原(NT-proBNP)]。结果:观察组患者用药后心电图及心绞痛症状表现两方面的疗效评估结果均显示比对照组总有效率更高(均P<0.05),干预后两组中医症候各主、次症积分均明显降低(P<0.05),且观察组低于对照组(P<0.05)。干预后1周两组各临床表现均明显缓解(P<0.05),而观察组缓解更为明显(P<0.05)。干预后两组TC、TG、LDL-C、ET-1、NT-proBNP明显降低,HDL-C、NO明显升高(均P<0.05),观察组TC、TG、LDL-C、ET-1、NT-proBNP明显低于对照组(均P<0.05),TC、TG、LDL-C干预前后差值以及NO则高于对照组(均P<0.05)。结论:三七参芪汤干预肥胖且LDL-C不达标的SAP患者后,疗效明显,能明显降低异常升高的LDL-C,并调控其他血脂指标,修复心肌及血管损伤,改善心功能。

Objective:To observe the intervention value of Sanqi Shenqi decoction on obese patients with stable angina pectoris(SAP)and substandard low-density lipoprotein cholesterol(LDL-C)among patients with coronary heart disease.Methods:Totally 80 obese SAP patients with substandard LDL-C were selected.All patients were divided into control group(n=40)and observation group(n=40)by random sampling method through random number table tool.The control group was treated with western medicine therapy,while the observation group was added with Sanqi Shenqi decoction on this basis.The two groups were compared in terms of efficacy of electrocardiogram display and angina pectoris symptoms,and scores of primary and secondary syndromes of TCM syndromes before and after intervention,clinical manifestations(angina pectoris attack frequency and duration,time of taking nitroglycerin)at 1 week before and after intervention,blood lipids[total cholesterol(TC),triglyceride(TG),LDL-C,high-density lipoprotein cholesterol(HDL-C)]and their differences before and after intervention as well as other serological indicators[endothelin-1(ET-1),nitric oxide(NO),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]before and after intervention.Results:The efficacy evaluation results of electrocardiogram and angina pectoris symptoms in the observation group showed that the total effective rate was higher than that in the control group(all P<0.05).After intervention,the scores of TCM primary and secondary syndromes in the two groups were declined significantly(P<0.05),and the observation group had lower scores(P<0.05).The clinical manifestations in both groups were significantly relieved at 1 week after intervention(P<0.05),and the reliefs in the observation group were more obvious(P<0.05).After intervention,the levels of TC,TG,LDL-C,ET-1 and NT-proBNP in the two groups were significantly decreased while the levels of HDL-C and NO were significantly increased(all P<0.05),and the TC,TG,LDL-C,ET-1 and NT-proBNP levels in the observation group were significantly lower than those in the control group while the differences of TC,TG,LDL-C before and after intervention and NO were higher than those in the control group(all P<0.05).Conclusion:Sanqi Shenqi decoction has obvious efficacy on SAP patients with obesity and substandard LDL-C.It can significantly reduce the abnormally elevated LDL-C,regulate other blood lipids,repair myocardial injury and vascular injury,and improve cardiac function.