针药并用对冠心病患者血瘀高凝状态的影响

Effect of Combined Acupuncture and Medicine Treatment of Hypercoagulability in Coronary Heart Disease Patients

目的 :观察针刺对冠心病患者血瘀高凝状态中血栓长度 (VLT)、纤维蛋白原 (Fbg)、血小板聚集率 (PAGM)的影响。方法 :将 60例冠心病患者随机分为针药组、药物组各 3 0例 ,测定其治疗前后VLT、Fbg、PAGM水平。结果 :冠心病患者的VTL、Fbg、PAGM水平明显高于正常健康体检者 (P <0 0 1 ) ,针药组治疗后VTL、PAGM低于药物组 (P <0 0 5) ,且临床疗效优于药物组 (P<0 0 5)。结论 :针药并用可较好地改善冠心病患者血瘀高凝状态 ,提高冠心病的疗效 。

Objective: To observe the effect of acupuncture plus medicines on the hypercoagulable state of blood in coronary heart disease (CHD) patients. Methods: A total of 60 CHD patients were randomized into acupuncture plus medicine group (n=30) and medication group (n=30). In addition, other 30 cases of normal people were attributed to control group. Main acupoints used were Neiguan (PC 6), Juque (CV 14), Tanzhong (CV 17), Xinshu (BL 15) and Jueyinshu (BL 14); and medicines employed were 1) 5% glucose 200 mL plus Danshen (red sage root) injection 20 mL; and 2) revised polarized liquid (10% glucose 500 mL, 10% potassiumichloride 10 mL and insulin 8 U for intravenous infusion, once daily, with 15 days being a therapeutic course; as well as enteric soluble Aspirin 50 mg (qid), Beitaloke 25 mg (bid), Catopril 12.5 mg (bid), etc. for oral administration. Acupuncture was given once daily, with 15 sessions being a therapeutic course. Vitro length of thrombus(VLT), fibrinogen (Fib) and platelet agglutination rate (PAGM) were detected separately. Results: After one course of treatment, of the 30 cases in medication group, 10 had marked improvement in clinical symptoms and ECG-ST, 12 were effective and 8 failed in the treatment, with the effective rate being 73.3%. In acupuncture plus medicine group, of the 30 cases, 13 had pronounced improvement in symptoms and ECG-ST, 15 were effective and 2 failed in the treatment, with the effective rate being 93.3%. The therapeutic effect of acupuncture plus medicine group was significantly superior to that of medication group (P<0.05). Before treatment, there were no significant differences between acupuncture plus medicine group and medication group in VLT, Fib and PAGM; following treatment, self-comparison of each group showed that all the 3 indexes decreased significantly in values (P<0.05～0.01), and comparison between two groups indicated that VLT and PAGM of acupuncture plus medicine group were evidently lower than those of medication group (P<0.05). Conclusion: Acupuncture combined with medicines may improve clinical symptoms of CHD patients and reduce their hypercoagulable state of blood.