摘要
目的:观察逍遥通脉汤联合西药治疗气滞血瘀型冠心病稳定型心绞痛(SAP)的疗效及对冠脉微循环、血管内皮功能的影响。方法:采用随机数字表法将2020年3月~2021年3月在我院治疗的82例气滞血瘀型SAP患者分为观察组与对照组,每组各41例。对照组患者给予常规西药治疗,观察组患者在对照组基础上联合使用逍遥通脉汤治疗。比较两组患者临床疗效,记录治疗前、治疗3个月后两组患者中医证候积分(胸闷、胸痛、胸邪胀满、心悸、唇暗、舌紫暗、脉涩)、冠脉微循环指标[循环抵抗指数(IMR)、冠状动脉血流储备(CFR)]、血管内皮功能[血栓素(TX)B2、血管内皮生长因子(VEGF)、内皮素-1(ET-1)]及血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)]水平变化情况。结果:观察组患者临床总有效率明显高于对照组(P<0.05)。治疗3个月后,观察组患者各中医证候积分、IMR、ET-1、TXB2、CRP、TNF-α、IL-6水平均低于同期对照组(P<0.05);CFR、VEGF水平均高于同期对照组(P<0.05)。结论:逍遥通脉汤联合西药治疗气滞血瘀型SAP效果显著,对改善冠脉微循环功能及血管内皮功能,调节机体炎性状态有利。
Objective:To observe the efficacy of using Xiaoyao Tongmai Decoction combined with western medicine in the treatment of coronary heart disease with Qi-stagnation and blood-stasis type stable angina pectoris(SAP)and its influence on coronary microcirculation and vascular endothelial function.Methods:82 patients with Qi-stagnation and blood-stasis type SAP treated in the hospital between March 2020 and March 2021 were divided into an observation group and a controlled group by using the random number table method,with 41 cases in each group.The patients in the controlled group were treated with conventional western medicine,and the patients in the observation group were combined with Xiaoyao Tongmai Decoction on the basis of the controlled group.The clinical efficacy of the two groups of patients was compared,and the scores of TCM syndromes(chest tightness,chest pain,fullness in chest and hypochondrium,palpitation,dark lips,dark purple tongue,unsmooth pulse)and changes in coronary microcirculation indicators[index of microcirculation resistance(IMR),coronary flow reserve(CFR)],vascular endothelial function[thromboxane(TX)B2,vascular endothelial growth factor(VEGF),endothelin-1(ET-1)]and serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factorα(TNF-α),interleukin 6(IL-6)]were recorded in the two groups before treatment and after 3 months of treatment.Results:The total clinical effective rate of the observation group was significantly higher than that of the controlled group(P<0.05).After 3 months of treatment,the scores of TCM syndromes and levels of IMR,ET-1,TXB2,CRP,TNF-αand IL-6 were lower in the observation group than those in the controlled group(P<0.05)while the levels of CFR and VEGF were higher than those in the controlled group(P<0.05).Conclusion:Xiaoyao Tongmai Decoction combined with western medicine has a significant effect in the treatment of Qi-stagnation and blood-stasis type SAP,and it is beneficial to improve the coronary microcirculation function and vascular endothelial function and regulating the body’s inflammatory status.
作者
尹培永
熊婷
吴文虎
YIN Peiyong;XIONG Ting;WU Wenhu(Department of Second Internal,Sanya Municipal Traditional Chinese Medicine Hospital,Sanya Hainan 572000,China;Department of Third Internal,Sanya Municipal Traditional Chinese Medicine Hospital,Sanya Hainan 572000,China)
出处
《四川中医》
2022年第7期90-93,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
冠心病
心绞痛
气滞血瘀证
逍遥通脉汤
冠脉微循环
血管内皮功能
Coronary heart disease
Angina pectoris
Qi-stagnation and blood-stasis syndrome
Xiaoyao Tongmai Decoction
Coronary microcirculation
Vascular endothelial function
