益气活血中药对冠心病患者冠脉靶血管干预效果的临床研究

发布时间：2018-04-26 18:03

本文选题：益气活血 + 冠心病　；参考：《广州中医药大学》2017年硕士论文

【摘要】：背景:冠状动脉粥样硬化性心脏病(冠心病)是死亡率最高的疾病之一,严重威胁着人类健康与社会发展。经皮冠状动脉介入治疗(PCI)已成为治疗冠心病并提高患者生存质量的重要手段,虽然现代治疗技术有了长足进步,但是冠状动脉支架内再狭窄(ISR)等问题的存在使患者死亡率依然没有明显下降。目的:通过对临床资料的回顾分析研究,探索益气活血中药对冠心病患者冠状动脉靶血管的作用及其他效果。方法:本研究通过回顾性分析,利用广东省中医院胸痛诊疗中心2010年1月1日至2014年12月31日的冠脉造影患者数据库进行筛选、数据整理与分析,纳入曾在此期间于我院行两次或两次以上冠状动脉造影或PCI术的病例(同一名患者两次手术至少间隔6个月),将第一次术后长期坚持服用通冠胶囊的人群定义为益气活血中药组,将单纯使用西药治疗的人群定义为标准西药治疗组。通过分析前后两次手术的冠脉造影及实验室检验结果等资料,对益气活血中药对冠心病患者冠状动脉血管的作用进行评价。结果:本研究纳入70个病例,男性48人,女性22人,患者平均年龄为58.35±7.04岁。其中益气活血中药组患者39人(55.7%),标准西药治疗组31人(44.3%),他们在人口学资料、个人史、既往病史、第一次PCI术前实验室指标、冠状动脉Gensini评分等基线差异无统计学意义(P0.05),两组人群具有可比性。两组人群在第一次PCI术前两组人群在Gensini评分上未见统计学差异,然而,在第二次术后益气活血中药组的Gensini评分显著低于标准西药治疗组(P0.05)。而且益气活血中药组的支架内斑块发生率(12.8%)明显低于标准西药治疗组(35.5%,P0.05)。在血脂指标方面,两种治疗方案均能降低总胆固醇(TC),但是益气活血中药组对总胆固醇的降低程度更明显(P0.05)。另外,益气活血中药组对于心脏彩超指标射血分数(EF)、每搏输出量(SV)具有明显的改善作用。研究结论:气虚血瘀证冠心病患者在PCI术后服用益气活血中药能够降低支架内斑块的发生,同时很可能具有改善血脂异常和改善心脏射血功能等作用。
[Abstract]:Background: coronary atherosclerotic heart disease (coronary heart disease) is one of the highest mortality diseases, which is a serious threat to human health and social development. Percutaneous coronary intervention (PCI) has become an important means to treat coronary heart disease and improve the quality of life of patients, although modern treatment technology has made great progress. But problems such as restenosis in coronary stents caused no significant decrease in mortality. Objective: to explore the effect of Yiqi Huoxue herbs on coronary artery target vessels in patients with coronary heart disease by retrospective analysis of clinical data. Methods: through retrospective analysis, the database of coronary arteriography from January 1, 2010 to December 31, 2014 in chest pain diagnosis and treatment Center of Guangdong traditional Chinese Medicine Hospital was used to screen and analyze the data. Those who had performed two or more coronary angiography or PCI procedures in our hospital during the same period (the same patient had two operations at least 6 months apart) were included in the study. The people who took Tongguan capsule for a long period of time after the first operation were defined as the people who took Tongguan capsule for a long time after the first operation. Invigorating Qi and activating Blood Circulation Group, The people who were treated with western medicine alone were defined as the standard western medicine treatment group. By analyzing the results of coronary angiography and laboratory examination before and after two operations, the effect of Yiqi Huoxue herbs on coronary artery vessels in patients with coronary heart disease was evaluated. Results: this study included 70 cases, male 48, female 22, the average age of the patients was 58.35 卤7.04 years old. Among them, 39 patients in the group of supplementing qi and activating blood circulation were treated with 55.75.7U, 31 patients in the standard western medicine treatment group were treated with 44.3s, their demographic data, personal history, past medical history, laboratory indexes before the first PCI operation, The baseline difference of coronary Gensini score was not statistically significant (P 0.05), and the two groups were comparable. There was no significant difference in Gensini score between the two groups before the first PCI, however, the Gensini score in the second postoperative group was significantly lower than that in the standard western medicine group (P 0.05). In addition, the incidence of plaque in stents in the group of invigorating qi and activating blood circulation was significantly lower than that in the treatment group of standard western medicine (P 0.05). In the aspect of blood lipid index, the two kinds of treatment schemes can reduce the total cholesterol of TCX, but the group of supplementing qi and activating blood circulation can reduce the total cholesterol more obviously (P0.05N). In addition, Yiqi Huoxue Chinese medicine group has obvious improvement effect on ejection fraction (EFG) and stroke volume (SVV) of cardiac color Doppler ultrasound index. Conclusion: taking Qi-deficiency and blood-stasis syndrome in patients with coronary heart disease after PCI can reduce the occurrence of plaque in stents and may also improve the blood lipid abnormality and cardiac ejection function.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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