冠心颗粒对稳定性心绞痛炎症反应的影响

发布时间：2019-01-29 19:04

【摘要】：目的:观察冠心颗粒治疗稳定性心绞痛心血瘀阻证的临床疗效及对炎症反应和血小板功能的影响。方法:将154例患者按就诊先后,依据分层,随机分为对照组和观察组各77例。对照组给予拜阿司匹林肠溶片0.1 g,1次/d;盐酸曲美他嗪片20 mg,3次/d;对高血脂、高血压和糖尿病患者给予对症处理(冠心病二级预防药物)。观察组在对照组治疗的基础上加用冠心颗粒,1剂/d,早晚分2次冲服。两组疗程均为20周。记录心绞痛发作次数、发作持续时间、疼痛程度、诱发因素及与体力活动的关系;测量治疗前后心电图和血脂变化,进行治疗前后西雅图心绞痛量表(SAQ)和心血瘀阻证评分;检测治疗前后超敏C反应蛋白(hs-CRP),同型半胱氨酸(HCY),血清胱抑素C(Cys-C),血小板膜糖蛋白CD63,CD42 b和基质金属蛋白酶-9(MMP-9)水平。结果:观察组疾病疗效总有效率为92.21%,高于对照组的77.92%(P0.05);观察组中医证候疗效总有效率为93.51%,高于对照组的72.73%(P0.01);治疗后观察组心绞痛发作次数少于对照组,持续时间缩短于对照组,硝酸甘油用量少于对照组(P0.01);治疗后观察组ST段下移导联数,T波低平导联数,和T波倒置导联数均少于对照组(P0.01);治疗后观察组TG异常率为10.39%,低于对照组的22.08%(P0.05),TC异常率为9.09%,低于对照组的25.97%(P0.01),HDL-C异常率为12.99%,低于对照组的28.57%(P0.05);治疗后观察组SAQ量表评分均高于对照组,心血瘀阻证评分低于对照组(P0.01);治疗后观察组hs-CRP,HCY,Cys C,CD63和MMP-9水平均低于对照组,CD42 b水平高于对照组(P0.01)。结论:冠心颗粒治疗心血瘀阻型稳定性心绞痛能减少心绞痛发作程度,能调节脂代谢,还抑制炎症反应和血小板的活化功能,从而改善心肌缺血,提高临床疗效。
[Abstract]:Objective: to observe the clinical effect of Guanxin granule in treating stable angina pectoris with heart blood stasis syndrome and its effect on inflammatory reaction and platelet function. Methods: 154 patients were randomly divided into control group (77 cases) and observation group (77 cases). The control group was given Aspirin enteric-coated tablets once a day and trimetazidine hydrochloride tablets for 20 mg,3 / d. The patients with hyperlipidemia, hypertension and diabetes were given symptomatic treatment (secondary prophylaxis for coronary heart disease). The observation group was treated with Guanxin granule (1 dose / d) on the basis of the treatment in the control group, which was taken twice in the morning and evening. The course of treatment was 20 weeks in both groups. The frequency of angina pectoris attack, duration of angina pectoris attack, pain degree, inducing factors and the relationship between angina pectoris attack and physical activity were recorded, the changes of ECG and blood lipid were measured before and after treatment, and the scores of (SAQ) and blood stasis syndrome were measured before and after treatment. The levels of hypersensitive C-reactive protein (hs-CRP), homocysteine (HCY), serum cystatin C (Cys-C), platelet membrane glycoprotein CD63,CD42 b and matrix metalloproteinase-9 (MMP-9) were measured before and after treatment. Results: the total effective rate of disease in the observation group was 92.21, which was higher than that in the control group (77.92%) (P0.05), the total effective rate of TCM syndrome in the observation group was 93.51%, higher than that in the control group (72.73%) (P0.01). After treatment, the number of angina pectoris attack in the observation group was less than that in the control group, the duration was shortened and the dosage of nitroglycerin was less than that in the control group (P0.01). After treatment, the number of lower leads of ST segment, lower leads of T wave, and number of inverted leads of T wave in the observation group were lower than those in the control group (P0.01). After treatment, the abnormal rate of TG in the observation group was 10.39, which was lower than that in the control group (22.08%) (P0.05 the abnormal rate of), TC was 9.09, lower than 25.97% of the control group (P0.01), and the abnormal rate of HDL-C was 12.99%. Lower than the control group 28.57% (P0.05); After treatment, the score of SAQ scale in observation group was higher than that in control group, and the score of heart blood stasis syndrome was lower than that of control group (P0.01). After treatment, the levels of hs-CRP,HCY,Cys CD63 and MMP-9 in the observation group were lower than those in the control group, and the level of CD42 b was higher than that in the control group (P0.01). Conclusion: Guanxin granule can reduce angina pectoris attack, regulate lipid metabolism, inhibit inflammatory reaction and platelet activation function, improve myocardial ischemia and improve clinical efficacy.
【作者单位】：重庆市中医院;
【基金】：重庆市集成示范计划项目(cstc2015jcsf10011)
【分类号】：R259

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