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      中醫中藥

      探討血府逐瘀湯對冠心病患者血脂、血清炎癥因子及內皮功能的影響

      王姣

      [文章下載]

      【摘要】  【摘要】目的 探討血府逐瘀湯對冠心病患者血脂、血清炎癥因子及內皮功能等相關指標水平的影響。方法 研究對象為2018年1月至2019年1月期間于本院心血管內科住院治療的冠心病患者110例,隨機分為實驗組和對照組各55例。對照組患者予常規治療,實驗組患者在常規治療的基礎上予血府逐瘀湯治療,共治療24周。24周后對比兩組患者血脂、血清炎癥因子及內皮功能等指標水平。

      【關鍵字】  冠心病,血府逐瘀湯,血脂,血清炎癥因子,內皮功能

      中圖分類號:文獻標識碼:文章編號:

      [Abstract]Objective To study the effect of xuefu zhuyu decoction on blood lipid, serum inflammatory factors and endothelial function in patients with coronary heart disease. Methods 110 patients with coronary heart disease who were hospitalized in the department of cardiovascular medicine of our hospital from January 2018 to January 2019 were selected as subjects for this study,who were randomly divided into the experimental group and the control group.The control group received conventional treatment ang the experimental group was treated with xuefu zhuyu decoction on the basis of conventional treatment.Patients in both groups were treated for 24 weeks.serum lipids, inflammatory cytokines and endothelial functions of the two groups were compared after 24 weeks. Results after 24 weeks, the levels of serum lipid, inflammatory cytokines and endothelial function in the two groups were all improved compared with those before treatment, but the improvement degree of the experimental group was significantly better than that of the control group,the difference was significant and statistically significant (P<0.05). Conclusions Xuefu zhuyu decoction can significantly reduce the level of blood lipid in patients with coronary heart disease, inhibit inflammatory reaction, protect vascular endothelial function, so that it can reduce the cardiovascular and cerebrovascular accidents caused by atherosclerosis, and improve the treatment effect of coronary heart disease. It is worthy of wide clinical application.

      作為臨床常見疾病,冠心病又稱為缺血性心臟病,是由于冠狀動脈發生粥樣硬化,動脈管壁增厚變硬,心肌供血不足而致壞死引起的胸悶、胸痛為主要表現的疾病[1]。隨著經濟社會的蓬勃發展,高血壓、高血脂癥及2型糖尿病等疾病的發病率激增,同時也作為冠心病的高危因素威脅我國人民的身心健康[2]。臨床研究顯示,動脈粥樣硬化最重要的危險因素即為脂質代謝異常,同時血清炎癥因子與內皮功能也參與了冠心病的發生與發展[3]。冠心病屬于中醫的胸痹病范疇,研究顯示[4],血府逐瘀湯對心血瘀阻型胸痹效果顯著,本文研究血府逐瘀湯對心血瘀阻型胸痹患者的血脂、血清炎癥因子及內皮功能的影響取得良好效果?,F報道如下。 1 資料與方法 1.1 一般資料:本文的研究對象為2018年1月至2019年1月于本院治療的冠心病患者110例,隨機分為實驗組與對照組。對照組:男26例,女19例;年齡:49~78歲,平均(59.21±12.15)歲;病程1~8年,平均(4.65±2.41)年。實驗組:男:25例,女20例;年齡:51~79歲,平均(60.72±11.05)歲;病程1~9年,平均(4.86±2.62)年。兩組患者一般資料對比差異較小,具有可比性(P>0.05)。 1.2 納入與排除標準:納入標準:①符合《缺血性心臟病命名及診斷標準》中冠心病的診斷標準[5];②符合第三版中醫內科學中胸痹病心血瘀阻證的診斷標準[6];③心電圖檢查提示心肌缺血;④生命體征平穩;⑤患者及其家屬同意并簽署知情同意書。排除標準:①合并急性心肌梗死、嚴重心律失常及心肌炎的患者;②合并其他嚴重疾病者;③研究進行前1周內服用活血化瘀藥物史者;④精神疾病史者;⑤不能配合完成本研究內容者。 1.3 研究方法 1.3.1 對照組治療方案:對照組患者予常規治療方案:硫酸氫氯吡格雷片(Sanofi Winthrop Industrie,國藥準字:J20130083)75 mg qn po,酒石酸美托洛爾片(阿斯利康制藥有限公司,國藥準字:H32025391) 12.5 mg bid po,單硝酸異山梨酯緩釋片(齊魯制藥有限公司,國藥準字:H20066717) 40 mg qd po,瑞舒伐他汀鈣片(IPR PHARMACEUTICALS INCORPORATED,國藥準字:J20190009) 5 mg qn po。 1.3.2 實驗組治療方案:實驗組患者在對照組患者治療的基礎上予血府逐瘀湯,方藥組成:桃仁15 g,紅花、當歸、生地、牛膝各10 g,川芎、桔梗、柴胡各5 g,赤芍、枳殼各10 g,甘草3 g。瘀血痹阻較重者可加乳香、沒藥各10 g,丹參15 g;乏力、氣虛明顯者加黃芪15 g,黨參10 g。日1劑,水煎服,分2次溫服。 1.4 評價指標:①血脂:總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C及低密度脂蛋白膽固醇(LDL-C)等。②血清炎癥因子:白細胞介素-1β(IL-1β)、白細胞介素-18(IL-18)及超敏-C反應蛋白(hs-CRP)。③血管內皮功能:一氧化氮(NO)、內皮素1(ET-1)、血栓素B2(TXB2)及6-酮-前列腺素F-1α(6-Keto-PGF-1α)。 1.5 統計學處理:采用SPSS 23.0軟件處理本研究數據,計量資料采用( )表示,采用t檢驗;P<0.05為差異具有統計學意義。

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