清热化痰活血法治疗冠心病不稳定型心绞痛临床研究  

Clinical Study for the Treatment Using Clear up Heat,Resolve Phlegm and Promoting Blood Circulation in Unstable Angina Pectoris

作　　者：洪永敦[1] 黄衍寿[1] 陈宇鹏[1] 吴辉[1] 

机构地区：[1]广州中医药大学第一附属医院心内科,广东广州510405

出　　处：《辽宁中医杂志》2005年第7期625-627,共3页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:探讨不稳定型心绞痛与炎症的关系,以清热化痰活血法综合治疗不稳定型心绞痛的近期临床疗效及其对炎症指标的影响。方法:将120例不稳定型心绞痛患者随机分为治疗组和对照组,两组均予西医常规处理,治疗组加用注射用丙酯及小陷胸汤合冠心2号方加减汤剂,观察临床疗效和治疗前后C反应蛋白(CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF-α)水平的变化情况。结果:治疗组心绞痛疗效、心电图疗效、西医综合疗效,心血管事件的发生率,中医证候积分及治疗前后积分差值比较等均较对照组优,两组比较经统计学检验(P<0.05),差异有显著性意义;治疗后两组炎症指标(IL-6、CRP、TNF-α)均明显下降,而治疗组较对照组下降更为明显,经统计学检验(P<0.05),差异有显著性意义。结论:炎症机制在不稳定型心绞痛中起着重要的作用;以清热化痰活血法为主的综合治疗对不稳定型心绞痛有比较肯定的治疗效果及减轻其炎症反应,可适度地降低不稳定型心绞痛近期心血管事件的发生率。Objective:Study the relationship between the unstable angina pectoris and inflammation,the short term clinical effect of the treatment using clear up heat,resolve phlegm and promoting blood circulation in Unstable Angina Pectoris patients,and the affect to the inflammation indices.Methods:Using 120 patients which clinical diagnosis are unstable angina pectoris,randomize to two groups,the comparison group and the therapy group.The regular treatment of the unstable angina pectoris were used in both two groups,in addition,the therapy group using the propylgallate for injection,and the modified decoction of the combination with XiaoXianXiong decocion and No.2 coronary disease prescription,and then observed the clinical treatment effect and the blood indices such as CRP,IL-6,TNF-α,and compared the change after the treatment.Results:In the therapy group,all the indices are better than the comparison group,such as the overall treatment effect including the angina,electrocardiogram,the incidence rate of the cardiovascular events,the TCM syndromes calculated points,and the comparison of the calculated points difference before and after the therapy.And the difference is significant(P<0.05).About the inflammation indices,there are decrease of the CRP,IL-6,TNF-α in both groups,but more obviously in the therapy group,and the difference is significant(P<0.05).Conclusion:The inflammation mechanism is important in the unstable angina pectoris;the effect of the treatment using clear up heat,resolve phlegm and promoting blood circulation in unstable angina pectoris is sure,and the inflammation reaction is decreased.The short term incidence rate of cardiovascular events is also decreased in certain degree for the unstable angina pectoris patients.

关 键 词：不稳定型心绞痛 清热化痰活血法 C反应蛋白 白细胞介素-6 肿瘤坏死因子 

分 类 号：R259.414[医药卫生—中西医结合]