冠心平对冠心病心绞痛患者血脂和抗氧化应激指标影响的机理及其临床研究  

Mechanism and Clinical Study on GuanxinpingAffecting Blood Lipids and Anti-oxidative Stress Indexes of Angina Pectoris

作　　者：韩旭[1] 李七一[1] 王令谆[1] 蒋萌[1] 周琴妹[1] 朱波[1] 赵惠[1] 刘福明[1] 刘健[1] 严士海[1] 

机构地区：[1]江苏省中医院,江苏南京210029

出　　处：《中华中医药学刊》2012年第12期2649-2654,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：教育部高等学校博士学科点专项科研基金资助项目(20093237110001);南京市科技发展计划资助项目(200805011)

摘　　要：目的:通过观察冠心平治疗冠心病(CHD)中医临床症状的发作情况和用药前后对心电图及血脂[总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、抗氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH)]的影响与关联性,评价其改善CHD的内皮功能障碍(EDF)作用机理和临床疗效。方法:应用随机、盲法、平行对照、独立评价的临床研究方法,选择160例符合条件的CHD心绞痛患者随机分为治疗组和对照治疗组,每组80人。在常规治疗基础上,治疗组加用冠心平治疗,每次4片,每日3次;对照组加用心可舒片,每次4片,每日3次。各组均连续服药4周为1个疗程,每7天复诊一次。观察时间为1个疗程。观察CHD心绞痛患者综合疗效、临床症状疗效、心电图疗效及TC、TG、HDL-C、LDL-C、SOD、GSH治疗前后含量变化。结果:两组CHD心绞痛患者在CHD的综合疗效和总有效率方面,治疗组改善更明显,与对照组比较P<0.05。治疗后两组中医胸闷、心慌、气短、神疲乏力、舌象、脉象症状均有改善P<0.05,治疗组疗效更优,与对照组比较P<0.05。治疗后两组心电图ST段下移、T波低平及倒置均有改善P<0.05,但治疗组与对照组比较P>0.05。治疗后两组TC、LDL-C较治疗前降低P<0.05,治疗组疗效更优,与对照组比较P<0.05;治疗组TG较治疗前有降低趋势P>0.05,对照组TC较治疗前有升高趋势P>0.05,治疗组疗效更优,与对照组比较P<0.05;两组HDL-C较治疗前有升高趋势P>0.05,治疗组与对照组比较P>0.05。治疗组SOD、GSH较治疗前升高P<0.05,对照组SOD、GSH较治疗前有降低趋势P>0.05,治疗组各项指标改善更明显,与对照组比较P<0.05。结论:冠心平治疗CHD心绞痛,可以明显缓解中医临床症状,改善心电图及血脂和抗氧化应激反应的相关指标;其治疗机理可能是通过调节血脂代谢、抗氧化等途径而发挥保护VEC、改善EDF,进而达到�Objective ： Research the effect of Guanxinping on TCM symptoms of coronary heart disease （ CHD）, ECG, blood lipids （ TC, TG, HDL - C, LDL - C）, anti - oxidative stress indexes （ SOD, GSH）, and the association between them before and after treatment, then evaluate the mechanism of its improvement of CHD endothelial dysfunction（EDF） and the clinical effect. Methods ： By using random, blind, parallel control, and independent evaluation clinic research methods, 160 patients of Angina Pectoris were enrolled and randomly divided into 2 groups ： the treatment group and the control group, 80 patients in each group. Based on routine therapy,Guanxinping was added in the treatment group,4 pills for each time by 3 times a day. While Xinkeshu Tablet was added in the control group,4 pills for each time by 3 times a day. Each group was continuously treated for 4 weeks as a course, and patients were asked to return visit every 7 days. Observation time lasted for a course. Effect of comprehensive therapy to Angina Pectoris, effect of clinical symptoms, effect of ECG, and content variation of TC ,TG, HDL - C, LDL - C, SOD, GSH before and after treatment were observed. Results ： Com pared with the control group,the treatment group had a better improvement of comprehensive therapeutic effect and total effective rates （P 〈 0.05 ）. After treatment, TCM symptoms such as thoracic stuffiness, palpitation, short breath, weakness and tiredness, tongue picture and pulse condition in both groups had been improved （ P 〈 O. 05 ）, and compared with the control group, the treatment group was better（P 〈 0.05 ）. All patients＇ ECGs revealed ST segment depression, T wave low - flat and inversion were some con：ected after treatment （ comparing with pre - treatment, P 〈 0.05 ）, but there was no statistical significance between the two groups（ P 〉 0.05）. Levels of TC and LDL- C in both post treatment groups de creased significantly（ P 〈0.05） ,which were even lower in the treated group tha

关 键 词：CHD心绞痛 辨证论治 SOD GSH TC TG HDL—C LDL—C 

分 类 号：R541.5[医药卫生—心血管疾病]