超敏C反应蛋白在活血解毒中药治疗不稳定型心绞痛中的临床意义及其辅助评价指标研究  

Clinical Significance of High-sensitivity C-reactive Protein in Blood-activating and Toxin-resolving Medicine for Unstable Angina Patients

作　　者：冯妍[1] 张京春[2] 王以新[1] 郭芳[1] 陈顺华[1] 吕树铮[3] 

机构地区：[1]首都医科大学附属北京安贞医院全科医学科,北京市100029 [2]中国中医科学院西苑医院心血管病中心 [3]首都医科大学附属北京安贞医院心内科,北京市100029

出　　处：《中国全科医学》2014年第17期1964-1968,共5页Chinese General Practice

基　　金：国家重点基础研究发展规划(973)项目(2006CB504803);院长基金项目(Z201305)

摘　　要：目的分析超敏C反应蛋白(hs-CRP)在活血解毒中药治疗不稳定型心绞痛中的临床意义,并对其辅助评价指标进行初步探索。方法选取2008年3—9月于首都医科大学附属北京安贞医院心内科及首都医科大学附属同仁医院心内科住院的经冠状动脉造影确诊的不稳定型心绞痛患者65例,并按照随机数字表法将其分为活血组和活血解毒组,剔除不符合标准的患者后,最终活血组31例,活血解毒组30例。在西医标准化治疗的基础上,活血组加用芎芍胶囊治疗,活血解毒组加用芎芍胶囊和黄连胶囊治疗,两组疗程均为1个月。比较治疗前后血清hs-CRP水平、心绞痛计分、血瘀证计分、中医主症计分、血脂指标的变化。结果治疗前、后活血解毒组血清hs-CRP水平均低于活血组(P<0.05);活血组治疗前后血清hs-CRP水平比较,差异无统计学意义(P>0.05);活血解毒组治疗后血清hs-CRP水平低于治疗前(P<0.05)。治疗前两组心绞痛计分比较,差异无统计学意义(P>0.05);治疗后活血解毒组心绞痛计分低于活血组(P<0.05);活血组和活血解毒组患者治疗后的心绞痛计分均低于治疗前(P<0.05)。治疗前、后两组血瘀证计分、中医主症计分比较,差异均无统计学意义(P>0.05);两组治疗后血瘀证计分、中医主症计分均低于治疗前(P<0.05)。治疗前、后两组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)比较,差异均无统计学意义(P>0.05);两组治疗后的TC、LDL-C均低于治疗前(P<0.05)。结论与活血组相比,血清hs-CRP水平在评价活血解毒中药治疗不稳定型心绞痛患者的临床疗效中意义更加明显;心绞痛计分可能可以作为hs-CRP的辅助指标综合评价治疗不稳定型心绞痛药物的临床疗效。Objective To analyze the clinical significance of high-sensitivity C-reactive protein（hs-CRP） in blood-activating and toxin-resolving medicine for unstable angina（USA） patients,and a preliminary exploration of its secondary index.Methods Sixty-five USA patients hospitalized in department of cardiology,Anzhen Hospital Affiliated to Capital Medical University from March to September 2008 were randomly assigned into groups A（blood-activating group）,B（blood-activating and toxin-resolving group）.Excluding the patient does not meet the standards,and ultimately group were31 cases,30 cases of group B.Based on standard treatment of Western Medicine,group A were given Xiongshao capsules,group B given capsules of Xiongshao and Huanglian.The treatment lasted 1 month.Serum hs-CRP level,scores of angina,stagnation of blood and TCM main symptoms,changes of lipid parameters were compared between 2 groups before treatments and after.Results The level of serum hs-CRP was lower in group B than in group A before and after treatment（P〈0.05）.There was no significant difference in hs-CRP between pre-and post-treatments in group A（P〉0.05）.The level of hs-CRP was lower after treatment than before in group B（P〈0.05）.There was no difference in score of angina between 2 groups before treatment（P〈0.05）,and was lower in group B than in group A after treatment（P〉0.05）,and was lower after treatment than before between 2 groups（P〈0.05）.There was no difference in scores of stagnation of blood and TCM main symptoms between 2 groups（P〉0.05）,and lower after treatment than before treatment between 2 groups（P〉0.05）.There was no difference in TC,TG,LDL-C,HDL-C between 2 groups before and after treatment（P〈0.05）,TC,LDL-C lower after treatment than before between 2 groups（P〈0.05）.Conclusion Compared with group A,serum hs-CRP level was more significant in evaluating the clinical effects of blood-activating and toxin-resolving medicine on USA.Score of angina may be used as an auxil

关 键 词：超敏C反应蛋白 心绞痛 不稳定型 活血 炎性反应 

分 类 号：R541.42[医药卫生—心血管疾病]