化痰祛瘀方对冠心病患者胰岛素抵抗及纤维蛋白溶解活性的影响  

Effect of resolving phlegm and removing blood stasis formula on insulin resistance and fibrinolytic activity of patients with coronary heart disease

作　　者：简亚平[1] 徐琼芳[1] 陈晓育[2] 张毅敏[1] 唐敏[2] 欧阳晓明[2] 

机构地区：[1]湖南省永州职业技术学院 [2]湖南省永州职业技术学院附属医院

出　　处：《山西中医》2016年第2期22-24,共3页Shanxi Journal of Traditional Chinese Medicine

基　　金：2012年度湖南省高校科研中标项目(编号:12C1252)

摘　　要：目的：观察化痰祛瘀方对冠心痛患者胰岛素抵抗及纤维蛋白溶解活性的影响.方法：80例痰瘀互结型冠心病患者随机分为两组,在西医常规治疗的基础上,治疗组服化痰祛瘀方,对照组服复方丹参片,治疗1个月.观察临床疗效及治疗前后空腹血糖（FBG）、胰岛素（INS）、胰岛素敏感指数（ISⅠ）、纤溶酶原激活剂抑制物-1（PAI-1）的变化.结果：治疗组总有效率为87.50％ （95％ CI=77.25％ ～ 97.75％）,对照组为72.50％ （95％ CI=58.66％ ～ 86.34％）,两组综合疗效比较（u=2.159 6,P=0.030 9）,差异有显著性意义;与对照组比较,治疗组可降低FBG（t＇=-2.773 8,P＜0.01）,升高ISI（t ＇=4.016 7,P＜0.01）,降低PAI-1（t=-2.379 9,P＜0.05）.结论：在西医常规治疗基础上,采用化痰祛瘀方治疗冠心痛患者胰岛素抵抗及纤维蛋白溶解活性的疗效优于复方丹参片,其收益为OR =0.38（95％ CI =0.12 ～ 1.21）,NNT =7（95％ CI=3.07 ～46.19）;且可降低FBG,升高ISI,降低PAI-1.Objective ： To observe the effect of resolving phlegm and removing blood stasis formula on insulin resistance and fibrinolytic activity of patients with coronary heart disease. Methods ： 80 cases of patients with coronary artery disease of phlegm and blood stasis type were randomly divided into two groups. On the basis of treatment with conventional western medicine, the treatment group took resolving phlegm and removing blood stasis formula, while the control group took fu fang dan shen pian. Both groups were treated for a month. The clinical effects and the changes of fasting blood glucose （ FBG）, insulin （ INS）, insulin sensitivity index （ ISI）, plasminogen activator inhibitor-1 （ PAI-1 ） before and after treatment were observed. Results ： The total effective rate of treatment group was 87.50% （95% CI =77.25% -97.75%）, the control group was 72.50% （95% CI = 58.66% 86.34% ）. Compared the effects of two groups comprehensively（ u = 2. 159 6, P = 0. 030 9） , the difference had re- markable significance. Compared with the control group, the treatment group could reduce FBG （t＇ = -2. 773 8, P 〈0. 01） and PAl- 1 （t = -2. 379 9, P 〈0. 05）. increase ISI （t＇ = 4. 0167, P 〈0.01）. Conclusion： On the basis of treatment with conventional western medicine, the effect of resolving phlegm and removing blood stasis formula on insulin resistance and fibrinolytic activity of patients with coronary heart disease is better than that of fu fang dan shen pian. Its benefits is OR = 0.38 （95 % CI = 0. 12 - 1.21 ）, NNT = 7 （95 % CI = 3.07 - 46. 19 ） ; and resolving phlegm and removing blood stasis formula can reduce the FBG and PAI- 1, increase ISI.

关 键 词：冠心病 胰岛素抵抗 痰瘀互结证 化痰祛瘀方 纤维蛋白溶解活性 中医药疗法 

分 类 号：R541.4[医药卫生—心血管疾病]