活血解毒降糖方对糖尿病急性冠脉综合征非血运重建患者促炎／抗炎因子平衡的影响  

Effects of Huoxue Jiedu Jiangtang formulation on the balance between pro- and anti- inflammatory cytokines in non-revascularization patients with diabetic acute coronary syndrome

作　　者：符显昭[1] 许靖[1] 李春燕[1] 黄文华[1] 李星婵[1] 邱石源 

机构地区：[1]右江民族医学院附属医院中医科,广西壮族自治区百色533000

出　　处：《中国中西医结合急救杂志》2016年第1期6-10,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家自然科学基金地区资助项目（81460698）;广西自然科学基金资助项目（2015GXNSFAA139221）;广西中医药民族医药传承创新专项（GZLC16-62）;广西中医药民族医药自筹经费科研项目（GZZC14-62）;广西壮族自治区百色市科技开发项目（百科计字[2014]9号）

摘　　要：目的探讨活血解毒降糖方对糖尿病急性冠脉综合征（DACS）非血运重建患者促炎／抗炎平衡的影响，并分析其可能的机制。方法采用前瞻性研究方法，选择广西右江民族医学院附属医院心血管内科和中医科2014年8月至2015年7月收治的因各种原因未能行血运重建治疗的DACS患者67例，按随机数字表法分为对照组（33例）和观察组（34例），对照组给予单纯的西医标准化治疗，观察组在标准化西医治疗基础上加用活血解毒降糖方（人参10g、黄芪15g、麦冬15g、山茱萸10g、生地黄15g、大黄5g、鳖甲15g、桃仁10g、牡丹皮10g、黄连8g、丹参10g、山药15g、五味子10g），每日1剂，水煎约300mL，每次i00mL分早、中、晚3次温服；两组疗程均为2个月。观察两组中医临床证候胸闷、胸痛发作频率和持续时间、心悸、气短、乏力、自汗及证候总评分的变化，记录心电图；检测两组治疗前后促炎症因子[C-反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）]与抗炎因子（IL-10、脂联素（ADPN）]，并观察不良反应发生情况。结果与治疗前比较，两组治疗后胸闷胸痛发作频率评分均降低；且观察组胸闷胸痛持续时间、疲乏及证候总评分均较对照组明显降低（分：0．6±0．3比1．2±0．8，1．2±0．4比1．5±0．6，7．2±3．2比14．1±6．8，均P〈0．05）；两组治疗后心电图sT段下移导联数、T波低平导联数、T波倒置导联数均较治疗前明显降低，且以观察组的降低更显著（ST段下移导联数（次）：2．8±0．6比4．7±0．7，T波低平导联数（次）：2．1±0．9比2．5±1．0，T波倒置导联数（次）：2．0±0．8比2．3±1．5]；与治疗前比较，两组治疗后血清CRP、IL-6、TNF-α水平均显著降低，IL-10、ADPN水平均显著升高，且以观察组的变化更为显著[CRP（mg／L）：2．82±0．37比4．11±0．52，IL-6（nObjective To explore the effects of Huoxue Jiedu Jiangtang formulation （HJJF） on the balance between pro-inflammatory and anti-inflammatory cytokines in un-revascularization patients with diabetic acute coronary syndrome （DACS） and analyze its possible therapeutic mechanisms. Methods A prospective study was conducted, 67 DACS patients admitted to Departments of Cardiology or Traditional Chinese Medicine （TCM） in Affiliated Hospital of Youjiang National Medical College from August 2014 to July 2015 without undergoing any revascularization therapy for various reasons were enrolled, and they were randomly divided into control group （33 cases） and observation group （34 cases）. Both control and observation groups received the routine Western medical treatment, and in observation group, additionally the patients were treated with HJJF [ginseng 10 g, astragalus 15 g, radix ophiopogonis 15 g, cornus 10 g, radix rehmanniae 15 g, rhubarb 5 g, turtle shell 15 g, peach kernel 10 g, cortex montan 10 g, rhizome coptidis 8 g, salvia miltiorrhiza 10 g, yam 15 g, magnoliaceae 10 g] decocted with water into 300 mL, warmly taken 100 mL, 3 times a day （in the morning, at noon and in the evening daily）. The therapeutic course for all the patients was 2 months. Before and after treatment the changes of total score of traditional Chinese medicine （TCM） clinical symptoms such as chest tightness, chest pain and their frequency and duration of onset, palpitation, shortness of breath, fatigue spontaneous perspiration and total symptom score were observed, and the changes of electrocardiogram （ECG） were recorded; the serum levels of pro-inflammatory cytokines [C-reactive protein （CRP）, interleukins-6 （IL-6）, tumor necrosis factor-α （TNF-α）] and anti-inflammatory cytokines [interleukins-10（IL-10）, adiponectin （ADPN）] were studied, and their adverse reactions were observed in two groups. Results Compared with those before treatment, the frequencies and scores of chest tightness and pain af

关 键 词：活血解毒降糖方 糖尿病急性冠脉综合征 非血运重建 促炎因子 抗炎因子 

分 类 号：R541.4[医药卫生—心血管疾病]