通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制  

Efficacy and mechanism of Tongxinluo capsule in treating angina pectoris of coronary heart disease with Qi deficiency and blood stasis

作　　者：段丙军[1] 林德智[1] 熊富权[1] 王小兵[1] 黄乐[1] DUAN Bingjun LIN Dezhi XIONG Fuquan WANG Xiaobing HUANG Le(Department of Internal Medicine, the First People＇s Hospital of Neijiang City, Sichuan Province, Neijiang 641000, China)

机构地区：[1]四川省内江市第一人民医院心血管内科,641000

出　　处：《疑难病杂志》2016年第10期1065-1068,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制。方法选取2013年7月—2015年11月四川省内江市第一人民医院心血管内科收治气虚血瘀型冠心病心绞痛患者105例,按随机数字表法随机分为2组,对照组51例,观察组54例。对照组予常规抗心绞痛治疗,观察组在对照组基础上加服通心络胶囊4粒,3次/d,2组均4周为1疗程,治疗3个疗程后观察比较临床疗效、心电图疗效,检测治疗前后2组患者血清白介素-6(IL-6)、白介素-18(IL—18)、血脂指标及心绞痛症状改善情况。结果治疗后,观察组总有效率高于对照组(94.3%vs.75.5%,x^2=6.949,P=0.003);观察组心电图总有效率高于对照组(90.8%vs.70.6%,x^2=8.777,P=0.032)。观察组治疗后每周心绞痛发作次数低于对照组(t=4.405,P=0.001),每次心绞痛持续时间明显短于对照组(t=5.074,P=0.000)。观察组患者血清IL-6及IL—18的水平均低于对照组(t=7.708,P=0.001;t=13.088,P=0.000),TC、TG及LDL-C水平亦显著低于对照组(t=10.097,P=0.003;t=4.115,P=0.023;t=4.312,P=0.029);而2组患者HDL—C水平治疗前后无显著变化(t=0.544、0.612,P=0.493、0.885)。结论通心络胶囊治疗气虚血瘀型冠心病心绞痛具有良好的临床疗效,其作用机制可能与调节炎性因子IL-6及IL—18相关。Objective To observe the therapeutic effect and mechanism of Tongxinluo capsule in treating angina pec-toris of coronary heart disease with Qi deficiency and blood stasis.Methods One hundred and five cases of coronary heart disease with Qi deficiency and blood stasis were randomly divided into 2 groups, 51 cases in the control group and 53 cases in the observation group.Control group was treated with routine treatment;the observation group added Tongxinluo capsule on the basis of control group（4 pills additionally, 3 times daily, 4 weeks for a course of treatment, continuous treatment 3 courses. The content of serum IL-6 and IL-18, blood lipid and clinical efficacy were observed and compared between the 2 groups be-fore and after treatment.Results After treatment, the total effective rate of observation group was higher than the control group （94.3%vs.75.5%,χ2 =6.949, P =0.003）.Comparison of the efficacy of ECG in 2 groups after treatment, the total effective rate of observation group was higher than the control group （90.8% vs.70.6%,χ2 =8.777, P =0.032）.In the observation group, the number of angina attacks per week was lower than that of the control group （ t =4.405, P =0.001）, and the duration of angina was significantly shorter than that of the control group （ t =5.074, P =0.000）.The observation group patients serum IL-6 and IL-18 levels were lower than the control group （ t =7.708, P =0.001;t =13.088, P =0.000） , TC, TG and LDL-C levels were also significantly lower than the control group （ t =10.097, P =0.003;t =4.115, P =0.023;t =4.312, P =0.029）;while the HDL-C level of patients before and after treatment in the 2 groups had no sig-nificant change （ t =0.544, t =0.612, P =0.493, P =0.885）.Conclusion Tongxinluo capsule in the treatment of coro-nary heart disease with Qi deficiency and blood stasis has good clinical effect, and its mechanism may be related to the regula-tion of inflammatory factor IL-6 and IL-18.

关 键 词：通心络胶囊 冠心病心绞痛 气虚血瘀型 白介素-6 白介素-18 疗效 

分 类 号：R259[医药卫生—中西医结合]