雪莲通脉丸对冠心病心绞痛患者血管内皮影响的临床研究  

Clinical Study on the Effects of Xuelian Tongmai Pills on Vascular Endothelium of Patients with Coronary Heart Disease Angina

作　　者：任小娟 祝婕 张秀芬 帕丽旦 赵金娜 王卫 Ren Xiaojuan Zhu Jie Zhang Xiufen Pa Lidan Zhao Jinna Wang Wei(Xinjiang Urumqi Hospital of Traditional Chinese Medicine, Urumqi 830011, China)

机构地区：[1]新疆乌鲁木齐市中医医院,乌鲁木齐830011

出　　处：《世界中医药》2017年第9期1993-1996,共4页World Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2014CB542903)--"基于冠心病痰瘀互结证辨证方法的创新研究";国家重大新药创制科技重大专项课题(2013ZX09303301)--"中药新药临床研究技术平台规范建设";新疆乌鲁木齐市科技局科学技术计划项目(Y151310021)

摘　　要：目的:通过观察雪莲通脉丸治疗冠心病心绞痛患者前后,血浆一氧化氮(NO)、抗氧化应激指标超氧化物歧化酶(SOD)、血栓素B2(TXB2)、P-选择素(P-selectin)等血管内皮功能指标的变化,评估雪莲通脉丸对血管内皮功能的影响。方法:选取2014年5月至2017年5月新疆乌鲁木齐市中医医院冠心病心绞痛患者60例,按随机数字表分成观察组和对照组,每组30例。对照组给予西医常规治疗,根据患者病情选用阿司匹林肠溶片100 mg,1次/d;他汀类(口服辛伐他汀片20 mg,1次/d);β-受体阻滞剂(口服比索洛尔5 mg,1次/d,或美托洛尔25 mg,2次/d),硝酸酯类(口服欣康40 mg,1次/d);疗程8周。观察组:在对照组的基础上,同时给予雪莲通脉丸,9 g/次,2次/d,疗程8周。治疗8周后观察2组患者中医症候积分、NO、SOD、TXB2、P-selectin的变化。结果:1)中医证候:治疗后2组中医证候积分均有明显改善,差异有统计学意义(P<0.05),且观察组改善程度明显优于对照组,差异有统计学意义(P<0.05)。医证候临床疗效方面:观察组显效率60.00%,明显优于对照组的33.33%,差异有统计学意义(P<0.05),观察组总有效率96.7%,明显优于对照组的80%,差异有统计学意义(P<0.05)。2)血浆一氧化氮(NO)水平:治疗后2组患者血浆NO水平升高,且观察组前后比较差异有统计学意义(P<0.05),对照组前后比较差异无统计学意义(P>0.05),治疗后2组患者血浆NO比较差异有统计学意义(P<0.05)。3)血浆SOD水平:治疗后2组患者SOD水平均有所升高,差异有统计学意义(P<0.05),且观察组前后比较差异有统计学意义(P<0.05),对照组前后比较差异无统计学意义(P>0.05),治疗后2组患者血浆SOD比较差异有统计学意义(P<0.05)。4)血浆TXB_2、P-selectin水平:治疗后2组患者TXB2、P-selectin水平均有所下降,且观察组与治疗前比较明显下降,差异有统计学意义(P<0.05);对照组前后比较差异无统计学意义(P>0.05)。治疗后组间�Objective： To observe the changes of vascular endothelial function indexes of plasma-nitric oxide（ NO）,superoxide dismutase（ SOD）,thromboxane B2（ TXB2） and P-selectin of patients with coronary heart disease（ CHD） angina by treating with Xuelian Tongmai Pills,and to evaluate the effects of Xuelian Tongmai Pills on vascular endothelial function. Methods： A total of 60 patients with CHD angina in accordance from May 2014 to May 2017 with diagnosis criteria were divided into control group（ conventional western medicine treatment group） and treatment group（ Xuelian Tongmai Pills ＋ conventional western medicine treatment）,30 cases in each group. The control group was treated with conventional western medicine treatment. The patients were given Aspirin Enteric-coated Tablets 100 mg,qd,Statins（ oral administration of Simvastatin Tablets 20 mg,qd）,β-receptor blocker（ oral administration of bisoprolol 5 mg,qd or metoprolol 25 mg,bid）,Nitrates（ oral administration of xinkang 40 mg,qd）. The treatment course was 8 weeks. The treatment group was added Xuelian Tongmai Pills 9 g per time,bid for 8 weeks. The changes of TCM pattern scores,NO,SOD,TXB2 and P-selectin of patients in two groups after 8 weeks’ treatment were observed. Results： 1） For TCM pattern,TCM pattern scores of two groups were significantly improved after treatment（ P 〈 0. 05）,and the improvement of treatment group was significantly better than that of control group（ P 〈 0. 05）. For clinical efficacy,the effective rate of treatment group was60. 00%,which was significantly better than 33. 33% in control group（ P 〈 0. 05）. The total effective rate of treatment group was96. 7%,which was significantly better than 80% of control group（ P 〈 0. 05）. 2） For plasma NO level,plasma NO levels of two groups were increased after treatment,and there was significant difference in treatment group before and after treatment（ P 〈0. 05）,while the difference was not significant in control group（ P �

关 键 词：雪莲通脉丸 冠心病 血管内皮功能 

分 类 号：R285.6[医药卫生—中药学]