中西医联合用药预防冠心病冠状动脉支架置入术后支架内再狭窄疗效观察  

Observation of curative effect of combined Chinese and western medicine on prevention of restenosis after PCI in patients with coronary heart disease

作　　者：梁泽明[1] 

机构地区：[1]陕西省宝鸡市中医医院,陕西宝鸡721001

出　　处：《现代中西医结合杂志》2018年第8期829-832,836,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察中西医联合用药预防冠心病冠状动脉支架置入术后支架内再狭窄的疗效。方法将144例拟行冠状动脉支架置入术的冠心病患者随机分为观察组72例和对照组72例,对照组支架置入术后给予即刻常规西药治疗,观察组在对照组治疗基础上给予自拟活血通脉汤治疗,治疗至术后6个月,观察2组术前、术后6个月的血脂、相关炎性因子、冠脉血管内超声变化情况,并记录术后6个月时支架内再狭窄发生率。结果 2组术后6个月三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平和血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、D-二聚体(D-D)水平均显著降低(P均<0.05),且观察组上述指标水平均明显低于对照组(P均<0.05);观察组术后6个月中薄层纤维帽硬化斑块(TCFA)比例、斑块体积、钙化组织比例、纤维组织比例均显著低于对照组(P均<0.05),术后6个月支架内再狭窄发生率(普通支架和药物洗脱支架)低于对照组(P<0.05)。结论中西医联合用药能够显著调节冠状动脉支架置入术后患者的血脂水平,抑制炎性反应,降低高凝状态,抑制冠脉内粥样硬化斑块发展进程,降低术后支架内再狭窄发生率。Objective It is to observe the curative effect of integrated traditional Chinese and western medicine in preventing in-stent restenosis( ISR) after coronary stenting in patients with coronary heart disease. Methods A total of 144 patients with coronary artery disease undergoing coronary stent implantation were randomly divided into observation group( n = 72) and control group( n = 72),the control group was given immediate conventional western medicine after stent implantation,the observation group was treated with the decoction for resolving stasis and unblocking channels on the basis of control group for 6 months after PCI. The changes of blood lipids,relevant inflammatory factors and intracoronary ultrasound before and 6 months after operation were observed in both groups,and the incidence of intra-stent restenosis( ISR)within 6 months after operation was recorded. Results The levels of triglyceride( TG),cholesterol( TC),low density lipoprotein cholesterol( LDL-C),high density lipoprotein cholesterol( HDL-C) and serum high-sensitivity C-reactive protein( hs-CRP),IL-6,TNF-α and D-dimer were all significantly decreased in 6 months after operation( P < 0. 05),and the levels of these indexes in the observation group were significantly lower than those in the control group( P < 0. 05). The intracoronary ultrasound findings( proportion of medium-thickness fiber cap of sclerosis plaque,plaque volume,proportion of calcified tissue,proportion of fibrous tissue) in the observation group at 6 months after operation were significantly lower than those in the control group( all P < 0. 05),the incidence of ISR( common stents and drug-eluting stents) with 6 months after operation was lower than that of the control group( all P < 0. 05). Conclusion The combination therapy of Chinese and western medicine can significantly regulate the blood lipid level,inhibit the inflammatory reaction,decrease the hypercoagulable state and inhibit the progression of coronary atherosclerotic plaque and reduce the incidence of postoperative ISR

关 键 词：冠心病 冠状动脉支架置入术 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]