小陷胸汤治疗难治性心绞痛气滞血瘀证临床研究  

Clinical Study on Xiaoxianxiong Decoction for Treatment of Refractory Angina Pectoris with Qi Stagnation and Blood Stasis Syndrome

作　　者：薛瑞文 郭颖强 侯杰军 XUE Rui-wen;GUO Ying-qiang;HOU Jie-jun(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中国中医药信息杂志》2018年第8期17-20,共4页Chinese Journal of Information on Traditional Chinese Medicine

摘　　要：目的观察小陷胸汤治疗难治性心绞痛气滞血瘀证临床疗效,探讨其可能的作用机制。方法采用随机数字表法将83例患者分为观察组43例和对照组40例。对照组予西医常规治疗,观察组在对照组治疗基础上予小陷胸汤,每日1剂,每日2次口服。均连续治疗4周。评价2组临床疗效及心电图疗效,观察2组治疗前后心绞痛症状评分,检测血清细胞色素C(CytC)、心肌营养素-1(CT-1)及血小板活化因子(PAF)、血小板活化因子乙酰水解酶(PAF-AH)、P-选择素(Ps)、血小板激活复合物-1(PAC-1)含量变化。结果对照组临床疗效、心电图疗效总有效率分别为62.50%、67.50%,观察组分别为74.42%、76.74%,观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后心绞痛发作次数、持续时间、疼痛性质、硝酸甘油用量、疼痛程度评分降低(P<0.05);2组治疗后比较,观察组上述症状评分优于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清CytC、CT-1、PAF、Ps、PAC-1含量降低,PAF-AH含量升高(P<0.05);2组治疗后比较,观察组血清学指标改善明显优于对照组(P<0.05)。结论小陷胸汤治疗难治性心绞痛气滞血瘀证疗效显著,其机制可能与抗心肌细胞凋亡、抗血小板活化相关。Objective To observe the clinical efficacy of Xiaoxianxiong Decoction for the treatment of refractory angina pectoris with qi stagnation and blood stasis syndrome;To explore its possible mechanism of action.Methods Totally 83 patients of refractory angina pectoris with qi stagnation and blood stasis syndrome were divided into observation group(43 cases)and control group(40 cases)according to random number table method.The control group was given routine Western medical treatment.The observation group was treated with Xiaoxianxiong Decoction on the basis of the control group,one dosage per day,twice daily orally.The treatment for both groups lasted for four weeks.Clinical efficacy and ECG efficacy of both groups were evaluated.The scores of angina pectoris synptoms,content changes of serum levels of cytochrome C(Cyt C),Cardiotrophin-1(CT-1),platelet activating factor(PAF),platelet activating factor acetylhydrolase(PAF-AH),P-selectin(Ps)and platelet-activating complex-1(PAC-1)in both groups before and after treatment were measured.Results The total effective rates of clinical efficacy and ECG efficacy were 62.5%and 67.5%respectively in the control group and 74.42%and 76.74%respectively in the observation group.The observation group was significantly higher than the control group(P<0.05).Compared with before treatment,number of episodes of angina pectoris,duration,pain properties,nitroglycerin usage,and pain degree scores were reduced in both groups after treatment(P<0.05).Comparing the two groups after treatment,the above symptoms in observation group were better improved than control group(P<0.05).Compared with before treatment,contents of serum Cyt C,CT-1,PAF,Ps and PAC-1 decreased,and content of PAF-AH increased after treatment in both groups(P<0.05).Comparing the two groups after treatment,the changes of above indexes in observation group were better than control group(P<0.05).Conclusion Xiaoxianxiong Decoction has obvious efficacy for refractory angina pectoris with qi stagnation and blood stasis syndrome.Its

关 键 词：小陷胸汤 难治性心绞痛 抗血小板活化 抗细胞凋亡 

分 类 号：R259.414.2[医药卫生—中西医结合]