稳斑汤联合增强型体外反搏治疗冠心病不稳定型心绞痛临床研究  

Wenban Decoction combined with enhanced external counterpulsation in treatment of unstable angina pectoris with coronary heart disease

作　　者：陈用贵 宫丽鸿[2] 杨柏松 汪雨静 CHEN Yong-gui;GONG Li-hong;YANG Bai-song;WANG Yu-jing(Department of Cardiology,No.463 Hospital of PLA,Shenyang 110000,China)

机构地区：[1]北部战区空军医院心内科,辽宁沈阳110000 [2]辽宁中医药大学附属医院心内科,辽宁沈阳110847

出　　处：《临床军医杂志》2018年第10期1169-1171,共3页Clinical Journal of Medical Officers

基　　金：国家中医药管理局国家中医药临床研究基地业务建设科研专项课题(JDZX2015033);辽宁省重点专科能力建设项目中医药临床学专科能力建设项目;沈阳市心血管康复技术重点实验室项目(F14-189-1-00)

摘　　要：目的探讨稳斑汤联合增强型体外反搏(EECP)治疗冠心病不稳定型心绞痛的机制及临床疗效。方法选取辽宁中医药大学附属医院心内康复中心自2014年10月至2016年2月收治的60例冠心病不稳定型心绞痛痰瘀互结患者为研究对象。将所有患者随机分成A组和B组,每组各30例。A组给予稳斑汤及西医规范治疗; B组在A组治疗基础上加入增强型体外反搏治疗。比较两组患者治疗前后心绞痛症状积分疗效和中医证候积分及疗效,血清超氧化物歧化酶(SOD)、血管内皮生长因子(VEGF)、前列环素(PGI2)、一氧化碳(NO)水平及不良反应发生情况。结果 B组心绞痛治疗有效率为90. 0%(27/30),显著高于A组的76. 7%(23/30),两组比较,差异有统计学意义(P <0. 05)。B组中医症候有效率为90. 0%(27/30),显著高于A组的83. 3%(26/30),两组比较,差异有统计学意义(P <0. 05)。两组患者治疗后SOD、VEGF、PGI2、NO水平均显著增加,且B组水平显著高于A组,两组比较,差异均有统计学意义(P <0. 05)。两组均无肝、肾功能损害、心力衰竭、脑出血等并发症发生。结论稳斑汤联合EECP治疗能改善冠心病不稳定型心绞痛PCI术后患者心绞痛症状及中医证候,上调SOD、VEGF、PGI2、NO表达水平,改善远期预后,为冠心病康复治疗提供很好的借鉴作用。Objective To investigate the mechanism and clinical effect of Wenban Decoction combined with enhanced external counterpulsation(EECP)in the treatment of unstable angina pectoris of coronary heart disease(CHD).Methods A retrospective study was performed on 60 cases of CHD patients with unstable angina pectoris who were admitted from October 2014 to February 2016.All the patients were randomly divided into the Group A and Group B,with 30 cases in each group.Patients in Group A were treated with Wenban Decoction and western medicine;patients in Group B added enhanced extracorporeal counterpulsation on the basis of Group A.The effects of angina pectoris symptom score,TCM syndrome score,serum superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),prostacyclin(PGI2),nitric oxide(NO)levels and adverse reactions were compared between the two groups before and after treatment.Results The effective rate of angina pectoris treatment in Group B was 90.0%(27/30),which was significantly higher than that in Group A(76.7%,23/30).There was a significant difference between the two groups(P<0.05).The effective rate of TCM symptom in Group B was 90.0%(27/30),which was significantly higher than that in Group A(83.3%,26/30).The difference between the two groups was statistically significant(P<0.05).The level of SOD,VEGF,PGI2,NO in Group B was significantly higher than that in Group A(P<0.05).No liver,renal function damage,heart failure,cerebral hemorrhage and other complications occurred in both groups.Conclusion The combined treatment with EECP can improve the symptoms of angina pectoris and TCM syndromes in patients with unstable angina pectoris after PCI,upregulates the expression level of SOD,VEGF,PGI2 and NO,improve the long-term prognosis,and provide a good reference for the rehabilitation of coronary heart disease.

关 键 词：稳斑汤 增强型体外反搏 冠心病 不稳定型心绞痛 超氧化物歧化酶 血管内皮生长因子 前列环素 

分 类 号：R541.4[医药卫生—心血管疾病]