加味小陷胸汤结合西医常规疗法治疗难治性心绞痛气滞血瘀证临床研究  

Clinical study of Jiawei-Xiaoxianxiong decoction combined with conventional western medicine therapy in the treatment of refractory angina pectoris with Qi stagnation and blood stasis syndrome

作　　者：李爱玲[1] 贾晓霞[2] 马林[1] 许永梅 Li Ailing;Jia Xiaoxia;Ma Lin;Xu Yongmei(Internal Medicine-Cardiovascular Department,Shanxian County Central Hospital,Shanxian 274300,China;Gastroscope Room Department,Shanxian County Central Hospital,Shanxian 274300,China)

机构地区：[1]山东省菏泽市单县中心医院心内科,274300 [2]山东省菏泽市单县中心医院胃镜室,274300

出　　处：《国际中医中药杂志》2019年第9期941-945,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的观察加味小陷胸汤结合西医常规疗法治疗难治性心绞痛气滞血瘀证的临床疗效并探讨其作用机制.方法将符合入选标准的98例难治性心绞痛患者按随机数字表法将分为2组,每组49例.对照组采用常规疗法治疗,研究组在对照组基础上联用加味小陷胸汤,2组均治疗4周.分别于治疗前后进行心绞痛症状评分;采用ELISA法检测血清心肌营养素-1(cardiotrophin-1,CT-1)、细胞色素C(cytochrome C,Cyt C)、可溶性细胞间黏附因子-1(soluble intercellular adhesion molecular-1,sICAM-1)、血管性假血友病因子(von Willebrand Factor,vWF)、MDA、SOD水平,评价临床疗效.结果研究组总有效率为75.5%(37/49)、对照组为63.3%(31/49),2组比较差异有统计学意义(χ^2=5.235,P=0.022).治疗后,研究组CT-1[(105.19±12.04)ng/L比(158.25±14.18)ng/L,t=19.967]、Cyt C[(0.53±0.11)ng/L比(0.81±0.15)ng/L,t=10.537]水平及血清sICAM-1[(261.13±38.40)μg/L比(415.55±42.26)μg/L,t=18.930]、vWF[(105.22±18.63)μg/L比(145.57±21.18)μg/L,t=10.013]、MDA[(4.80±0.59)mol/L比(6.21±0.87)mol/L,t=9.389]水平均低于对照组(P<0.01),SOD[(12.07±1.84)mol/L比(10.89±1.65)mol/L,t=3.342]水平高于对照组(P<0.01);研究组治疗后发作次数、持续时间、疼痛程度、疼痛性质、硝酸甘油用量评分均低于对照组(t值分别为9.711、11.521、8.818、13.922、17.791,P值均<0.01).结论加味小陷胸汤结合西医常规疗法可明显改善难治性心绞痛气滞血瘀证患者的心绞痛症状,提高临床疗效,其作用机制可能与抗心肌细胞凋亡、减轻血管内皮损伤及抗氧化有关.Objective To observe the clinical effect of Jiawei-Xiaoxianxiong decoction combined with conventional western medicine for the refractory angina pectoris with Qi stagnation and blood stasis syndrome and to explore its mechanism. Methods A total of 98 patients who met the inclusion criteria were divided into two groups according to the random number table method, 49 in each group. The control group was treated with conventional therapy. The study group was treated with Jiawei-Xiaoxianxiong decoction on the basis of the control group. Both groups were treated for 4 weeks. The symptom of angina pectoris was scored before and after treatment. The Serum level of cardiotrophin-1 (CT-1), cytochrome C (Cyt C), soluble intercellular adhesion molecule-1 (sICAM-1), von Willebrand Factor (vWF), MDA and SOD were measured by ELISA, and the clinical effect was evaluated. Results The total effective rate was 75.5% (37/49) in the study group and 63.3% (31/49) in the control group. There was significant difference between two groups (χ^2=5.235, P=0.022). After treatment, the level of CT-1 (105.19 ± 12.04 ng/L vs. 158.25 ± 14.18 ng/L, t=19.967), Cyt C (0.53 ± 0.11 ng/L vs. 0.81 ± 0.15 ng/L, t=10.537) in the study group were significantly lower than those in the control group (P<0.01);the serum level of sICAM-1 (261.13 ± 38.40 μg/L vs. 415.55 ± 42.26 μg/L, t=18.930), vWF (105.22 ± 18.63 μg/L vs. 145.57 ± 21.18 μg/L, t=10.013), MDA (4.80 ± 0.59 mol/L vs. 6.21 ± 0.87 mol/L, t=9.389) in the study group were significantly lower than those of the control group (P<0.01);the SOD (12.07 ± 1.84 mol/L vs. 10.89 ± 1.65 mol/L, t=3.342) level in the study group was significantly higher than that of the control group (P<0.01). The number of attacks, duration, degree of pain, nature of pain and nitroglycerin dosage in the study group were significantly lower than those in the control group (t=9.711, 11.521, 8.818, 13.922, 17.791, respectively, all Ps<0.01). Conclusions The Jiawei-Xiaoxianxiong decoction combined with routine weste

关 键 词：心绞痛 小陷胸汤 细胞凋亡 抗氧化剂 中西医结合疗法 

分 类 号：R54[医药卫生—心血管疾病]