解毒通脉胶囊治疗热毒痰瘀型冠心病合并高血脂症疗效观察  

Observation on curative effect of Jiedu Tongmai capsule on coronary heart disease with hypertoxicity of type of heat toxicity and phlegm stasis

作　　者：郭晓艳 张翠英 吉锋 GUO Xiaoyan;ZHANG Cuiying;JI Feng(Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, Shaanxi, China;Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, Shaanxi, China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712046

出　　处：《现代中西医结合杂志》2020年第10期1053-1057,1081,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察解毒通脉胶囊治疗热毒痰瘀型冠心病合并高血脂症临床疗效。方法选取2017年7月—2018年7月就诊于陕西中医药大学附属医院心血管内科的86例冠心病合并高血脂症且中医证型属于热毒痰瘀型的患者,随机分为对照组和治疗组各43例,对照组给予抗血小板、抗心绞痛及阿托伐他汀钙治疗,治疗组在对照组治疗基础上给予解毒通脉胶囊口服,2组均治疗8周。比较2组患者治疗前后心绞痛发作的次数、持续时间、服用硝酸异山梨酯的减停情况、心电图、血脂指标和血管炎症因子水平、中医证候疗效及不良事件的发生情况。结果治疗后2组患者心绞痛发作次数、持续时间较治疗前明显减少,心电图较前好转,总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-18)、脂蛋白相关磷脂酶A2(LP-PLA2)水平均较治疗前明显下降,高密度脂蛋白胆固醇(HDL-C)水平均较治疗前明显上升,差异均有统计学意义(P均<0.05);且治疗组治疗后TC、TG、LDL-C、MMP-9、hs-CRP、IL-18、LP-PLA2水平均明显低于对照组(P均<0.05),HDL-C水平明显高于对照组(P<0.05)。治疗组心电图总有效率为55.8%(24/43),对照组为41.9%(18/43),2组比较差异无统计学意义(P>0.05)。治疗组中医证候总有效率为93.0%(40/43),明显高于对照组的86.0%(37/43)。治疗组不良反应发生率为4.6%(2/43),对照组为9.3%(4/43),2组比较差异无统计学意义(P>0.05)。结论解毒通脉胶囊能明显改善热毒痰瘀型冠心病合并高血脂症患者的临床症状,可调节血脂水平,抑制炎症因子表达,临床疗效好,且安全。Objective It is to observe the clinical efficacy of Jiedu Tongmai capsule in the treatment of coronary heart disease with hypertoxicity of type of heat toxicity and phlegm stasis.Methods 86 patients who were diagnosed with coronary heart disease and hyperlipidemia and had TCM syndrome type of heat toxicity and phlegm stasis in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from July 2017 to July 2018 were randomly divided into control group and treatment group,43 cases in each group.The control group was given the treatment with antiplatelet,antiangina pectoris and atorvastatin calcium.The treatment group was given Jiedu Tongmai capsules orally on the basis of treatment in the control group.Both groups were treated for 8 weeks.The attack times and duration of angina pectoris,dosage change of isosorbide dinitrate,change of electrocardiogram,and the levels of blood lipid indexes and vascular inflammatory factors,TCM syndrome scores before and after treatment,and occurrence of adverse events were compared between the two groups.Results After treatment,the number and duration of angina pectoris in the two groups were significantly reduced,and the electrocardiogram was improved,the levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and matrix metalloproteinase-9(MMP-9),high-sensitivity C-reactive protein(hs-CRP),interleukin 8(IL-18),and lipoprotein-associated phospholipase A2(LP-PLA2)were significantly lower than those before treatment(P<0.05),high-density lipoprotein cholesterol(HDL-C)levels were significantly higher than those before treatment in the two groups(P<0.05);the levels of TC,TG,LDL-C,MMP-9,hs-CRP,IL-18,LP-PLA2 in the treatment group were significantly lower than those in the control group(P<0.05),and the HDL-C level was significantly higher than that in the control group(P<0.05).The total effective rate of electrocardiogram was 55.8%(24/43)in the treatment group,41.99%in the control group’s 41.9%(18/43),there was no significant diff

关 键 词：解毒通脉胶囊 热毒痰瘀 冠心病 高血脂症 动脉粥样硬化斑块 炎症反应 

分 类 号：R541.4[医药卫生—心血管疾病]