清热活血汤对急性冠脉综合征患者中医证候疗效及与巨噬细胞极化表型M2关系  

Effect of Qingre Huoxue Decoction on TCM Syndrome Curative Effect and Relationship with Macrophage Polarization Phenotype M2

作　　者：褚庆民[1] 唐娜 鹿金 李荣[1] CHU Qingmin;TANG Na;LU Jin;LI Rong(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Baiyun District Sanyuanli Street Community Health Service Center,Guangzhou 510406,Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州市白云区三元里街社区卫生服务中心,广东广州510406

出　　处：《辽宁中医药大学学报》2020年第4期158-162,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：广东省自然科学基金(2017A030313745);广东省中医药局项目(20181087);广东省医学科学技术研究基金(A2018222)。

摘　　要：目的通过观察清热活血汤对急性冠脉综合征(ACS)患者证候改善及CD163、hs-CRP的影响,以探讨清热活血法对急性冠脉综合征患者的临床疗效及对斑块稳定性、炎症水平的影响,为中医药治疗急性冠脉综合征提供参考。方法将80例急性冠脉综合征患者,采用随机分配原则,分为对照组(n=40)和试验组(n=40),对照组予西医基础治疗,试验组予西医基础治疗+清热活血汤,疗程为7~14 d,比较两组患者治疗前基线水平及治疗后中医证候改善情况和CD163、hs-CRP改变情况。结果 (1)试验组和对照组治疗7~14 d后CD163、hs-CRP水平均较治疗前有所下降;试验组CD163水平治疗前后差值明显大于对照组。(2)试验组和对照组治疗7~14 d后中医证候评分均较治疗前下降,且试验组在改善口干口苦、大便干结、小便短黄、舌苔黄厚腻方面评分治疗前后差值大于对照组,差异具有统计学意义。结论 (1)短期西药基础治疗和西药基础治疗+清热活血汤均可降低急性冠脉综合征患者CD163、hs-CRP水平,且试验组降低CD163水平方面效果更好,提示清热活血汤可能具有稳定斑块作用。(2)两组均可降低急性冠脉综合征患者中医证候评分,表明两种方案对改善胸闷胸痛、口干口苦、大便干结、小便短黄、舌苔黄厚腻等中医证候疗效指标均有较好效果;西药标准治疗+清热活血汤组在改善中医证候方面总体来说更有优势。Objective To observe the effect of Qingre Huoxue Decoction on CD163,hs-CRP and syndrome improvement in patients with acute coronary syndrome,and to explore the effect of Qingre Huoxue method on acute coronary artery. The clinical efficacy of patients with syndrome and its effect on plaque stability provide a reference for the treatment of acute coronary syndrome in Chinese medicine. Methods Eighty patients with acute coronary syndrome(40 patients with unstable angina pectoris and 40 patients with acute myocardial infarction)were randomly divided into control group(n=40)and observation group(n=40). The group was treated with Western medicine standard treatment. The observation group was treated with Western medicine standard treatment + Qingre Huoxue Decoction. The course of treatment was 1 week. The baseline levels before treatment and the improvement of CD163,hs-CRP and syndrome after treatment were compared between the two groups. Results(1)The levels of CD163,hypersensitive troponin,and high-sensitivity CRP in the control group and the observation group decreased after 7-14 d. The difference between the CD163 level of the observation group before and after the intervention was significantly greater than that of the control group.(2)The control group and the observation group were lower than the pre-intervention symptom scores after 7-14 d of intervention,indicating that the two regimens have effects on improving TCM syndromes such as chest tightness and chest pain. Moreover,the difference between the observation group and the stool in the stool,urination,and mouth dry mouth was greater than that of the control group,and the improvement of the tongue coating before and after the intervention was greater than that of the observation group. Conclusion(1)Short-term Western medicine standard treatment and Western medicine standard treatment + Qingre Huoxue Decoction can reduce the levels of CD163 and hs-CRP in patients with acute coronary syndrome,and the effect of lowering CD163 level in the observation group is b

关 键 词：清热活血汤 急性冠脉综合征 CD163 

分 类 号：R289.5[医药卫生—方剂学] R541.4[医药卫生—中药学]