活血通脉益心汤对气滞血瘀型微血管性心绞痛病人血管内皮功能、冠状动脉血流储备及心脏微循环的影响  

Influences of Huoxue Tongmai Yixin Decoction on Vascular Endothelial Function,Coronary Flow Reserve and Cardiac Microcirculation in Patients with Microvascular Angina of Qi Stagnation and Blood Stasis

作　　者：李艳红 杨亚莉 李静[2] 万翔[1] 龚芳[3] LI Yanhong;YANG Yali;LI Jing;WAN Xiang;GONG Fang(Xiantao First People′s Hospital Affiliated to Yangtze University,Xiantao 433000,Hubei,China)

机构地区：[1]长江大学附属仙桃市第一人民医院,湖北仙桃433000 [2]华中科技大学同济医学院附属协和医院 [3]襄阳市中心医院/湖北文理学院附属医院,湖北襄阳441021

出　　处：《中西医结合心脑血管病杂志》2020年第18期2963-2967,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：湖北省自然科学基金(No.2016CFB344);湖北省科学研究与技术开发重点计划项目(No.2018ADC275)。

摘　　要：目的研究活血通脉益心汤对气滞血瘀型微血管性心绞痛病人血管内皮功能、冠状动脉血流储备及心脏微循环的影响。方法选取2016年3月—2018年12月于长江大学附属仙桃市第一人民医院门诊或住院部接受治疗的气滞血瘀型微血管性心绞痛病人140例,根据随机数字表法分为观察组与对照组,每组70例。对照组给予西药常规治疗,观察组加用活血通脉益心汤治疗,两组均连续治疗4周。比较两组治疗前后一氧化氮(NO)、内皮素-1(ET-1)、超敏C反应蛋白(hs-CRP)含量、冠状动脉血流储备功能(CFR)、心肌平台期强度(A)、再充盈平均速度(β)、心绞痛症状、中医证候和生活质量,评价临床疗效。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组NO水平高于对照组,ET-1、hs-CRP低于对照组,差异有统计学意义(P<0.05);观察组A、β和CFR均高于对照组,差异均有统计学意义(P<0.05);观察组心绞痛发作持续时间、发作次数和疼痛程度评分均低于对照组,差异均有统计学意义(P<0.05);观察组中医证候评分低于对照组,生活质量评分高于对照组,差异均有统计学意义(P<0.05);观察组总运动时间多于对照组,ST段压低0.1 mV时间和ST段压低幅度小于对照组,差异均有统计学意义(P<0.05)。结论活血通脉益心汤能够改善气滞血瘀型微血管性心绞痛病人心脏微循环,提高病人血管内皮功能和冠状动脉血流储备,从而缓解心绞痛症状,疗效较好。Objective To explore the effects of Huoxue Tongmai Yixin Decoction on vascular endothelial function,coronary flow reserve,and cardiac microcirculation in patients with microvascular angina of qi stagnation and blood stasis.Methods One hundred and forty patients with microvascular angina of qi stagnation and blood stasis were divided into observation group and control group according to random number table method,with 70 patients in each group.The patients in control group were treated with routine western medicine,while the patients in observation group were treated with Huoxue Tongmai Yixin Decoction on the basis of routine western medicine.Both groups were treated for 4 weeks.The levels of nitric oxide(NO),endothelin-1(ET-1),hypersensitive C-reactive protein(hs-CRP),coronary flow reserve function(CFR),plateau strength(A),average refilling velocity(β),the symptoms of angina pectoris,traditional Chinese medicine(TCM)syndrome,quality of life,and clinical efficacy were compared before and after treatment between two groups.Results The effective rate of observation group was higher than that of control group(P<0.05).After treatment,the NO level in observation group was higher,while the ET-1 and hs-CRP levels were lower than those in control group(P<0.05).The levels of A,β,and CFR in observation group were higher than those in control group(P<0.05).The duration,frequency,and degree of angina pectoris in observation group were lower than those in control group(P<0.05).The scores of TCM symptoms in observation group were lower,and the scores of life quality in observation group were higher than those in control group(P<0.05).The total exercise time and ST segment depression time of observation group were more than those in control group(P<0.05),and the range of ST segment depression 0.1 mV time was less than that in control group(P<0.05).Conclusion Huoxue Tongmai Yixin Decoction can improve cardiac microcirculation,vascular endothelial function,and coronary blood flow reserve in patients with microvascular angina of

关 键 词：微血管性心绞痛 气滞血瘀 活血通脉益心汤 心脏微循环 内皮功能 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]