益气健脾方治疗冠状动脉粥样硬化性心脏病心绞痛临床观察  

Clinical Observation of Yiqi Jianpi Prescription on Angina Pectoris of Coronary Atherosclerotic Heart Disease

作　　者：邵妍[1] 孟晓媛[2] 陈智慧[2] 裴宇鹏[2] 张哲[1] SHAO Yan;MENG Xiaoyuan;CHEN Zhihui;PEI Yupeng;ZHANG Zhe(The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]辽宁中医药大学,辽宁沈阳110847

出　　处：《辽宁中医杂志》2020年第9期72-75,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：辽宁省自然科学基金计划项目(2019-ZD-0445);辽宁省教育厅高校科研基金(L201721);沈阳市科学技术局项目(18-013-0-65);辽宁中医药大学科研项目(2016XJ03)。

摘　　要：目的观察益气健脾方干预对冠心病稳定型心绞痛患者血清血管细胞黏附分子1(VCAM-1)、可溶性CD40配体(s CD40L)、转化生长因子β1(TGF-β1)水平、中医症状评分、血液流变学指标、心电图检查结果的影响。方法将纳入研究的110例冠心病稳定型心绞痛患者进行随机分组,对照组(55例)予以常规西医治疗,观察组(55例)在对照组治疗基础上予以益气健脾方治疗,两组均连续治疗4周。比较两组患者血清VCAM-1、s CD40L、TGF-β1水平、中医症状及心电图疗效、血液流变学指标、心电图检查结果、治疗前后主要症状评分结果改善情况。结果观察组中医症状有效率(89.09%,49/55)明显高于对照组(72.72%,40/55),观察组心电图改善有效率(74.54%,41/55)明显高于对照组(54.54%,30/55),差异有统计学意义(P <0.05);治疗后两组比较,观察组胸闷、胸痛症状评分、红细胞聚集指数、血小板聚集率、全血黏度指标均明显降低,差异有统计学意义(P <0.05);治疗后与对照组比较,观察组PTF-V1≤-0.04mm·s几率(27.27%,15/55)显著低于对照组(47.27%,26/55)(P <0.05),ST段异常改变较对照组少,差异无统计学意义(P> 0.05);经治疗,两组患者血清VCAM-1、s CD40L、TGF-β1水平均有明显改善,且观察组改善更为显著。结论益气健脾方配合常规西药治疗疗冠心病稳定型心绞痛,可影响降低血黏度,改善心电图异常水平,其治疗机制可能为益气健脾方通过干预血清VCAM-1、s CD40L、TGF-β1因子的表达水平并进行调节,从而对血管内皮起保护作用,延缓动脉粥样硬化性改变。Objective To observe the effects of Yiqi Jianpi Prescription on serum levels of vascular cell adhesion molecule-1( VCAM-1),soluble CD40 ligand( s CD40 L),transforming growth factor-beta 1( TGF-beta 1),TCM symptom scores,hemorheological indexes and electrocardiogram results in patients with stable angina pectoris of coronary heart disease. Methods A total of 110 patients with stable angina pectoris of coronary heart disease were randomly divided into two groups. The control group( 55 cases) was treated with routine western medicine and the observation group( 55 cases) was treated with Yiqi Jianpi Prescription on the basis of the control group. Both groups were treated continuously for 4 weeks. The serum levels of VCAM-1,s CD40 L and TGF-beta-1,TCM symptoms and electrocardiogram efficacy,hemorheological indexes,electrocardiogram examination results and the improvement of main symptoms scores before and after treatment were compared between the two groups. Results The effective rate of TCM symptoms in the observation group( 89. 09%,49/55) was significantly higher than that in the control group( 72. 72%,40/55). The effective rate of ECG improvement in the observation group( 74. 54%,41/55) was significantly higher than that in the control group( 54. 54%,30/55). The difference was significant( P < 0. 05). After treatment,the two groups’ chest tightness,chest pain symptom score,erythrocyte aggregation index,platelet aggregation rate and so on were significantly decreased( P < 0. 05). After treatment,the probability of PTF-V1 < 0. 04 mm·s( 27. 27%,15/55) in the observation group was significantly lower than that in the control group( 47. 27%,26/55)( P < 0. 05) and the abnormal change of ST segment was less than that in the control group( P > 0. 05). After treatment,the serum levels of VCAM-1,s CD40 L and T in the two groups were not significantly different( P > 0. 05). The level of GF-beta-1 was significantly improved in the observation group. Conclusion Yiqi Jianpi Prescription combined with conventional western medi

关 键 词：冠心病稳定型心绞痛 益气健脾方 VCAM-1 s CD40L TGF-Β1 

分 类 号：R541.4[医药卫生—心血管疾病]