参红通络方对经皮冠状动脉介入治疗不稳定型心绞痛患者及对其血管内皮及心肌损伤的影响  

The effects of the Shenhong Tongluo prescription on vascular endothelium and myocardial injury in UAP patients treated by PCI

作　　者：王义强[1] 赵慧林 雷添予 靳宏光 Wang Yiqiang

机构地区：[1]长春中医药大学附属医院,吉林长春130021

出　　处：《中医临床研究》2021年第10期20-23,共4页Clinical Journal Of Chinese Medicine

基　　金：吉林省中医药管理局(2019089);吉林省卫生与健康青年科技骨干培养计划项目(2018Q041)。

摘　　要：目的:观察不稳定型心绞痛患者经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)围术期应用参红通络方对血管内皮及心肌损伤的影响,同时观察参红通络方干预下患者的症状改善情况及生活质量情况。方法:选取择期行PCI的不稳定型心绞痛患者71例,随机分为两组,对照组36例采用西医治疗,治疗组35例采用西医加参红通络方治疗。检测入院时及行PCI 24 h后血中内皮素-1(Endothelin-1,ET-1)、一氧化氮(Nitric Oxide,NO)、肌酸激酶同工酶(Creatine Kinase Isoenzymes,CKMB)、肌钙蛋白I(Cardiac Troponin I,cTnI)水平。同时统计应用参红通络方前及应用7 d后患者的36项简明健康状况调查量表(SF-36)评分及用药后的中医证候有效率及心绞痛临床有效率。结果:PCI后7 d两组患者血中ET-1水平明显高于PCI前(P<0.05),治疗组明显低于对照组(P<0.05);PCI后24 h两组患者血中NO水平明显低于PCI前,治疗组显著高于对照组(P<0.05);PCI后两组患者血中CK-MB、cTnI水平高于参考值,治疗组明显低于对照组(P<0.05)。PCI后7 d对照组患者SF-36评分明显低于PCI前(P<0.05),治疗组明显低于对照组(P<0.05);治疗组中医证候与心绞痛临床总有效率均优于对照组(P<0.05)。结论:参红通络方可以通过改善血管内皮功能从而降低心肌损伤的发生,同时缓解患者的临床症状,提高生活质量。Objective:To observe the effects of the Shenhong Tongluo prescription(参红通络方)on vascular endothelium and myocardial injury in UAP patients during PCI perioperative period,and to observe the amelioration of symptoms and improvement of life quality of the patients.Methods:71 cases were randomly divided into two groups,36 cases in the control group were treated by Western medicine,and 35 cases in the treatment group were treated by Western medicine plus the Shenhong Tongluo prescription.The blood levels of ET-1,NO,CK-MB and cTnI at admission and 24 hours after PCI were detected.Results:7 days after PCI,the level of ET-1 in blood in the groups was significantly higher than that before PCI(P<0.05),and in the treatment group was obviously lower than the control group(P<0.05).24 hours after PCI,the level of NO in the blood in the groups was significantly lower than before,and in the treatment group was higher than the control group(P<0.05).The levels of CK-MB and cTnI in the groups after PCI were higher than the reference values,and in the treatment group were lower than the control group(P<0.05).SF-36 scores of patients 7 days after PCI in the control group were significantly lower than those before PCI(P<0.05),and in the treatment group were significantly lower than the control group(P<0.05).The total efficiency of TCM syndromes and angina pectoris in the treatment group were obviously better than the control group(P<0.05).Conclusion:The Shenhong Tongluo prescription can reduce the occurrence of myocardial injury by improving the vascular endothelial function,alleviate the clinical symptoms of patients,and improve the quality of life.

关 键 词：不稳定型心绞痛 经皮冠状动脉介入术 血管内皮 心肌损伤 参红通络方 

分 类 号：R256.2[医药卫生—中医内科学]