枳实薤白桂枝汤对不稳定性心绞痛患者血清基质金属蛋白酶-9水平及其基因表达的影响  

Effects of Zhishi Xiebai Guizhi Decoction on the level and gene expression of matrix metalloproteinase-9 in patients with unstable angina

作　　者：朱德建 朱志仑 吴溧兴 陆曙 ZHU Dejian;ZHU Zhilun;WU Lixing;LU Shu(Department of Cardiology,Nanjing Lishui District Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 211200;不详)

机构地区：[1]江苏省南京市溧水区中医院心血管科,江苏南京211200 [2]南京中医药大学无锡附属医院心血管科,江苏无锡214071

出　　处：《河北中医》2021年第12期2003-2007,2012,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察枳实薤白桂枝汤对寒凝、痰浊、血瘀、气滞证素不稳定性心绞痛(UA)患者血清基质金属蛋白酶-9(MMP-9)水平及其基因表达的影响。方法将62例UA患者按照随机数字表法分为2组,对照组30例予西医标准治疗,治疗组32例在对照组治疗基础上加枳实薤白桂枝汤治疗,2组均连续治疗2周。比较2组治疗前后中医证候评分、心绞痛发作次数(每周)和持续时间、硝酸甘油用量(每周)、血清MMP-9水平和基因表达情况。结果治疗后治疗组胸痛胸闷、心悸、气短、畏寒、体寒肢冷、脘腹胀闷、舌脉评分及总分均较本组治疗前下降(P<0.05),且均低于对照组治疗后(P<0.05);治疗后对照组胸痛胸闷、心悸、气短评分及总分均较本组治疗前下降(P<0.05)。治疗后2组心绞痛发作次数和持续时间、硝酸甘油用量均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后2组血清MMP-9水平及其基因表达水平均较本组治疗前降低(P<0.05),且治疗组血清MMP-9水平低于对照组(P<0.05)。结论枳实薤白桂枝汤可降低UA患者血清MMP-9及其基因表达水平,防止动脉粥样硬化斑块消化降解,稳定易损斑块,改善患者临床症状。Objective To observe the clinical efficacy of Zhishi Xiebai Guizhi Decoction for patients with unstable angina(UA)of cold coagulation,phlegm turbidity,blood stasis,and Qi stagnation syndrome and its effect on level and gene expression of serum matrix metalloproteinase 9(MMP-9).Methods Totally 62 UA patients were randomly enrolled into 2 groups,30 cases in the control group were treated with standard therapy of Western medicine,32 cases in the treatment group with Zhishi Xiebai Guizhi Decoction on the basis of the control group additionally,2-week continuous treatment were conducted in both groups,aiming to compare inter-groups traditional Chinese medicine(TCM)syndromes scores,the weekly frequency and duration of angina attacks,nitroglycerin consumption,levels and gene expression of MMP-9 before and after treatment.Results After treatment,patients in treatment group has decreased score and total score in chest pain and chest tightness,palpitations,shortness of breath,chills,cold body and limbs,abdominal distention and stuffiness,lingual vessels(P<0.05),and which were all lower in comparison to control group(P<0.05).Compared with before treatment,patients in control group had decreased score and total scores in chest pain and chest tightness,palpitations,shortness of breath after treatment(P<0.05).Patients in two groups had significantly lower the frequency and duration of angina attacks and nitroglycerin consumption after treatment,(P<0.05),and the treatment group was more common(P<0.05).The serum levels and gene expression of MMP-9 of patients in the two groups were lower(P<0.05),and the serum level of MMP-9 was lower in treatment group than in control group(P<0.05).Conclusion For UA patients,Zhishi Xiebaiguizhi decoction can not only reduce the serum levels and gene expression of MMP-9,but also prevent the digestion and degradation of atherosclerotic plaques,stabilize vulnerable plaques,and improve the clinical symptoms.

关 键 词：心绞痛 不稳定型 枳实薤白桂枝汤 基质金属蛋白酶9 基因表达 

分 类 号：R541.420.531[医药卫生—心血管疾病] R349.64[医药卫生—内科学]