瓜蒌夏苓汤联合美托洛尔对冠心病不稳定型心绞痛(痰阻心脉证)患者心脏重构及MMP-9、miR-155水平的影响  

Effects of Gualou Xialing decoction combined with metoprolol on cardiac remodeling and MMP-9,miR-155 levels in patients with unstable angina pectoris of coronary heart disease(phlegm blocking heart pulse syndrome)

作　　者：张渊博 郭欣 任耀龙 ZHANG Yuanbo;GUO Xin;REN Yaolong(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2022年第24期124-127,共4页Clinical Research and Practice

基　　金：陕西中医药大学2019年省教育厅专项科研计划项目(No.19JK0236)。

摘　　要：目的 探讨瓜蒌夏苓汤联合美托洛尔治疗冠心病不稳定型心绞痛(痰阻心脉证)的效果。方法 选取2019年1月至2021年1月收治的90例冠心病不稳定型心绞痛(痰阻心脉证)患者,以抽签法将其随机分为对照组和观察组,每组45例。对照组在基础治疗基础上给予美托洛尔,观察组在对照组治疗基础上加用瓜蒌夏苓汤。比较两组的治疗效果。结果 治疗后,观察组的N末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)、肽素及心肌肌钙蛋白Ⅰ(cTnⅠ)水平均低于对照组(P<0.05)。治疗后,观察组的心电图QT间期离散度(QTd)及校正QT间期离散度(QTcd)均短于对照组(P<0.05)。治疗后,观察组的基质金属蛋白酶-9(MMP-9)、微小核糖核酸155(miR-155)水平均低于对照组(P<0.05)。观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的血小板颗粒膜蛋白140(GMP-140)、核转录因子-κB(NF-κB)、血栓素B_(2)(TXB_(2))水平低于对照组(P<0.05)。结论 瓜蒌夏苓汤联合美托洛尔治疗冠心病不稳定型心绞痛(痰阻心脉证)的效果显著,有助于改善心脏重构、心功能,下调MMP-9、miR-155、GMP-140、NF-κB、TXB_(2)表达。Objective To explore the effect of Gualou Xialing decoction combined with metoprolol on unstable angina pectoris of coronary heart disease(phlegm blocking heart pulse syndrome).Methods Ninety patients with unstable angina pectoris of coronary heart disease(phlegm blocking heart pulse syndrome) admitted from January 2019 to January 2021were selected and randomly divided into control group and observation group by drawing lots,with 45 cases in each group.The control group was treated with metoprolol on the basis of the basic treatment,and the observation group was treated with Gualou Xialing decoction on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),homocysteine(Hcy),peptide and cardiac troponin Ⅰ(cTnⅠ) in the observation group were lower than those in the control group(P<0.05).After treatment,the electrocardiogram QT dispersion(QTd) and corrected QT dispersion(QTcd) in the observation group were shorter than those in the control group(P<0.05).After treatment,the levels of matrix metalloproteinase-9(MMP-9) and microRNA-155(miR-155) in the observation group were lower than those in the control group(P <0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of platelet granule membrane protein 140(GMP-140),nuclear factor-kappa B(NF-κB) and thromboxane B_(2)(TXB_(2)) in the observation group were lower than those in the control group(P<0.05).Conclusion Gualou Xialing decoction combined with metoprolol in the treatment of unstable angina pectoris of coronary heart disease(phlegm blocking heart pulse syndrome) has a significant effect,which helps to improve cardiac remodeling and cardiac function,and down-regulates MMP-9,miR-155,GMP-140,NF-κB and TXB_(2) expression.

关 键 词：瓜蒌夏苓汤 美托洛尔 冠心病 不稳定型心绞痛 痰阻心脉证 心脏重构 

分 类 号：R541.4[医药卫生—心血管疾病]