化瘀通脉汤对冠心病血运重建术后心绞痛患者血脂、血液流变学水平的影响  

Observation of Blood Lipids and Hemorheology of Patients with Angina Pectoris after revascularization of coronary heart disease with Huayu Tongmai Decoction

作　　者：张曼 杨晓红 徐浩[2] 陈爱莲 Zhang Man;Yang Xiao-hong;Xu Hao;Chen Ai-lian(Chinese Medicine Hospital of Puyang,Puyang Henan 457000;Xiyuan Hospital,Chinese Academy of Chinese Medical Sciences,Beijing 100091)

机构地区：[1]濮阳市中医医院,河南濮阳457000 [2]中国中医科学院西苑医院,北京100091

出　　处：《世界中西医结合杂志》2024年第4期746-749,754,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：首都卫生发展科研专项项目(2018-1-4171)。

摘　　要：目的 研究化瘀通脉汤对冠心病血运重建术后心绞痛患者血脂、血液流变学水平的影响。方法 选取2019年1月—2020年12月期间濮阳市中医医院收治的冠心病血运重建术后心绞痛患者96例纳入研究,通过随机数字表法分为对照组和观察组,每组各48例。两组患者均给予低脂饮食、休息等常规干预。对照组给予西医常规药物治疗,观察组在对照组基础上给予化瘀通脉汤治疗。治疗1个月后,观察比较两组患者临床疗效、不良反应发生情况,治疗前后中医症状积分、血脂指标[三酰甘油(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(Low density lipoprotein cholesterol,LDL-C)]水平、血液流变学指标[全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原]水平。结果 治疗后观察组总有效率93.75%(45/48)明显高于对照组79.17%(38/48),差异有统计学意义(P<0.05)。治疗后两组患者胸痛、胸闷、心悸、食少纳呆、胃脘痞满积分较治疗前降低,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TG、TC、LDL-C水平较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TG、TC、LDL-C水平明显低于对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平较治疗前降低,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 化瘀通脉汤对冠心病血运重建术后心绞痛患者有较好疗效,能够有效缓解患者临床症状,并改善其血脂、血液流变学水平,同时安全性较高,具有临床应用价值。Objective To study the effect of Huayu Tongmai Decoction on the levels of blood lipids and hemorheology in patients with angina pectoris after coronary artery disease revascularization.Method A total of 96 patients with angina pectoris after coronary artery disease revascularization admitted to Chinese Medicine Hospital of Puyang from January 2019 to December 2020 were enrolled in the study and randomly divided into control group and observation group by random number table method,with 48 patients in each group.Both groups received conventional interventions,including a low-fat diet and rest.The control group was treated with conventional western medicine,and the observation group was treated with Huayu Tongmai decoction on the basis of the control group′s treatmnet.After one month of treatment,the clinical efficacy and adverse reactions were compared between the two groups.Additionally,changes in the traditional Chinese medicine symptom scores,blood lipid indexes[triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],and hemorheological indexes whole blood high-shear viscosity,whole blood low-shear viscosity,plasma viscosity,fibrinogen were evaluated before treatment.Results The total effective rate in the observation group after treatment was 93.75%(45/48),which was significantly higher than the 79.17%(38/48)in the control group,with a statistically significant difference(P<0.05).After treatment,both groups showed a significant reduction in the symptom scores of chest pain,chest tightness,palpitations,poor appetite and epigastric fullness compared to before treatment,with a statistically significant difference(P<0.05);and the the observation group had significantly lower scores compared to the control group(P<0.05)After treatment,the levels of TG,TC and LDL-C in both groups were significantly decreased compared with those before treatment,while the levels of HDL-C were significantly increased,with a statistically significant difference(P<

关 键 词：冠心病 心绞痛 化瘀通脉汤 血脂 血液流变学 

分 类 号：R541.2[医药卫生—心血管疾病]