麝香保心丸治疗稳定型心绞痛(寒凝心脉型)的疗效及作用机制研究  

Efficacy and mechanisms of Shexiang Baoxin Pill in treating stable angina pectoris(cold coagulation heart pulse type)

作　　者：张灵雁 闫付兴 朱春胜[1] 郑玲玲 ZHANG Ling-yan;YAN Fu-xing;ZHU Chun-sheng;ZHENG Ling-ling(Department of Traditional Chinese Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Chinese and Western Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院中药科,河南郑州450000 [2]郑州大学第一附属医院中西医结合科,河南郑州450000

出　　处：《海南医学》2025年第3期316-321,共6页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190273)。

摘　　要：目的基于Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核因子-κB(NF-κB)通路分析麝香保心丸治疗稳定型心绞痛(寒凝心脉型)的临床效果,并探讨其作用机制。方法前瞻性选取2021年2月至2024年2月郑州大学第一附属医院收治的96例稳定型心绞痛(寒凝心脉型)患者纳入研究,按随机数表法分为联合治疗组和常规治疗组各48例。常规治疗组患者接受常规治疗,联合治疗组患者在常规治疗组基础上接受麝香保心丸治疗,两组患者均治疗1个月。比较两组患者治疗1个月后的临床疗效,以及治疗前后的TLR4/MyD88/NF-κB通路信使核糖核酸(mRNA)表达水平、血脂水平、心功能及心绞痛发作情况,同时比较两组患者治疗期间的不良反应发生情况。结果治疗后,联合治疗组患者的治疗总有效率为93.75%,明显高于常规治疗组的75.00%,差异有统计学意义(P<0.05);治疗后,两组患者的外周血单个核细胞(PBMC)中TLR4、MyD88、NF-κB m RNA表达水平均下降,且联合治疗组分别为2.71±0.78、1.48±0.47、1.45±0.48,明显低于常规治疗组的3.42±0.73、3.18±0.76、2.37±0.59,差异均有统计学意义(P<0.05)。治疗后,两组患者的血清高密度脂蛋白胆固醇(HDL-C)水平均升高,且联合治疗组患者为(2.26±0.26)mmol/L,高于常规治疗组的(1.93±0.21)mmol/L,两组患者的血清甘油三酯(TG)、胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平均降低,且联合治疗组患者分别为(1.90±0.41)mmol/L、(5.46±0.59)mmol/L、(2.64±0.46)mmol/L,低于常规治疗组的(2.11±0.43)mmol/L、(5.93±0.54)mmol/L、(3.16±0.44)mmol/L,差异均有统计学意义(P<0.05);治疗后,两组患者的心室射血分数(LVEF)、每搏输出量(SV)水平均升高,且联合治疗组患者分别为(58.61±4.61)%、(71.24±7.79)m L,高于常规治疗组的(53.52±4.42)%、(64.71±6.05)m L,差异均有统计学意义(P<0.05);治疗后,两组患者的心绞痛发作次数、疼痛持续时间均降低,且联合治疗组Objective To investigate the clinical efficacy of Shexiang Baoxin Pill in the treatment of stable angina pectoris(cold coagulation heart pulse type)based on Toll like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor kappa B(NF-κB)pathway,and to explore its underlying mechanisms of action.Methods A prospective study enrolled 96 patients with stable angina pectoris(cold coagulation heart pulse type)admitted to the First Affiliated Hospital of Zhengzhou University from February 2021 to February 2024.Patients were randomly divided into a combination therapy group and a conventional therapy group,with 48 patients in each group.Patients in the conventional therapy group received conventional treatment,while those in the combination treatment group received treatment with Shexiang Baoxin Pill on the basis of the conventional treatment.Both groups were treated for one month.Clinical efficacy after one month of treatment,as well as the expression levels of TLR4/MyD88/NF-κB pathway messenger RNA(mRNA),blood lipid levels,cardiac function,and angina attacks before and after treatment,was compared between the two groups.At the same time,the incidence of adverse reactions during the treatment period was also compared.Results After treatment,the total effective rate of treatment in the combination therapy group was 93.75%,which was significantly higher than 75.00%in the conventional therapy group(P<0.05).After treatment,the mRNA expression levels of TLR4,MyD88,NF-κB in peripheral blood mononuclear cells(PBMC)of patients decreased in the two groups,with the combination therapy group exhibiting significantly lower levels(2.71±0.78,1.48±0.47,and 1.45±0.48,respectively)compared to the conventional treatment group(3.42±0.73,3.18±0.76,and 2.37±0.59,respectively;P<0.05 for all comparisons).After treatment,serum high-density lipoprotein cholesterol(HDL-C)levels increased in both groups,with the combination therapy group demonstrating higher level[(2.26±0.26)mmol/L]compared to the conventional therapy g

关 键 词：稳定型心绞痛 寒凝心脉型 麝香保心丸 TOLL样受体4 髓样分化因子88 核因子-ΚB 心功能 血脂 作用机制 

分 类 号：R541.4[医药卫生—心血管疾病]