益气活血通冠汤对冠心病心绞痛患者血液流变学、心电图及外周血microRNA-155、VASP表达的影响  

Effects of Yiqi Huoxue Tongguan Decoction on hemorheology, electrocardiogram, and peripheral blood expression of microRNA-155 and vasodilator-stimulated phosphoprotein in patients with coronary heart disease and angina

作　　者：舒鹏钦 陈铁龙[1] 刘昭[1] Shu Pengqin;Chen Tielong;Liu Zhao(Department of Cardiology,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]杭州市中医院心内科,杭州310000

出　　处：《中国基层医药》2025年第2期166-171,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省中医药科技计划(2023ZL114)。

摘　　要：目的观察益气活血通冠汤对冠心病心绞痛患者血液流变学、心电图及外周血微小核糖核酸(microRNA)-155、血管扩张刺激磷蛋白(VASP)表达的影响。方法前瞻性选取杭州市中医院心内科2023年5月至2024年5月诊治的冠心病心绞痛患者102例, 采用信封法分为两组。对照组51例予常规治疗, 观察组51例在常规治疗基础上予益气活血通冠汤辅助治疗, 治疗后4周比较两组治疗效果。结果治疗后, 观察组左室射血分数(LVEF)、VASP、每搏输出量(SV)分别为(57.48±4.83)%、(385.95±87.44)ng/L、(78.96±4.77)mL, 均高于对照组的(52.22±4.26)%、(339.85±84.47)ng/L、(73.89±5.14)mL(t=5.83、2.71、5.16, 均P < 0.05);观察组血小板集聚率[(32.32±6.82)%]、microRNA-155(0.24±0.05)、血浆黏度[(1.32±0.29)mPa·s]、全血高切黏度[(4.11±0.77)mPa·s]、白细胞介素6(IL-6)[(16.45±3.81)μg/L]、纤维蛋白原(FIB)[(3.12±0.77)g/L]、高敏C反应蛋白(hs-CRP)[(9.85±2.15)mg/L]、左心室收缩末期内径(LVESD)[(36.25±3.59)mm]均低于对照组(t=5.90、4.86、3.64、3.31、9.58、3.95、7.25、6.23, 均P < 0.05);观察组中医证候积分[(9.52±1.04)分]低于对照组[(12.76±1.55)分], 心绞痛发作次数[(3.24±0.71)次/周]少于对照组[(4.56±0.94)次/周], 发作时间[(2.54±1.06)min/次]短于对照组[(4.26±1.14)min/次], 差异均有统计学意义(t=12.40、0.20、7.89, 均P < 0.001)。观察组心电图疗效高于对照组, 差异有统计学意义(Z=2.76, P=0.006)。结论益气活血通冠汤治疗冠心病心绞痛可调节炎症因子和microRNA-155、VASP的表达, 改善血液流变学和心功能, 减少心绞痛的发作。Objective:To investigate the effects of Yiqi Huoxue Tongguan Decoction on hemorheology,electrocardiogram,and peripheral blood expression of microRNA-155 and vasodilator-stimulated phosphoprotein(VASP)in patients with coronary heart disease and angina.Methods:A total of 102 patients with coronary heart disease and angina who were diagnosed and treated at the Department of Cardiology,Hangzhou Hospital of Traditional Chinese Medicine from May 2023 to May 2024 were prospectively selected and randomly assigned into two groups using the envelope method.The control group(n=51)received conventional treatment,while the observation group(n=51)received Yiqi Huoxue Tongguan Decoction in addition to conventional treatment.The therapeutic effects of both groups were compared 4 weeks after treatment.Results:After treatment,the observation group showed significantly higher values for left ventricular ejection fraction[(57.48±4.83)%],VASP[(385.95±87.44)ng/L],and stroke volume[(78.96±4.77)mL]compared with the control group[(52.22±4.26)%,(339.85±84.47)ng/L,(73.89±5.14)mL,t=5.83,2.71,5.16,all P<0.05].In addition,the observation group had significantly lower values for platelet aggregation rate[(32.32±6.82)%],microRNA-155(0.24±0.05),plasma viscosity[(1.32±0.29)mPa·s],whole blood high shear viscosity[(4.11±0.77)mPa·s],interleukin-6[(16.45±3.81)μg/L],fibrinogen[(3.12±0.77)g/L],high-sensitivity C-reactive protein[(9.85±2.15)mg/L],and left ventricular end-systolic diameter[(36.25±3.59)mm]compared with the control group(t=5.90,4.86,3.64,3.31,9.58,3.95,7.25,6.23,all P<0.05).The observation group also had a lower traditional Chinese medicine syndrome score[(9.52±1.04)points],fewer angina attacks per week[(3.24±0.71)times/week],and shorter attack duration[(2.54±1.06)min/attack]compared with the control group[(12.76±1.55)points,(4.56±0.94)times/week,(4.26±1.14)min/attack,t=12.40,0.20,7.89,all P<0.001].The observation group showed significantly better electrocardiogram outcomes than the control group(Z=2.76,P=0.006).Conc

关 键 词：冠状动脉疾病 心绞痛 血液流变学 心电描记术 核糖核酸酶类 磷蛋白类 炎症趋化因子类 益气活血通冠汤 

分 类 号：R259[医药卫生—中西医结合]