文章摘要
梁文华,周 炜,石纠纠,肖莎莎,赵 洋.芪蛭三七汤治疗气虚痰瘀阻络型不稳定型心绞痛患者的疗效及作用机制研究[J].,2020,(12):2396-2400
芪蛭三七汤治疗气虚痰瘀阻络型不稳定型心绞痛患者的疗效及作用机制研究
Study on the Effect and Mechanism of Astragalus Membranaceus-leech-pseudo Ginseng Soup on Unstable Angina Pectoris Patients with Qi Deficiency and Phlegm Stasis Type
投稿时间:2019-11-24  修订日期:2019-12-18
DOI:10.13241/j.cnki.pmb.2020.12.043
中文关键词: 不稳定型心绞痛  临床疗效  芪蛭三七汤  血液流变学  内皮功能
英文关键词: Unstable angina pectoris  Clinical efficacy  Astragalus membranaceus-leech-pseudo-ginseng soup  Blood rheology  Endothelial function
基金项目:湖南省卫生计生委基金项目(C20161028)
作者单位E-mail
梁文华 中国人民解放军联勤保障部队第九二二医院心血管内科 湖南 衡阳 421002 liangwenhua_1967@163.com 
周 炜 中国人民解放军联勤保障部队第九二二医院心血管内科 湖南 衡阳 421002  
石纠纠 中国人民解放军联勤保障部队第九二二医院心血管内科 湖南 衡阳 421002  
肖莎莎 中国人民解放军联勤保障部队第九二二医院中医科 湖南 衡阳 421002  
赵 洋 渭南市中心医院心血管内科 陕西 渭南 714000  
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中文摘要:
      摘要 目的:探讨芪蛭三七汤治疗气虚痰瘀阻络型不稳定型心绞痛(UA)患者的疗效,并探讨其作用机制。方法:选择2017年1月~2019年1月我院收治的109例气虚痰瘀阻络型UA患者,按数表法随机分为观察组与对照组。对照组患者给予常规心内科监护及规范治疗,观察组患者在对照组基础上给予自拟的芪蛭三七汤口服治疗。比较两组临床疗效、治疗前后的中医证候总积分、心绞痛的发作频率、硝酸甘油的用量、血液流变学指标(全血高切粘度、全血低切粘度、纤维蛋白原及血浆粘度)及内皮功能指标[一氧化氮(NO)、血栓素B2(TXB2)和内皮素-1(ET-1)]水平。结果:治疗过程中有7例患者中途退出,实际入组102例,观察组的总有效率为95.92%(47/49),高于对照组的73.58%(39/53)(P<0.05);治疗后两组患者的中医证候评分、心绞痛的发作频率及硝酸甘油的用量、血液流变学指标、TXB2、ET-1均显著低于治疗前,且观察组显著低于对照组(P<0.05);治疗后两组患者的NO水平显著上升,且观察组高于对照组(P<0.05)。结论:芪蛭三七汤治疗气虚痰瘀阻络型UA效果显著,其作用机制可能与降低患者血液粘度、促进血液循环及改善内皮功能有关。
英文摘要:
      ABSTRACT Objective: To investgate the curative effect and mechanism of astragalus membranaceus-leech-pseudo ginseng soup on unstable angina pectoris (UA) patients with Qi deficiency and phlegm stasis type. Methods: 109 UA patients with Qi deficiency and phlegm stasis type who were treated in our hospital from January 2017 to January 2019 were selected, and they were rdivided into the observation group and the control group according to number table method. The patients in the control group were given routine Department of Cardiology monitoring and standardized treatment, and the patients in the observation group were given oral treatment with Astragalus membranaceus-leech-pseudo ginseng soup on the basis of the control group. The clinical efficacy, the total TCM symptom scores, angina attack frequency, nitroglycerin dosage, blood rheology indexes (high shear viscosity of whole blood, low shear viscosity of whole blood, fibrinogen and viscosity of plasma) and endothelial function indexes [Nitric oxide (NO), thromboxan B2 (TXB2) and endothelin-1 (ET-1)] levels of two groups before and after treatment were compared. Results: In the course of treatment, 7 patients quit halfway and 102 patients were actually enrolled in the group. The total effective rate were 95.92%(47/49) in the observation group, which was higher than 73.58%(39/53) in the control group (P<0.05). After treatment, the total TCM symptom scores, angina attack frequency, nitroglycerin dosage,hemorheological indexes, TXB2 and ET-1 in the two groups were significantly lower than those before treatment, and the level of NO in the observation group was significantly lower than that in the control group (P<0.05); after treatment, the level of NO in the two groups increased significantly, and that in the observation group was higher than that in the control group (P<0.05). Conclusion: The effect of Astragalus membranaceus-leech-pseudo-ginseng soup in the treatment of UA patients with Qi deficiency and phlegm stasis type is significant, and the mechanism of action may be related to reducing the blood viscosity, promoting blood circulation and improving the endothelial function.
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