加味瓜蒌薤白半夏汤联合PCI术对稳定性心绞痛患者冠状动脉微循环、血流变学及炎性因子的影响
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Modified Gualou Xiebai Banxia Tang Combined with PCI Has Effect on Coronary Microcirculation,Hemorheology and Inflammatory Factors of Patients with Stable Angina Pectoris
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    摘要:

    目的:探讨稳定性心绞痛(SAP)应用加味瓜蒌薤白半夏汤联合经皮冠状动脉介入(PCI)术治疗的临床效果及对患者冠状动脉微循环、血流变学及炎性因子的影响。方法:选取126例SPA患者,采用随机数字表法分为观察组和对照组各63例。对照组行PCI术治疗,观察组在对照组基础上加用加味瓜蒌薤白半夏汤治疗。记录比较2组中医证候疗效,治疗前后冠张动脉微循环、心功能及血流变学状态和炎性因子水平变化。结果:观察组总有效率为92.06%,显著高于对照组的79.36%(P<0.05)。治疗后,2组前降支微循环阻力系数(IMR) 值较治疗前降低(P<0.05),左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)较治疗前升高(P<0.05),且观察组改善更显著(P<0.05)。治疗后,2组全血黏度(WBV)、血浆黏度(PV)、红细胞聚集指数(RCAI)较治疗前降低(P<0.05),红细胞变形指数(EDI)较治疗前升高(P<0.05);且观察组改善更显著(P<0.05)。治疗后,2组血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平较治疗前降低(P<0.05),且观察组各项指标低于对照组(P<0.05)。结论:SAP应用加味瓜蒌薤白半夏汤联合PCI术治疗更能有效缓解患者症状体征,调控机体冠状动脉微循环与血流变学状态,减轻炎性反应,延缓病情进展,疗效较好。

    Abstract:

    To discuss the clinical effect of modified Gualou Xiebai Banxia tang combined with percutaneous coronary intervention(PCI)for stable angina pectoris(SAP),and its effect on coronary microcirculation,hemorheology and inflammatory factors of patients.Methods:Selected 126 cases of patients with SAP,and divided them into the observation group and the control group randomly,63 cases in each group.The control group received PCI,while the observation group additionally received modified Gualou Xiebai Banxia tang.Recorded and compared the therapeutic effect of Chinese medicine syndrome in both groups and the changes of coronary microcirculation,hemorheology and levels of inflammatory factors before and after treatment.Results:The total effective rate was 92.06%in the observation group,being significantly higher than 79.36% in the control group(P < 0.05).After treatment,the index of microcirculatory resistance(IMR)in anterior descending branch of both groups was lower than that before treatment(P < 0.05),and left ventricular ejection fraction(LVEF),left ventricular end-diastolic dimension(LVEDD)and left ventricular end-systolic diameter(LVESD)were higher than those before treatment(P < 0.05);each index above in the observation group was improved more significantly than that in the control group(P < 0.05).After treatment,the whole blood viscosity(WBV),plasma viscosity(PV)and red blood cell aggregation index(RCAI)in both groups were lower than those before treatment(P < 0.05),and erythrocyte deformation index(EDI)was higher than that before treatment(P < 0.05);each index above in the observation group was improved more significantly than that in the control group(P < 0.05).After treatment,the levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α (TNF-α)and interleukin-8(IL-8)in both groups were lower than those before treatment(P < 0.05),and the levels of hs-CRP,TNF-α and IL-8 in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of modified Gualou Xiebai Banxia tang combined with PCI for SAP can effectively release the symptoms and signs of patients, regulate coronary microcirculation and hemorheological status, alleviate inflammatory reactions and prolong the progression of disease with relatively good therapeutic effect.

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杨磊,王春玲,赵帅,张富宝,戚馨月.加味瓜蒌薤白半夏汤联合PCI术对稳定性心绞痛患者冠状动脉微循环、血流变学及炎性因子的影响[J].新中医,2019,51(10):42-46

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  • 在线发布日期: 2019-10-11
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