| 王师菡,王阶,李霁,熊兴江,叶勇,朱明军.丹蒌片治疗痰瘀互阻型冠心病心绞痛的疗效评价[J].,2012,32(8):1051-1055 |
| 丹蒌片治疗痰瘀互阻型冠心病心绞痛的疗效评价 |
| Efficacy Assessment of Treating Patients with Coronary Heart Disease Angina of Phlegm and Stasis Mutual Obstruction Syndrome by Danlou Tablet |
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| DOI： |
| 中文关键词: 冠心病心绞痛 痰瘀互阻 丹蒌片 疗效评价 |
| 英文关键词:coronary heart disease angina phlegm and stasis mutual obstruction syndrome Danlou Tablet efficacy assessment |
| 基金项目:国家重点基础研究发展计划(No.2003CB517103) |
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| 中文摘要: |
| 目的评价丹蒌片对痰瘀互阻型冠心病心绞痛患者的临床疗效。方法从4个中心(中国中医科学院广安门医院、北京安贞医院、河南中医学院第一附属医院及湖北协和医院)选择66例痰瘀互阻型冠心病心绞痛患者,按随机数字表法分为丹蒌片联合西药治疗组(治疗组)及西药对照组(对照组),每组33例。治疗组在西药常规治疗基础上加服丹蒌片1.5g/次,每日2次;对照组在常规西药治疗基础上加服丹蒌片模拟剂,两组疗程均为28天。观察两组心绞痛疗效、心绞痛发作频率、持续时间、心绞痛积分、心电图ST段下移导联数、T波低平导联数、T波倒置导联数、硝酸甘油使用情况(包括服用硝酸甘油后心绞痛缓解时间、硝酸甘油用量),比较两组治疗前后中医临床证候评分变化,包括胸闷、胸痛、胸闷痛持续时间、胸闷痛发作频率、气短、疲乏、心悸、自汗、证候总评分。检测两组患者治疗前后超敏C反应蛋白(C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteic acid,HCY)、可溶性CD40配体(soluble CD40 ligand,sCD40L)、白介素-6(interleukin-6,IL-6)、髓过氧化物酶(myeloperoxidase,MPO)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、血管细胞黏附分子-1(vascular cell adhesion molecular-1,VCAM-1)水平变化。结果治疗组临床总有效率[81.2%(26/32)],显著优于对照组[43.3%(13/30),P<0.05]。与本组治疗前比较,两组患者心绞痛发作频率、持续时间、心绞痛积分、ST段下移导联数、T波低平导联数、T波倒置导联数、心绞痛缓解时间、硝酸甘油用量、胸闷、胸痛、胸闷痛发作频率、hs-CRP、sCD40L、HCY、IL-6、MMP-9、MPO水平均降低,治疗组VCAM-1水平降低,对照组VCAM-1水平升高,差异均有统计学意义(P<0.01,P<0.05)。与对照组治疗后比较,治疗组心绞痛发作频率、疼痛持续时间、心绞痛积分、服用硝酸甘油后心绞痛缓解时间、硝酸甘油用量,胸闷痛持续时间、疲乏、证候总评分,hs-CRP、sCD40L、HCY、IL-6、MMP-9、MPO、VCAM-1水平均降低(P<0.01,P<0.05)。结论丹蒌片可以改善痰瘀互阻型冠心病心绞痛患者临床症状,抑制炎症反应,具有稳定斑块及抗氧化作用。 |
| 英文摘要: |
| Objective To assess the clinical efficacy of Danlou Tablet(DT) in treating coronary heart disease angina(CHDA) patients of phlegm and stasis mutual obstruction syndrome(PSMOS).Methods Totally 66 CHDA patients of PSMOS were recruited from four centers(Beijing Guang’anmen Hospital,Beijing Anzhen Hospital,First Affiliated Hospital of Henan College of Traditional Chinese Medicine,and Hubei Union Hospital).They were assigned to two groups according to the random digit table,the treatment group(treated by DT+Western medicine) and the control group(treated by Western medicine),33 in each group.All patients took Western medicine.Patients in the treatment group were given DT,1.5 g each time,twice daily,while those in the control group took DT placebo.The treatment course was 28 days for all.The efficacy of angina,the angina attack frequency,its duration,the score of angina,the numbers of ST segment depression and flat or inversed T wave,the lead number of inversed T wave,the angina relief time after taking nitroglycerin,the amount of nitroglycerin were observed in the two groups.The changes of Chinese medicine(CM) syndrome scores,including the duration and frequency of chest tightness and pain,shortness of breath,fatigue,palpitation,spontaneous sweating,and total syndrome score were compared before and after treatment.The changes of hypersensitive C-reactive protein(hs-CRP),homocysteic acid(HCY),soluble CD40 ligand(sCD40L),interleukin-6(IL-6),myeloperoxidase(MPO),matrix metalloproteinase-9(MMP-9),and vascular cell adhesion molecular-1(VCAM-1) were also observed in both groups.Results The total effective rate was significantly higher in the treatment group(26/32 cases,81.2%) when compared with the control group(13/30 cases,43.3%,P<0.05).Compared with before treatment in the same group,the duration and frequency of chest tightness and pain,the score of angina,the numbers of ST segment depression and flat or inversed T wave,the lead number of inversed T wave,the angina relief time after taking nitroglycerin,the amount of nitroglycerin,the duration and frequency of chest tightness and pain,hs-CRP,sCD40L,HCY,IL-6,MMP-9,MPO were lowered after treatment in both groups(P<0.01,P<0.05).The VCAM-1 level decreased in the treatment group,while it increased in the control group,showing statistical difference(P<0.01,P<0.05).Compared with the control group after treatment,the duration and frequency of chest tightness and pain,the score of angina,the angina relief time after taking nitroglycerin,the amount of nitroglycerin,the duration and frequency of chest tightness and pain,fatigue,the total syndrome score,the levels of hs-CRP,sCD40L,HCY,IL-6,MMP-9,MPO,and VCAM-1 were lowered in the treatment group after treatment(P<0.01,P<0.05).Conclusion DT could improve CHDA patients’ clinical symptoms,inhibit the inflammation reaction,showing plaque stabilizing and anti-oxidization effects. |
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