中西医结合治疗对冠心病心绞痛气虚血瘀证患者心功能及内皮功能的影响

Influence of integrated TCM and Western medicine on heart and endothelial function in the patients of angina pectoris with syndrome of deficiency of vital energy and blood stasis

关键词:  芪参益气滴丸  冠心病  心绞痛  气虚血瘀证

Key words:  Qishen Yiqi dripping pill  coronary heart disease  angina pectoris  syndrome of deficiency of vital energy and blood stasis

摘要:

[目的] 通过芪参益气滴丸与西药联合应用于冠心病心绞痛气虚血瘀证患者,探讨中西医结合药物治疗对该患者心功能与内皮功能的影响.[方法] 59例冠心病心绞痛气虚血瘀证患者按随机数字表法随机分为中西医结合药物组(30例)和西药组(29例).西药治疗：以美国心脏病学院(ACC)/美国心脏学会(AHA)冠心病心绞痛诊断与治疗指南为指导.中药治疗：给予天津天士力制药股份有限公司提供的芪参益气滴丸,每日3次,每次0.5 g,疗程为60 d.观察治疗前后射血分数、无创血流动力学及内皮功能指标的变化.[结果] 两组在治疗后6-酮-前列腺素F1α(6-keto-PGF1α)、心输出量、加速指数和射血分数明显增加,内皮素(ET)、血液血栓素B₂(TXB₂)、体血管阻力和胸腔体液水平明显减少,治疗后与治疗前比较,差异有统计学意义(P < 0.01).中西医结合药物组与西药组比较6-keto-PGF1α、心输出量、加速指数和射血分数有所增加,ET、TXB₂、体血管阻力和胸腔体液水平有所减少,差异有统计学意义.[结论] 以芪参益气滴丸和西药为基础的中西医结合治疗能够有效改善冠心病心绞痛气虚血瘀证患者的心功能及内皮功能,为临床治疗提供理论依据.

Abstract:

[Objective] To study the effect of Qishen Yiqi dripping pills combined with Western medicine on the change of the heart and endothelial function in the patients of angina pectoris with syndrome of deficiency of vital energy and blood stasis. [Methods] The 59 patients met the diagnostic criteria were randomly divided into two groups. There were 30 patients in the integrated TCM and Western medicine group and 29 patients in the Western medicine group. Western medicine was used according to the guideline of diagnose and therapy of angina pectoris on ACC/AHA, while the TCM group was given with Qishen Yiqi dripping pills. The patients received the medicine three times a day, 0.5 g every time, for a treatment cause of 60 days. The changes of EF, the parameter of atraumatic haemodynamics detection and endothelial function were observed. [Results] After treatment, 6-keto-PGF1α, CO, ACI and EF were significantly increased, and ET, TXB2, SVR and TFC significantly decreased in both groups(P < 0.01). Compared with the Western medicine group, 6-keto-PGF1α, CO, ACI and EF were increased significantly and ET, TXB2, SVR and TFC decreased significantly in the integrated TCM and Western medicine group. [Conclusion] Qishen Yiqi dripping pills combined with Western medicine can effectively improve heart and endothelial function in the patients of angina pectoris with syndrome of deficiency of vital energy and blood stasis. It has provided some evidences for the clinical therapy.