摘要
目的观察疏肝清脂法对冠心病合并高脂血症患者血清炎症因子、血管内皮功能及心血管事件的影响。方法选取2018年6月—2019年6月收治的冠心病合并高脂血症患者56例,采用随机数字表法分为对照组和治疗组,各28例。其中对照组予以常规西医治疗;治疗组在对照组的基础上予以疏肝清脂法为原则的中药汤剂,两组患者均治疗12周。比较两组患者白介素-1β(IL-1β)、白介素-18(IL-18)及肿瘤坏死因子-α(TNF-α)、超敏-C反应蛋白(hs-CRP)等血清炎症因子指标,一氧化氮(NO)、内皮素1(ET-1)、血栓素B2(TXB2)及6-酮-前列腺素F-1α(6-Keto-PGF-1α)等内皮功能指标,中医证候积分、临床疗效及心血管事件发生情况。结果两组患者血清炎症因子指标IL-1β、IL-18、TNF-α及hs-CRP均有所改善(P<0.05),且与对照组相比,治疗组血清炎症因子指标降低更显著(P<0.05);两组患者内皮功能指标6-Keto-PGF-1α、NO均有所升高,而ET-1、TXB2均有所降低(P<0.05),且与对照组相比,治疗组患者内皮功能指标改善幅度更显著(P<0.05);两组患者中医证候积分变化有所改善(P<0.05),且与对照组相比,治疗组患者中医证候积分降低更显著(P<0.05);治疗组患者临床总有效率为89.29%,显著优于对照组患者的60.71%(P<0.05);治疗组心血管事件总发生率7.14%,对照组心血管事件总发生率21.43%,治疗组心血管事件总发生率明显低于对照组(P<0.05)。结论疏肝清脂法具有疏肝解郁、清脂化浊之功效,可有效抑制冠心病合并高脂血症患者炎症反应,保护内皮功能,降低心血管事件发生风险,故值得临床推广应用。
Objective The purpose of this study was to investigate the effect of Shugan Qingzhi method on serum inflammatory factors,vascular endothelial function and cardiovascular events in patients with coronary heart disease complicated with hyperlipidemia. Methods 56 patients with coronary heart disease complicated with hyperlipidemia admitted to our hospital from June 2018 to June 2019 were selected and randomly divided into treatment group and control group with 28 cases in each group according to the table of random number. The control group was administered with conventional western treatment,while the treatment group was administered with TCM decoction based on the method of Shugan Qingzhi on the basis of the control group. The patients in both groups were treated for 12 weeks. The levels of serum inflammatory factor indexes such as interleukin-1β(IL-1β),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(HS-CRP),endothelial function indexes such as nitric oxide(NO),endothelin-1(ET-1),thromboxane B2(TXB2)and 6-keto-prostaglandin F-1α(6-KetoPGF-1α),as well as TCM syndrome scores,clinical efficacy and occurrence of cardiovascular events in the two groups were compared. Results The serum inflammatory factor indexes IL-1β,IL-18,TNF-α and hs-CRP of the two groups of patients were improved(P<0.05). The serum inflammatory factor indexes of the treatment group decreased more significantly compared with the control group(P<0.05). The endothelial function indexes 6-Keto-PGF-1α and NO in the two groups increased,while ET-1 and TXB2 decreased(P<0.05). Compared with the control group,the improvement of endothelial function indexes in the treatment group was more significant(P<0.05). The changes of TCM syndrome scores in the two groups were decreased(P<0.05),and compared with the control group,the TCM syndrome scores in the treatment group were significantly reduced(P<0.05). The total clinical effective rate of the treatment group and control group was 89.29% and 60.71%,respectively. The clinical effect of the treatment group was significantly better than that of the control group(P<0.05). The total incidence of cardiovascular events of the treatment group and control group was 7.14% and 21.43%,respectively. The total incidence of cardiovascular events of the treatment group was significantly lower than that in the control group(P<0.05). Conclusion The method of Shugan Qingzhi has the effects of soothing liver-Qi stagnation and removing fat and turbidity,can effectively inhibit inflammatory reaction in patients with coronary heart disease complicated with hyperlipidemia,protect endothelial function and reduce the risk of cardiovascular events,so it is worthy of clinical promotion and application.
作者
丁宇
胡楠
DING Yu;HU Nan(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2020年第12期176-179,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81702623)
辽宁省教育厅一般项目(L201907)。
关键词
疏肝清脂法
冠心病
高脂血症
炎症因子
内皮功能
心血管事件
Shugan Qingzhi method
coronary heart disease
hyperlipidemia
inflammatory factors
endothelial function
cardiovascular event
