自拟养心饮辅助西药治疗冠状动脉粥样硬化性心脏病心绞痛的效果

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摘要目的探讨自拟养心饮辅助西药治疗冠状动脉粥样硬化性心脏病（CHD）心绞痛患者的效果及对心绞痛症状、外周血血脂、载脂蛋白B/A1（ApoB/A1）比值、N末端脑钠肽前体（NT-pro-BNP）、血栓素B2（TXB2）和6-酮-前列腺素F1α（6-Keto-PGF1α）水平的影响。方法选取2016年2月～2017年4月于河北省秦皇岛市中医医院收治的140例CHD心绞痛患者，按随机数字表法以1∶1比例分为传统西药组和养心饮组，各70例。传统西药组给予常规西药对症治疗，养心饮组基于以上治疗加予自拟养心饮口服治疗。治疗1个月后，评估治疗前后的中医证候积分和中医证候疗效，对比治疗前后的心绞痛发作情况、心功能指标、ApoB/A1和血浆NT-pro-BNP、TXB2、6-keto-PGF1α水平。结果治疗后，两组中医证候积分较治疗前显著降低，且养心饮组低于传统西药组（P < 0.05）；养心饮组的中医证候总有效率显著高于传统西药组（P < 0.05）。治疗后，两组心绞痛发作次数、心肌耗氧量较治疗前显著减少，心绞痛发作持续时间较治疗前显著缩短，LVDD和LVEF较治疗前显著降低（P < 0.05），且养心饮组以上指标变化幅度显著大于传统西药组（P < 0.05）。治疗后，两组ApoB/A1和血浆NT-pro-BNP、TXB2水平较治疗前显著降低，6-keto-PGF1α水平较治疗前显著升高（P < 0.05），且养心饮组变化幅度显著大于传统西药组（P < 0.05）。结论自拟养心饮辅助西药治疗CHD心绞痛患者疗效确切，可明显减轻心绞痛相关症状，改善心绞痛发作情况、心功能损伤、血管内皮功能障碍，降低动脉粥样硬化风险。

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	王海涛黄春莉翟瑶瑶

关键词 ：自拟养心饮, 心绞痛症状, 载脂蛋白B/A1比值, 血管内皮功能

Abstract：Objective To explore the effects of self-made Yangxin Drink assisted with Western medicine in the treatment of angina pectoris of coronary heart disease (CHD) and the influence on angina pectoris symptoms, peripheral blood lipids, apolipoprotein B/A1 (ApoB/A1) ratio, N-terminal pro-brain natriuretic peptide (NT-pro-BNP), thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α). Methods A total of 140 patients with angina pectoris of CHD in Qinhuangdao Muncipality Traditional Chinese Medicine Hospital of Hebei Province from February 2016 to April 2017 were selected and divided into traditional Western medicine group and Yangxin Drink group according to the random number table method by 1∶1 ratio, with 70 cases in each group. Traditional Western medicine group was given symptomatic treatment with traditional Western medicine, and Yangxin Drink group was given oral therapy of self-made Yangxin Drink based on the above treatment. After 1 month of treatment, traditional Chinese medicine syndrome scores and efficacy of traditional Chinese medicine syndrome were evaluated before and after treatment, and the angina pectoris attack, cardiac function indexes, ApoB/A1 and plasma NT-pro-BNP, TXB2 and 6-keto-PGF1α were compared before and after treatment. Results After treatment, traditional Chinese medicine syndrome score of two groups was significantly lower than that before treatment, and Yangxin Drink group was lower than that traditional Western medicine group (P < 0.05). Total effective rate of traditional Chinese medicine syndrome in Yangxin Drink group was significantly higher than that in traditional Western medicine group (P < 0.05). After treatment, the number of angina pectoris attacks and myocardial oxygen consumption in two groups were significantly reduced, the duration of angina pectoris attack was significantly shorter than before treatment, and LVDD and LVEF were significantly lower than before treatment (P < 0.05), the changes of the above indexes in Yangxin Drink group were significantly larger than those in traditional Western medicine group (P < 0.05). After treatment, the levels of ApoB/A1, NT-pro-BNP and TXB2 in two groups were significantly lower than before treatment, and the level of 6-keto-PGF1α was significantly higher than before treatment (P < 0.05), change range of Yangxin Drink group was significantly larger than that of traditional Western medicine group (P < 0.05). Conclusion Self-made Yangxin Drink assisted with Western medicine has exact efficacy in the treatment of patients with angina pectoris of CHD, and it can significantly alleviate the angina pectoris-related symptoms, improve the angina pectoris attack, cardiac function damage and vascular endothelial dysfunction, and reduce the risk of atherosclerosis.

Key words： Self-made Yangxin Drink Angina pectoris symptoms Apolipoprotein B/A1 ratio Vascular endothelial function

基金资助:河北省科技厅科技计划项目（132777225）。

作者简介: 王海涛（1981.11-），男，硕士，副主任中医师；研究方向：中西医结合治疗心血管疾病。

引用本文:

王海涛黄春莉翟瑶瑶. 自拟养心饮辅助西药治疗冠状动脉粥样硬化性心脏病心绞痛的效果[J]. 中国医药导报, 2020, 17(5): 63-66.
WANG Haitao HUANG Chunli ZHAI Yaoyao. Effects of self-made Yangxin Drink assisted with Western medicine in the treatment of angina pectoris of coronary atherosclerotic heart disease. 中国医药导报, 2020, 17(5): 63-66.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I5/63

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