冠心丹參滴丸對冠心病穩(wěn)定性心絞痛血瘀證患者炎癥因子干預(yù)作用研究
發(fā)布時間：2018-08-26 19:35
【摘要】：研究目的:通過觀察冠心丹參滴丸對冠心病穩(wěn)定性心絞痛血瘀證患者血清炎癥因子水平、心絞痛療效和血瘀證的影響,從抑制炎癥反應(yīng)、抗氧化、保護內(nèi)皮等方面探討冠心丹參滴丸治療冠心病穩(wěn)定性心絞痛的可能機制。研究方法:收集2015年12月-2016年9月期間,在中國中醫(yī)科學(xué)院廣安門醫(yī)院就診的72例冠心病穩(wěn)定性心絞痛血瘀證患者,按照隨機數(shù)字表法,將納入病例分為對照組和治療組,每組各36例。對照組給予冠心病常規(guī)治療,治療組在對照組用藥基礎(chǔ)上加用冠心丹參滴0.4g,舌下含服,3次/天,連續(xù)治療4周。比較治療前后治療組和對照組各炎癥因子、內(nèi)皮功能指標(biāo)及氧化應(yīng)激指標(biāo)的變化,包括高敏C反應(yīng)蛋白(hs-CRP)、白介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)、單核細胞趨化蛋白-1(MCP-1)、基質(zhì)金屬蛋白酶-9(MMP-9)、內(nèi)皮素-1(ET-1)、可溶性血管細胞黏附分子-1(sVCAM-1)、超氧化物歧化酶(SOD)以及丙二醛(MDA);比較治療前后Zung氏焦慮自評量表(SAS)、Zung氏抑郁自評量表(SDS)以及漢密頓焦慮量表(HAMA)、漢密頓抑郁量表(HAMD)評分變化;同時比較治療前后心絞痛積分、中醫(yī)證候積分、血瘀證積分改善及中醫(yī)癥狀改善情況。研究結(jié)果:1.經(jīng)過4周治療后,與對照組比較,治療組血清炎癥因子hs-CRP、IL-6、TNF-α,內(nèi)皮功能指標(biāo)ET-1以及氧化應(yīng)激指標(biāo)SOD、MDA均明顯降低,效果優(yōu)于對照組(P0.05),但炎癥因子MMP-9、MCP-1及內(nèi)皮指標(biāo)sVCAM-1下降程度不明顯,差異無統(tǒng)計學(xué)意義(P0.05)。2.經(jīng)過4周治療后,與對照組相比,治療組SAS、HAMA、SDS與HAMS評分均明顯降低,差異具有統(tǒng)計學(xué)意義(P0.05)。3.經(jīng)過4周治療后,治療組心絞痛療效優(yōu)于對照組(81.25%vs 47.06%,P0.05),與對照組相比,治療組心絞痛積分、中醫(yī)證候積分及血瘀證積分均明顯降低,同時心絞痛發(fā)作次數(shù)、硝酸甘油使用情況及胸痛、胸悶、氣短、心煩等癥狀改善情況治療組亦明顯優(yōu)于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。研究結(jié)論:1.冠心丹參滴丸治療冠心病血瘀證,能夠降低血清hs-CRP、IL-6、TNF-α、ET-1、SOD和MDA水平,說明冠心丹參滴丸具有良好的抗炎、抗氧化、保護內(nèi)皮的作用,其治療冠心病心絞痛的機制可能與此密切相關(guān)。2.冠心丹參滴丸能夠降低冠心病患者的SAS、HAMA、SDS與HAMD評分,說明冠心丹參滴丸具有改善冠心病患者焦慮抑郁等情志障礙的作用。3.冠心丹參滴丸可以降低冠心病患者心絞痛積分、中醫(yī)證候積分、血瘀證積分等,說明冠心丹參滴丸可以改善冠心病血瘀證患者心絞痛療效及血瘀證癥狀,并且調(diào)節(jié)患者胸痛、胸悶、氣短、心煩等臨床癥狀,冠心丹參滴丸具有良好的臨床療效,通過活血化瘀的方法可以改善冠心病心絞痛。
[Abstract]:Objective: to observe the effects of Guanxin Danshen dropping pills on serum inflammatory factor level, angina pectoris curative effect and blood stasis syndrome in patients with stable angina pectoris and blood stasis syndrome of coronary heart disease. To explore the possible mechanism of Guanxin Danshen dropping pills in the treatment of stable angina pectoris of coronary heart disease. Methods: from December 2015 to September 2016, 72 patients with stable angina pectoris and blood stasis syndrome of coronary heart disease were collected and divided into control group and treatment group. There were 36 cases in each group. The control group was treated with routine therapy of coronary heart disease, and the treatment group was treated with Guanxin salvia miltiorrhiza (0.4 g) on the basis of the medicine used in the control group, 3 times a day under the tongue for 4 weeks. The changes of inflammatory factors, endothelial function index and oxidative stress index before and after treatment were compared between the treatment group and the control group. Comparison of Gao Min C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor- 偽 (TNF- 偽), monocyte chemotactic protein 1 (MCP-1), matrix metalloproteinase-9 (MMP-9), endothelin 1 (ET-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), superoxide dismutase (SOD) and malondialdehyde (MDA) (MDA); Before and after treatment, Zung's self-rating anxiety scale (SAS) / Zung), self-rating depression scale (SDS) and Hamilton anxiety scale (HAMA), (HAMD) score of Hamilton depression scale were changed. At the same time, the improvement of angina pectoris score, TCM syndrome score, blood stasis syndrome score and TCM symptom improvement were compared before and after treatment. The result of the study was: 1. After 4 weeks of treatment, compared with the control group, the serum inflammatory factor hs-CRP,IL-6,TNF- 偽, endothelial function index ET-1 and oxidative stress index SOD,MDA in the treatment group were significantly lower than those in the control group (P0.05), but the degree of the decrease of the inflammatory factor MMP-9,MCP-1 and the endothelial index sVCAM-1 was not obvious. The difference was not statistically significant (P0.05). After 4 weeks of treatment, compared with the control group, the SAS,HAMA,SDS and HAMS scores in the treatment group were significantly lower than those in the control group (P0.05). 3. After 4 weeks of treatment, the therapeutic effect of angina pectoris in the treatment group was better than that in the control group (81.25%vs 47.06). Compared with the control group, the scores of angina pectoris, TCM syndromes and blood stasis syndrome in the treatment group were significantly lower than those in the control group. The use of nitroglycerin and chest pain, chest tightness, shortness of breath, upset and other symptoms of the treatment group was also significantly better than the control group, the difference was statistically significant (P0.05). Conclusion: 1. Guanxin Danshen dropping pills can reduce the levels of hs-CRP,IL-6,TNF- 偽 ET-1 and MDA in blood stasis syndrome of coronary heart disease, indicating that Guanxin Danshen dropping pill has good anti-inflammatory, antioxidant and protective effects on endothelium. The mechanism of Guanxin Danshen dropping pill in treating angina pectoris of coronary heart disease may be closely related to this. Guanxin Danshen dropping pills can reduce the scores of SAS,HAMA,SDS and HAMD in patients with coronary heart disease, indicating that Guanxin Danshen dropping pills can improve anxiety and depression in patients with coronary heart disease. Guanxin Danshen dropping pills can reduce angina pectoris score, TCM syndrome score, blood stasis syndrome integral and so on. It shows that Guanxin Danshen dropping pill can improve the angina curative effect and blood stasis syndrome symptoms of coronary heart disease patients with blood stasis syndrome, and regulate the chest pain of patients. Guanxin Danshen dropping pill has good clinical effect and can improve angina pectoris of coronary heart disease by activating blood circulation and removing blood stasis.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4
本文編號：2205946
[Abstract]:Objective: to observe the effects of Guanxin Danshen dropping pills on serum inflammatory factor level, angina pectoris curative effect and blood stasis syndrome in patients with stable angina pectoris and blood stasis syndrome of coronary heart disease. To explore the possible mechanism of Guanxin Danshen dropping pills in the treatment of stable angina pectoris of coronary heart disease. Methods: from December 2015 to September 2016, 72 patients with stable angina pectoris and blood stasis syndrome of coronary heart disease were collected and divided into control group and treatment group. There were 36 cases in each group. The control group was treated with routine therapy of coronary heart disease, and the treatment group was treated with Guanxin salvia miltiorrhiza (0.4 g) on the basis of the medicine used in the control group, 3 times a day under the tongue for 4 weeks. The changes of inflammatory factors, endothelial function index and oxidative stress index before and after treatment were compared between the treatment group and the control group. Comparison of Gao Min C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor- 偽 (TNF- 偽), monocyte chemotactic protein 1 (MCP-1), matrix metalloproteinase-9 (MMP-9), endothelin 1 (ET-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), superoxide dismutase (SOD) and malondialdehyde (MDA) (MDA); Before and after treatment, Zung's self-rating anxiety scale (SAS) / Zung), self-rating depression scale (SDS) and Hamilton anxiety scale (HAMA), (HAMD) score of Hamilton depression scale were changed. At the same time, the improvement of angina pectoris score, TCM syndrome score, blood stasis syndrome score and TCM symptom improvement were compared before and after treatment. The result of the study was: 1. After 4 weeks of treatment, compared with the control group, the serum inflammatory factor hs-CRP,IL-6,TNF- 偽, endothelial function index ET-1 and oxidative stress index SOD,MDA in the treatment group were significantly lower than those in the control group (P0.05), but the degree of the decrease of the inflammatory factor MMP-9,MCP-1 and the endothelial index sVCAM-1 was not obvious. The difference was not statistically significant (P0.05). After 4 weeks of treatment, compared with the control group, the SAS,HAMA,SDS and HAMS scores in the treatment group were significantly lower than those in the control group (P0.05). 3. After 4 weeks of treatment, the therapeutic effect of angina pectoris in the treatment group was better than that in the control group (81.25%vs 47.06). Compared with the control group, the scores of angina pectoris, TCM syndromes and blood stasis syndrome in the treatment group were significantly lower than those in the control group. The use of nitroglycerin and chest pain, chest tightness, shortness of breath, upset and other symptoms of the treatment group was also significantly better than the control group, the difference was statistically significant (P0.05). Conclusion: 1. Guanxin Danshen dropping pills can reduce the levels of hs-CRP,IL-6,TNF- 偽 ET-1 and MDA in blood stasis syndrome of coronary heart disease, indicating that Guanxin Danshen dropping pill has good anti-inflammatory, antioxidant and protective effects on endothelium. The mechanism of Guanxin Danshen dropping pill in treating angina pectoris of coronary heart disease may be closely related to this. Guanxin Danshen dropping pills can reduce the scores of SAS,HAMA,SDS and HAMD in patients with coronary heart disease, indicating that Guanxin Danshen dropping pills can improve anxiety and depression in patients with coronary heart disease. Guanxin Danshen dropping pills can reduce angina pectoris score, TCM syndrome score, blood stasis syndrome integral and so on. It shows that Guanxin Danshen dropping pill can improve the angina curative effect and blood stasis syndrome symptoms of coronary heart disease patients with blood stasis syndrome, and regulate the chest pain of patients. Guanxin Danshen dropping pill has good clinical effect and can improve angina pectoris of coronary heart disease by activating blood circulation and removing blood stasis.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4
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