摘要
目的观察自拟化痰活血方联合西医对稳定型心绞痛(SAP)患者血管内皮功能、T淋巴细胞亚群、炎性因子和生活质量的影响。方法将2017年1月—2018年9月在唐县人民医院治疗的100例SAP患者患者随机分为2组,对照组50例给予常规西医治疗,观察组50例在常规西医治疗基础上给予自拟化痰活血方口服,2组疗程均为4周。观察2组治疗前后中医症状积分、动态心电图指标、血管内皮功能指标、T淋巴细胞亚群、炎性因子和生活质量的变化,并统计2组临床疗效。结果2组治疗后胸痛、胸闷、心悸、气短、纳差、疲乏评分和中医症状总积分、ST段压低次数、ST段最大压低幅度、血清内皮素-1(ET-1)、CD8+、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平均较治疗前明显降低(P均<0.05),且观察组治疗后均明显低于对照组(P均<0.05);2组治疗后一氧化氮(NO)、CD3+、CD4+、CD4+/CD8+、白细胞介素-4(IL-4)和白细胞介素(IL-10)水平均较治疗前明显升高(P均<0.05),且观察组治疗后均明显高于对照组(P均<0.05)。与治疗前比较,治疗后观察组西雅图心绞痛量表(SAQ)的躯体活动受限程度(PL)、心绞痛发作情况(AF)、心绞痛稳定状态(AS)、疾病认知程度(DS)、治疗满意程度(TS)评分和总分均明显增加(P均<0.05);治疗后观察组上述评分均明显高于对照组(P均<0.05)。总有效率观察组为92%(46/50),对照组为74%(34/50),观察组明显高于对照组(P<0.05)。结论自拟化痰活血方可显著保护SAP患者的血管内皮功能,改善细胞免疫功能,调节Th1/Th2淋巴细胞亚群平衡,抑制炎症反应,改善生活质量,其临床疗效优于单纯的西医疗法。
Objective It is to observe the effects of self-made Huatan Huoxue decoction combined with western medicine on vascular endothelial function,T lymphocyte subsets,inflammatory factors and quality of life in patients with stable angina pectoris(SAP).Methods 100 patients with SAP treated in the People’s Hospital of Tangxian County from January 2017 to September 2018 were randomly divided into 2 groups.The control group(n=50)was treated with conventional western medicine,and the observation group(n=50)was treated with conventional western medicine plus Huatan Huoxue decoction,and the course of treatment in both groups were 4 weeks.The changes of TCM symptom scores,dynamic electrocardiogram indexes,vascular endothelial function indexes,T lymphocyte subsets,inflammatory factors and quality of life before and after treatment were observed in the two groups,and the clinical efficacy of the two groups were evaluated.Results After treatment,the scores of chest pain,chest tightness,palpitations,shortness of breath,anorexia,fatigue and total scores of TCM symptoms,frequency of ST segment depression,maximum ST segment depression extent,levels of serum endothelin-1(ET-1),CD8+,TNF-αand INF-γwere significantly lower than those before treatment in the two groups(P<0.05),and these indexes in the observation group were significantly lower than those in the control group(P<0.05);The levels of nitric oxide(NO),CD3+,CD4+,CD4+/CD8+,IL-4 and IL-10 were significantly increased in the two groups(P<0.05),and the observation group was significantly higher than the control group after treatment(P<0.05).Compared with before treatment,the scores of physical limitation(PL),anginal frequency(AF),angina stability(AS),disease awareness(DS),treatment satisfaction(TS)of Seattle Angin Questionnaire(SAQ)after treatment and total score were increased significantly in both groups(P<0.05),the above scores in the observation group were significantly higher than those in the control group(P<0.05).The total effective rate was 92%(46/50)in the observation
作者
马民凯
王世卫
史春和
陈娜
韩福谦
MA Minkai;WANG Shiwei;SHI Chunhe;CHEN Na;HAN Fuqian(The Fourth Central Hospital of Baoding City, the People’s Hospital of Tangxian County, Baoding 072350, Hebei, China)
出处
《现代中西医结合杂志》
CAS
2020年第17期1856-1860,1938,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
保定市科技局资助项目(17ZF186)。
关键词
化痰活血方
稳定型心绞痛
血管内皮功能
T淋巴细胞亚群
炎性因子
生活质量
Huatan Huoxue decoction
stable angina pectoris
vascular endothelial function
T lymphocyte subsets
inflammatory factors
quality of life
