通痹汤对气虚痰瘀互结证稳定型心绞痛患者的临床疗效观察

李姗珊；赵稼萤；李良；马爱玲；闫淑婷；陈婷

文章摘要

李姗珊；赵稼萤；李良；马爱玲；闫淑婷；陈婷.通痹汤对气虚痰瘀互结证稳定型心绞痛患者的临床疗效观察[J].中医药信息,2023,40(7):62-66

通痹汤对气虚痰瘀互结证稳定型心绞痛患者的临床疗效观察

Clinical Observation of Tongbi Decoction on Stable Angina Pectoris of Qi Deficiency and Phlegm Stasis Syndrome

投稿时间：2022-12-23 录用日期：2023-02-01

DOI：10.19656/j.cnki.1002-2406.20230710

中文关键词: 通痹汤稳定型心绞痛气虚痰瘀互结证 sLOX－1 PDH

英文关键词: Tongbi Decoction Stable angina pectoris Qi deficiency and phlegm blood stasis syndrome sLOX－1 PDH

基金项目:上海市嘉定区卫计委课题(2020-KY-ZYY-04)

作者	单位
李姗珊；赵稼萤；李良；马爱玲；闫淑婷；陈婷

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中文摘要:

目的：观察通痹汤对气虚痰瘀互结证稳定型心绞痛患者的疗效及对sLOX-1水平和PDH活性的影响。方法：选取符合纳入标准的稳定型心绞痛患者102例，采用随机、对照方法分为治疗组、对照组和基础组，每组34例。基础组给予心绞痛常规治疗，治疗组在基础组治疗方案基础上联合通痹汤口服，对照组在基础组治疗方案基础上联合盐酸曲美他嗪缓释片口服，3组均治疗12周。观察并比较3组治疗前及治疗12周后中医证候积分、高敏肌钙蛋白I(hs-cTnI)、血凝素样氧化低密度脂蛋白受体-1(sLOX-1)以及丙酮酸脱氢酶(PDH)的变化情况，并对比临床疗效。结果：治疗后，治疗组总有效率为91.18%(31/34)，对照组为79.41%(27/34)，基础组为61.76%(21/34)，治疗组优于基础组和对照组(P<0.01);3组治疗后中医证候积分均降低(P<0.01)，且治疗组低于对照组和基础组(P<0.01)；治疗后，3组hs-cTnI水平均降低(P<0.01)，且治疗组和对照组hs-cTnI优于基础组(P<0.01)，但治疗组与对照组比较差异无统计学意义(P>0.05)；治疗后，3组PDH活性均有所提高，sLOX-1水平均降低(P<0.05)，治疗组和对照组较基础组PDH活性升高(P<0.01)，且治疗组PDH活性高于对照组(P<0.05)，治疗组sLOX-1水平明显低于对照组和基础组(P<0.01)。结论：通痹汤可改善气虚痰瘀互结证稳定型心绞痛患者临床症状，其作用机制可能与减少冠状动脉脂质堆积、血清炎症反应，改善心肌细胞葡萄糖有氧代谢，减轻心肌缺氧损伤有关。

英文摘要:

Objective:To observe the therapeutic effect of Tongbi Decoction in treatment of stable angina pectoris of Qi deficiency and phlegm blood stasis syndrome and its influence to sLOX-1 level and PDH activity.Methods:102 patients with stable angina pectoris,who met the inclusion criteria,were randomly divided into the treatment group,the control group and the basic group,with 34 patients in each group.The basic group was given routine treatment for angina pectoris;on which basis,the treatment group was treated with Tongbi Decoction,and the control group was treated with Trimetazidine Hydrochloride SustainedRelease Tablet.The changes in TCM symptoms scores,hs-cTnI,sLOX-1 and PDH were compared among the three groups after 12 weeks of the treatment.The clinical efficacy was also compared among the three groups.Results:In terms of the total effective rate,it was 91.18%(31/34) in the treatment group,which was significant higher than 79.41%(27/34) in the control group and 61.76%(21/34) in the basic group(P<0.01).The scores of TCM symptoms were all decreased in the three groups after the treatment(P<0.01),and the scores of TCM symptoms were lower in the treatment group than those in the control group and the basic group(P<0.01).The level of hs-cTnI was reduced in the three groups after the treatment,and the reduction in the treatment group and in the control group was more significant than that in the basic group(P<0.01);in which there was no statistical difference between the treatment group and the control group(P>0.05).After the treatment,the PDH activity was increased and the sLOX-1 level was decreased in the three groups(P<0.05),the PDH activity in the treatment group and in the control group was higher than that in the basic group(P<0.01),and the PDH activity in the treatment group was higher than that in the control group(P<0.05);the sLOX-1 level was significantly lower in the treatment group than that in the control group and in the basic group(P<0.01).Conclusion:Tongbi Decoction can improve the clinical symptoms of patients with stable angina pectoris of Qi deficiency and phlegm blood stasis syndrome.Its mechanism may be related to reducing coronary artery lipid accumulation,inhibiting serum inflammatory reaction,improving aerobic metabolism of glucose in myocardial cells,and alleviating myocardial hypoxia injury.

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