银丹心脑通软胶囊对冠状动脉慢血流微血管性心绞痛患者的作用
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摘要
目的观察银丹心脑通软胶囊对冠状动脉慢血流微血管性心绞痛患者的临床疗效。方法选择87例2013年12月—2017年6月于成都军区总医院经冠状动脉造影证实冠状动脉慢血流的微血管性心绞痛住院患者,采用随机数字表法将患者分为银丹心脑通组(43例)和对照组(44例)。对照组常规应用抗血小板、他汀类药物等治疗冠心病相关药物;银丹心脑通组在常规治疗基础上加服银丹心脑通软胶囊0.8 g/次,3次/d,连续服用6个月。应用加拿大心血管病学会(CCS)心绞痛分级及西雅图心绞痛量表(SAQ)评估两组治疗前后心绞痛严重程度,测定治疗前后冠脉血管微循环阻力指数(IMR),比较治疗后两组患者血高敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、凝血酶-抗凝血酶复合物(TAT)、血管内皮素-1(ET-1)、一氧化氮(NO)浓度的差异。结果两组患者治疗前IMR、CCS心绞痛分级、SAQ计分比较,差异无统计学意义(P>0.05)。与本组治疗前比较,治疗后两组IMR、CCS分级心绞痛降低(P<0.05,P<0.01),SAQ计分升高(P<0.01)。与对照组同期比较,银丹心脑通组治疗后IMR、CCS心绞痛分级、hs-CRP、IL-1β、TAT、ET-1浓度降低(P<0.01),SAQ计分及NO水平升高(P<0.01)。结论银丹心脑通软胶囊可改善合并冠状动脉慢血流的微血管心绞痛患者血管内皮功能,调节冠脉微循环功能,减轻心绞痛。
Objective To observe the effect of Yindan Xinnaotong Soft Capsule(YDSC) in microvascular angina patients with slow-flow coronary artery. Methods Totally 87 inhospital patients with microvascular angina were recruited from Chengdu military general hospital from December 2013 to July 2017. All patients were diagnosed as coronary artery slow flow by coronary angiography. The patients were randomly assigned to YDSC group(43 cases) and control group(44 cases). Antiplatelet, statin and other related drugs were used as treatment of coronary heart disease for 6 months. The patients in YDSC group were treated with YDSC 0.8 g each time, 3 times per day additionally. The Canadian Society of Cardiology(CCS) angina pectoris grade and Seattle angina questionnaire(SAQ) scale were used to assess the severity of angina pectoris. The cardiac microcirculation was evaluated by Index of microcirculatory resistance(IMR). The levels of high sensitive C-reaction protein(hs-CRP),interleukin-1β(IL-1β),thrombin-antithrombin(TAT),endothelin-1(ET-1) and nitric oxide(NO) concentration were also measured. Results There were no ststistical significance in IMR, CCS grade and SAQ score between the two groups before treatment(P>0.05). IMR and CCS grade in both groups were decreased after treatment(P<0.05, P<0.01), SAQ scores was increased(P<0.01). After treatment, the IMR and CCS grade, the levels of hs-CRP, IL-1β, TAT and ET-1 in YDSC group were significantly lower than those in control group(P<0.01), the SAQ score and the level of NO were significantly higher those that in control group(P<0.01). Conclusion YDSC could improve vascular endothelial function, promote microcirculation of coronary and ameliorate angina pain in patients with microvascular angina pectoris and slow-flow coronary artery.
Objective To observe the effect of Yindan Xinnaotong Soft Capsule(YDSC) in microvascular angina patients with slow-flow coronary artery. Methods Totally 87 inhospital patients with microvascular angina were recruited from Chengdu military general hospital from December 2013 to July 2017. All patients were diagnosed as coronary artery slow flow by coronary angiography. The patients were randomly assigned to YDSC group(43 cases) and control group(44 cases). Antiplatelet, statin and other related drugs were used as treatment of coronary heart disease for 6 months. The patients in YDSC group were treated with YDSC 0.8 g each time, 3 times per day additionally. The Canadian Society of Cardiology(CCS) angina pectoris grade and Seattle angina questionnaire(SAQ) scale were used to assess the severity of angina pectoris. The cardiac microcirculation was evaluated by Index of microcirculatory resistance(IMR). The levels of high sensitive C-reaction protein(hs-CRP),interleukin-1β(IL-1β),thrombin-antithrombin(TAT),endothelin-1(ET-1) and nitric oxide(NO) concentration were also measured. Results There were no ststistical significance in IMR, CCS grade and SAQ score between the two groups before treatment(P>0.05). IMR and CCS grade in both groups were decreased after treatment(P<0.05, P<0.01), SAQ scores was increased(P<0.01). After treatment, the IMR and CCS grade, the levels of hs-CRP, IL-1β, TAT and ET-1 in YDSC group were significantly lower than those in control group(P<0.01), the SAQ score and the level of NO were significantly higher those that in control group(P<0.01). Conclusion YDSC could improve vascular endothelial function, promote microcirculation of coronary and ameliorate angina pain in patients with microvascular angina pectoris and slow-flow coronary artery.
引文
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[15] 杨盼,钱凤华,钱义鸣.冠状动脉微循环功能不全在微血管性心绞痛中的作用[J].海南医学,2015,26(11):1637-1639.
[16] 赵洋,张金国.心脏X综合征与血管内皮功能的相关性研究进展[J].医学综述,2013,19(1):132-134.
[17] Long Cheng,Guo-feng Pan,Xiao-dong Zhang,et al.Yindanxinnaotong,a Chinese compound medicine,synergistically attenuates atherosclerosis progress[J].Sci Rep,2015,5:12333.
[18] 侯凤彩.丹参川芎嗪注射液联合银丹心脑通软胶囊治疗冠心病和心绞痛临床观察[J].中国现代药物应用,2012,6(8):85-86.
[19] Schoenenberger AW,Felber S,Gujer S,et al.Invasive findings in patients with angina equivalent symptoms but no coronary artery disease:Results from the heart quest cohort study[J].Int J Cardiol,2013,167(1):168-173.
[20] 熊旭光,唐其柱,刘文卫.凝血酶抗凝血酶复合物及D-二聚体在冠心病早期诊断中的价值[J].实用老年医学杂志,2015,29(2):131-133.
[21] Wang W,Wang L,Yang H,et al.Protective effects of Yindanxinnaotong capsule in a rat model of myocardial ischemia/reperfusion injury[J].J Tradit Chin Med,2014,34(6):699-709.
[22] Gong L,Xu H,Wang L,et al.Identification and evaluation of the chemical similarity of Yindan xinnaotong samples by ultra high performance liquid chromatography with quadrupole time-of-flight mass spectrometry fingerprinting[J].J Sep Sci,2016,39(3):611-622.
[23] 朴香兰,吴倩.绞股蓝研究进展[J].时珍国医国药,2010,21(7):1758-1760.
[2] Sadr-Ameli MA,Saedi S,Saedi T,et al.Coronary slow flow:Benign or ominous?[J] Anatol J Cardiol,2015,15(7):531-535.
[3] Singh S,Kothari SS,Bahl VK.Coronary slow flow phenomenon:an angiographic curiosity[J].Indian Heart J,2004,56(6):613-617.
[4] 毛建生,史载祥,黄力.银丹心脑通软胶囊治疗气滞血瘀型冠心病心绞痛临床观察[J].中国中西医结合杂志,2008,28(4):375-377.
[5] 谭茗月,赵水平,和渝斌,等.银丹心脑通软胶囊治疗稳定性心绞痛的随机临床对照研究[J].中华中医药学刊,2016,34(10):2537-2541.
[6] Gilles M,Udo S,Stephan A et al.2013 ESC guidelines on the management of stable coronary artery disease:the Task Force on the management of stable coronary artery disease of the European Society of Cardiology,[J].Eur Heart J,2013,34(38):2949-3003.
[7] Gibson CM,Cannon CP,Daley WL,et al.TIMI frame count:a quantitative method of assessing coronary artery flow[J].Circulation,1996,93(5):879-888.
[8] Kobayashi Y,Tremmel JA.The relationship between fractional flow reserve and index of microcirculatory resistance:be careful with whom you associate[J].Catheter Cardiovasc Interv,2015,85(4):593-594.
[9] Campeau L.Letter:Gradingofangina pectoris [J].Circulation,1976,54(3):522-523.
[10] Spertus JA,Winder JA,Dewhurst TA,et al.Monitoring the quality of life in patients with coronary artery disease [J].Am J Cardiol,1994,74(12):1240-1244.
[11] 李丹.银丹心脑通软胶囊对冠心病合并2型糖尿病患者血液流变学的影响[J].中国实用医药,2012,7(4):154-155.
[12] 郑莉.银丹心脑通软胶囊的临床应用分析[J].中西医结合心脑血管病杂志,2013,11(2):248-250.
[13] Mangieri E,Macchiarelli G,Ciavlella M,et al.Slow coronary flow:clinical and histopathological features in patients with otherwise normal epicardial coronary arteries[J].Cathet Cardiovasc Diagn,1996,37(4):375-381.
[14] Cuculi F,De maria GL,Meier P,et al.Impact of microvascular obstruction on the assessment of coronary flow reserve,index of microcirculatoryresistance,and fractional flow reserve after ST- segment elevation myocardial infarction[J].J Am Coll Cardiol,2014,64(18):1894-1904.
[15] 杨盼,钱凤华,钱义鸣.冠状动脉微循环功能不全在微血管性心绞痛中的作用[J].海南医学,2015,26(11):1637-1639.
[16] 赵洋,张金国.心脏X综合征与血管内皮功能的相关性研究进展[J].医学综述,2013,19(1):132-134.
[17] Long Cheng,Guo-feng Pan,Xiao-dong Zhang,et al.Yindanxinnaotong,a Chinese compound medicine,synergistically attenuates atherosclerosis progress[J].Sci Rep,2015,5:12333.
[18] 侯凤彩.丹参川芎嗪注射液联合银丹心脑通软胶囊治疗冠心病和心绞痛临床观察[J].中国现代药物应用,2012,6(8):85-86.
[19] Schoenenberger AW,Felber S,Gujer S,et al.Invasive findings in patients with angina equivalent symptoms but no coronary artery disease:Results from the heart quest cohort study[J].Int J Cardiol,2013,167(1):168-173.
[20] 熊旭光,唐其柱,刘文卫.凝血酶抗凝血酶复合物及D-二聚体在冠心病早期诊断中的价值[J].实用老年医学杂志,2015,29(2):131-133.
[21] Wang W,Wang L,Yang H,et al.Protective effects of Yindanxinnaotong capsule in a rat model of myocardial ischemia/reperfusion injury[J].J Tradit Chin Med,2014,34(6):699-709.
[22] Gong L,Xu H,Wang L,et al.Identification and evaluation of the chemical similarity of Yindan xinnaotong samples by ultra high performance liquid chromatography with quadrupole time-of-flight mass spectrometry fingerprinting[J].J Sep Sci,2016,39(3):611-622.
[23] 朴香兰,吴倩.绞股蓝研究进展[J].时珍国医国药,2010,21(7):1758-1760.