首页|疏肝温胆汤对不稳定型心绞痛中医证候疗效、动态心电图、血脂水平和炎症因子水平的影响

疏肝温胆汤对不稳定型心绞痛中医证候疗效、动态心电图、血脂水平和炎症因子水平的影响

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目的:分析疏肝温胆汤对不稳定型心绞痛中医证候疗效、动态心电图、血脂水平和炎症因子水平的影响.方法:2022年5月~2023年5月我院收治的121例不稳定型心绞痛患者,采用随机数字表法分为观察组和对照组,其中58例对照组患者采取低脂低盐饮食、适当运动和对症药物治疗等常规治疗,另63例在对照组基础上接受疏肝温胆汤治疗,均治疗3个月.检查和检测动态心电图、血脂水平,采用酶联免疫吸附法检测血清中炎性因子水平.结果:治疗3个月后,观察组中医证候疗效为95.24%,高于对照组的82.76%(P<0.05);观察组正常R-R间期的平均值标准差(SDNN)、正常相邻心跳差值>50ms与总心跳次数数的百分比(pNN50)、24h频域功率、最大频域功率小时、最小频域功率小时分别为(125.23±31.47)ms、(10.84±2.79)%、(2490.37±538.80)ms2/Hz、(886.14±227.51)ms2/Hz 和(5783.25±514.97)ms2/Hz,均高于对照组[(113.73±28.96)ms、(8.06±2.53)%、(2236.17±486.31)ms2/Hz、(772.39±213.52)ms2/Hz 和(5026.11±493.25)ms2/Hz,P<0.05];观察组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平分别为(3.89±0.86)mmol/L、(1.74±0.42)mmol/L 和(2.13±0.36)mmol/L低于对照组[(4.35±0.81)mmol/L、(2.35±0.56)mmol/L 和(2.55±0.40)mmol/L],观察组高密度脂蛋白胆固醇(HDL-C)水平为(2.41±0.39)mmol/L,高于对照组[(1.92±0.41)mmol/L,P<0.05];观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、脂蛋白相关的磷脂酶A2(Lp-PLA2)水平分别为(8.13±1.54)ng/L、(4.18±1.15)ng/L、(1.44±0.27)mg/L 和(155.37±36.31)ng/L 均低于对照组[(10.29±1.97)ng/L、(6.42±1.38)ng/L、(1.89±0.31)mg/L 和(187.59±32.46)ng/L,P<0.05].结论:应用疏肝温胆汤可有效提升不稳定型心绞痛患者中医证候疗效,改善心功能,降低血脂和炎症水平,进而改善脂质代谢和体内微环境.
Effect of Shugan WendanDecoction on TCM syndrome-based therapeutic effect,dynamic electrocardiogram,blood lipid levels and inflammatory factor levels in patients with unstable angina pectoris
Objective The purpose of this study was to analyze the effect of Shugan Wendan Decoction on TCM syndrome-based therapeutic effect,dynamic electrocardiogram,blood lipid levels and inflammatory factor levels in patients with unstable an-gina pectoris.Methods 121patients with unstable angina pectoris were admitted to our hospital between May 2022and May 2023.They were divided into the observation group and the control group using random number table method.58patients in the control group were given conventional treatments and 63patients in the observation group were treated with Shugan Wendan Decoction on the basis of the treatment of control group.All patients were treated for 3months.Dynamic electrocardiogram and blood lipid levels were detected.The levels of inflammatory factors in serum were measured by enzyme-linked immunosorbent assay.Results After 3months of treatment,the TCM syndrome-based effective rate in the observation group was 95.24%,higher than that in the con-trol group(82.76%,P<0.05).The standard deviation of normal RR intervals(SDNN),percentage of successive normal-to-normal interval differences larger than 50ms(pNN50),24-hour frequency domain power,maximum frequency domain power hour and minimum frequency domain power hour in the observation group were(125.23±31.47)ms,(10.84±2.79)%,(2490.37±538.80)ms2/Hz,(886.14±227.51)ms2/Hz and(5783.25±514.97)ms2/Hz,higher than those in the control group[(113.73±28.96)ms,(8.06±2.53)%,(2236.17±486.31)ms2/Hz,(772.39±213.52)ms2/Hz and(5026.11±493.25)ms2/Hz,P<0.05].The levels of total cholesterol(TC),triacylglycerol(TG)and low-density lipoprotein cholesterol(LDL-C)in the observation group were(3.89±0.86)mmol/L,(1.74±0.42)mmol/L and(2.13±0.36)mmol/L,lower than those in the control group[(4.35±0.81)mmol/L,(2.35±0.56)mmol/L and(2.55±0.40)mmol/L,P<0.05].The level of high—-density lipoprotein cholesterol(HDL-C)in the observation group was(2.41±0.39)mmol/L,higher than that in the control group[(1.92±0.41)mmol/L,P<0.05].The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)and lipoprotein-associated phospholipase A2(Lp-PLA2)in the observation group were(8.13±1.54)ng/L,(4.18±1.15)ng/L,(1.44±0.27)mg/L and(155.37±36.31)ng/L,lower than those in the control group[(10.29±1.97)ng/L,(6.42±1.38)ng/L,(1.89±0.31)mg/L and(187.59±32.46)ng/L,P<0.05].Conclusion Shugan Wendan Decoction can effectively enhance TCM syndrome-based therapeutic effect on patients with unstable angina pectoris,improve their cardiac function,and lower the levels of blood lipids and inflammatory factors,thereby improving lipid metabolism and internal microenvironment.

Unstable angina pectorisShugan Wendan DecoctionBlood lipidInflammatory factor

李庆敏、邱志远、欧阳震文、瞿武林

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郴州市第一人民医院中医科,湖南郴州 423000

不稳定型心绞痛 疏肝温胆汤 血脂 炎症因子

湖南省中医药科研计划项目

D2022100

2024

四川中医
四川省中医药学会,四川省中西医结合学会,四川省针灸学会,四川省中医药科学院

四川中医

CSTPCD
影响因子:0.522
ISSN:1000-3649
年,卷(期):2024.42(6)