目的 观察黄芪通痹汤联合尼可地尔片治疗心肾阳虚证冠心病稳定型心绞痛患者的临床疗效.方法 选取2020年1月-2022年1月期间河南省周口市中医院收治的心肾阳虚证冠心病稳定型心绞痛患者90例,按随机数字表法分为对照组和研究组,每组各45例.两组患者均予以西医常规治疗,对照组采用尼可地尔片治疗,研究组在对照组基础上加用黄芪通痹汤治疗.治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后心绞痛发作情况、中医证候积分、血脂指标[胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、高密度脂蛋白(High density lipoprotein,HDL)、低密度脂蛋白(Low density lipoprotein,LDL)]以及血管内皮功能指标[血栓素 A2(Thromboxane A2,TXA2)、血栓素 B2(ThromboxaneB2,TXB2)、一氧化氮(Nitric oxide,NO)、内皮素-1(Endo-thelin-1,ET-1)]的变化.结果 治疗后研究组临床总有效率91.11％(41/45)明显高于对照组73.33％(33/45),差异有统计学意义(P＜0.05).治疗后两组患者中医证候积分、发作次数及维持时间均较治疗前降低,差异有统计学意义(P＜0.05);且研究组中医证候积分、发作次数及维持时间均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者血脂TC、TG及LDL水平均较治疗前降低,HDL水平较治疗前升高,差异有统计学意义(P＜0.05);且研究组TC、TG及LDL水平均明显低于对照组,HDL水平明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者ET-1、TXA2及TXB2指标均较治疗前降低,NO指标较治疗前升高,差异有统计学意义(P＜0.05);且研究组ET-1、TXA2及TXB2指标均明显低于对照组,NO指标明显高于对照组,差异有统计学意义(P＜0.05).治疗期间,研究组总不良反应发生率13.33％(6/45)与对照组8.89％(4/45)比较,差异无统计学意义(P＞0.05).结论 黄芪通痹汤是治疗冠心病稳定型心绞痛有效且安全的方案,能减少心绞痛发作次数及维持时间,改善证候症状,可能与其能调节血脂及改善血管内皮功能有关.
Clinical Study on Huangqi Tongbi Decoction Combined with Nicorandil Tablets in Treating Stable Angina Pectoris of Coronary Heart Disease with Heart and Kidney Yang Deficiency Syndrome
Objective To observe the clinical effect of Huangqi Tongbi Decoction combined with nicorandil tab-lets in the treatment of stable angina pectoris of coronary heart disease with heart and kidney yang deficiency syndrome.Methods Ninety patients with stable angina pectoris of coronary heart disease with heart and kidney yang deficiency syn-drome treated at our hospital from January 2020 to January 2022 were selected as the research subjects.They were random-ly divided into a control group and a study group using a random number table method,with 45 cases in each group.Both groups of patients received conventional Western medicine treatment.The control group was treated with nicorandil tablets,while the study group was treated with Huangqi Tongbi Decoction in addition to nicorandil tablets.After 2 weeks of treat-ment,clinical efficacy and adverse reactions were observed and compared between the two groups.Changes in angina attack frequency,traditional Chinese medicine(TCM)syndrome scores,blood lipid indicators[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)],and vascular endothelial function indicators[thromboxane A2(TXA2),thromboxaneB2(TXB2),nitric oxide(NO),endothelin-1(et-1)]before and after treatment were also evaluated.Results After treatment,the total clinical effective rate in the study group was 91.11％(41/45),which was significantly higher than the 73.33％(33/45)in the control group,with a statistically significant difference(P＜0.05).After treatment,both groups showed a decrease in TCM syndrome scores,frequency,and duration of attacks com-pared to before treatment,with statistically significant differences(P＜0.05).The study group had significantly lower TCM syndrome scores,frequency,and duration of attacks compared to the control group,with statistically significant differences(P＜0.05).After treatment,the blood lipid indicators TC,TG,and LDL in both groups of patients decreased compared to before treatment,while HDL increased compared to before treatment,with statistical significances(P＜0.05).Further-more,the study group had significantly lower TC,TG,and LDL levels,and significantly higher HDL level compared to the control group,with statistical significances(P＜0.05).After treatment,ET-1,TXA2,and TXB2 in both groups of patients decreased compared to before treatment,while NO increased compared to before treatment,with statistical significances(P＜0.05);Additionally,the study group had significantly lower ET-1,TXA2,and TXB2 levels,and significantly higher NO level compared to the control group,with statistical significance(P＜0.05).During the treatment period,the total incidence of adverse reactions in the study group was 13.33％(6/45),compared to 8.89％(4/45)in the control group,with no sta-tistically significant difference(P＞0.05).Conclusion Huangqi Tongbi Decoction is an effective and safe treatment for stable angina pectoris of coronary heart disease,which can reduce the frequency and duration of angina pectoris attacks and improve syndrome symptoms,possibly because it can regulate blood lipid and improve vascular endothelial function.
Huangqi Tongbi DecoctionNicotine TabletsStable Angina Pectoris of Coronary Heart DiseaseHeart and Kidney Yang Deficiency SyndromeBlood LipidVascular Endothelial Function
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